The fundamental claim that the practice of medicine is essentially a moral enterprise remains highly contentious, not least among the dominant traditional moral theories. The medical profession itself is today characterized by multicultural pluralism and moral relativism that have left the Hippocratic moral tradition largely in disarray. In this paper, I attempt to clarify the ambiguity about practicing medicine as a moral enterprise and echo Pellegrino’s call for a phenomenologically and teleologically derived philosophy of medicine. I proffer a realistic trifocal (...) matrix in which the virtuous moral agency and the teleologically derived moral imperative of the physician are comprehensively integrated with an action-guiding practical analytical framework for the resolution of ethical dilemmas in medicine. I argue that this trifocal perspective points us towards an authentic philosophy of medicine that is not only verifiable through Lonerganian self-appropriation, but also authentically objective through the possible moral self-transcendence of the good physician. (shrink)

This paper discusses attempts to think historicity in the work of the theologian Rudolf Bultmann and the German philosopher Hans Blumenberg. It then draws on the work of the Jesuit theologian Robert Doran in order to suggest how an historical pragmatics without historicism might be relevant to a future theology with social import.

Concern about the commercialization of research is rising, notably in testing new drugs. The problem involves oversimplified, polarizing assumptions about research and development (R&D) and intellectual property (IP). To address this problem this paper sets forth a more complex three phase RT&D process, involving Scientific Research (R), Technological Innovation (T), and Commercial Product Development (D) or the RT&D process. Scientific research and innovation testing involve costly intellectual work and do not produce free goods, but rather require IP regulation. RT&D processes (...) involve an unrecognized IP shift from a common IP right in public goods like information and knowledge to private IP in products and other hard assets. The question then is, what kind of IP right: private or common? Since scientific research and innovation testing require openness about adverse findings, and wide, low cost diffusion of results, they require a common, inclusive IP right. Common IP is appropriate to both sharing knowledge goods and recovering the cost of production. Research is furthermore compatible with commercialization and support by other social interests. On the other hand it is incompatible with the exclusionary private IP rights that permit restrictive publication or total suppression of information. Private IP rather than commercialization conflicts with the openness requirements of scientific research and innovation testing. Commercial funding, however, is in principle compatible with research and testing, especially when regulated by a common IP right. This reflects a pragmatic view of the fundamental interconnections of knowledge and other social interests. (shrink)

One of the most important questions in the debate over the morality of euthanasia and assisted suicide is whether an important distinction between killing patients and allowing them to die exists. The U.S. Supreme Court, in rejecting challenges to the constitutionality of laws prohibiting physician-assisted suicide, explicitly invoked this distinction, but did not explicate or defend it. The Second Circuit of the U.S. Court of Appeals had previously asserted, also without argument, that no meaningful distinction exists between killing and allowing (...) to die. That court had reasoned that if this were so, it would be discriminatory to allow persons on life support to end their lives by removing such treatment, while those who are not connected to life support would be denied similar access to death. (shrink)

The disavowal of positivist science by many educational researchers has resulted in a deepening polarization of research agendas and an epistemological divide that appears increasingly difficult to span. Despite a turning away from science altogether by some, and thus toward various forms of poststructuralist inquiry, this has not held back the renewed entrenchment of more narrow definitions by policy elites of what constitutes scientific educational research. The new sciences of complexity signal the emergence of a new scientific paradigm that challenges (...) some of the core assumptions of positivism, while offering the potential to develop a new kind of social science that demands both rigour and imagination in coming to understand the emergence and behaviours of social systems and the subsystems that comprise them. The language, concepts and principles of complexity are central to the development of a new science of qualities to complement the science of quantities that has shaped our understanding of the physical and social worlds. Accomplishing this task promises to 1) open up new investigations that have thus far been beyond the purview of scientific study, 2) allow the study of social phenomena as fully embodied, or at least as more robust models than those represented in the abstracted empiricism upon which the sciences of quantities are predicated, and 3) allow for more coarse‐grained explanations and predictions of social phenomena to be legitimated as scientific. Both educational research and educational practice stand to gain from this expansion of the scientific repertoire to include rigorous and imaginative investigations of phenomena characterized by change and transformation. (shrink)

The postmodern enterprise, with its foundationlessness, fragmentariness, constructivism, and neopragmatism challenges interdisciplinarity. This paper discusses functional specialization and interdisciplinary method which provides a basis for interdisciplinary collaboration. In functional specialization, successive stages in the process of coming to know are distinguished. These stages correspond to Lonergan’s four levels of consciousness, namely experiencing the data, coming to understanding through addressing questions which arise from the data, and judgment about which hypothesis best fits the data. Authenticity, which involves genuine attentiveness, intelligence, reasonableness, (...) and responsibility, guides the appropriate attitude in interdisciplinary work. (shrink)

Drawing on philosophy, theology, comparative religion, spirituality, Holocaust studies, physics, biology, psychology, and personal experience, I argue that continued human existence depends on our willingness to reject nihilism–not as an expedient “noble lie” but because faith in a meaningful cosmos and the power of love is at least as validly grounded in human experience as insistence on cosmic indifference and ultimate futility. I maintain that hope will free us to develop nonimperialistic methods of bridging cultural differences by forming a mutually (...) intelligible vocabulary that celebrates diversity, enters the worlds of others in respectful dialogue, and fosters a postmechanistic, organic, ecological, holistic, dynamic, interactive, open‐ended model of reality. I lay the foundation for a “hermeneutics of love” to complement Paul Ricoeur's “hermeneutics of suspicion” and invite speculation on the ways science, technology, and society would be transformed if those “glasses of friendship” were widely applied. (shrink)

Physicalism holds that the laws of physics are inviolable and ubiquitous and thereby account for all of reality. Laws leave no “wiggle room” or “gaps” for action by numinous agents. They cannot be invoked, however, without boundary stipulations that perforce are contingent and which “drive” the laws. Driving contingencies are not limited to instances of “blind chance,” but rather span a continuum of amalgamations with regularities, up to and including nearly determinate propensities. Most examples manifest directionality, and their very definition (...) encompasses intentionality. Contingencies, via their interactions with laws, can reinforce and maintain one another, thereby giving rise to enduring, ordered configurations of constraints. All of ordered nature thus results from ongoing transactions between mutualistic contingencies that constrain possibilities and entropic chance events that degrade order but diversify opportunities. Laws do not of themselves determine reality; interactions among contingencies do. For believers, the robust abundance of indeterminacies provides ample latitude for divine intervention, free will, and prayer. The priority of contingency also affords some insight into the meaning of suffering and evil. (shrink)

The evidence-based practice and evidence-based medicine movements have promoted standardization through guideline development methodologies based on systematic reviews and meta-analyses of best available research. EBM has challenged clinicians to question their reliance on practical reasoning and clinical judgement. In this paper, we argue that the protagonists of EBM position their mission as reducing uncertainty through the use of standardized methods for knowledge evaluation and use. With this drive towards uniformity, standardization and control comes a suspicion towards intuition, creativity and uncertainty (...) as integral parts of medical practice. We question the appropriateness of attempts to standardize professional practice through a discussion of the importance of uncertainty. Greenhalgh’s taxonomy of uncertainty is used to inform an analysis of the clinical reasoning occurring in a potentially life threatening emergency situation with a young patient. The case analysis is further developed by the use of the Canadian philosopher Bernard Lonergan’s theory about understanding and objective knowing. According to Lonergan it is not by getting rid of or even by reducing uncertainty, but by attending systematically to it and by relating to it in a self-conscious way, that objective knowledge can be obtained. The paper concludes that uncertainty is not a regrettable and unavoidable aspect of decision making but a productive component of clinical reasoning. (shrink)