“ S pace, K no w l edge and P o w e r ” , en tr ev i s t a r ea l i z a d a en 1982 y pub li cada en P aul R ab i no w , The Foucau l t R eade r , N ueva Y o r k, 1984. A quí se pub li ca de acue r do a l a ve r s i ón f r (...) ancesa, t r aduc i da por P ab l o Bli t s t e i n y Tadeo L im a. (shrink)

If personhood involves the construction of a narrative identity, then what are we to say of someone who is seriously ill or disabled? How can her life have any narrative when she is unable to write one?

Patients with covert awareness who present as being vegetative raise the question of moral status and clinical decisions about those who have suffered major brain injuries. When the idea of moral s...

‘Neuroethics’ is a term which has come into use in the last few years, and which is variously defined. In the Preface to his book, Grant Gillett indicates the sense in which he is using it: the central questions in neuroethics, he says, are those of ‘human identity, consciousness and moral responsibility or the problem of the will’. His aim is to offer an account of human identity which can shed light on issues both in general philosophy and in bioethics.The (...) question which this account seeks to answer is stated in various ways in the book, but perhaps the simplest formulation is this: what is the difference between being somebody and being some body? The Cartesian answer, that the difference lies in the possession of an immaterial thinking substance, is rejected on the grounds that a thinking thing cannot be only a thinking thing: to think is to respond to the world in various ways, which requires bodily means of response. But the same argument also applies to the ‘Cartesian materialism’ which would identify ‘mind’ with ‘brain’. Instead …. (shrink)

The concept of futility is sometimes regarded as a cloak for medical paternalism in that it rolls together medical and value judgments. Often, despite attempts to disambiguate the concept, that is true and it can be applied in such a way as to marginalize the real interests of a patient. I suggest we replace it with a conceptual toolkit that includes physiological futility, substantial benefit (SB), and the risk of unacceptable badness (RUB) in that these concepts allow us to articulate (...) what is at stake in ethical judgments where outcomes are crucial in determining what should be done. (shrink)

Joseph Fins's book Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness is a considerable addition to the literature on disorders of consciousness and the murky area of minimally conscious states. Fins brings to this fraught area of clinical practice and neuroethical analysis a series of stories and reflections resulting in a pressing and sustained ethical challenge both to clinicians and to health care systems. The challenge is multifaceted, with diagnostic and therapeutic demands to be met by (...) clinicians and a mix of moral, scientific-economic, and political resonances for health care analysts. Everything in the book resonates with my own clinical experience and the often messy and emotionally wrenching business of providing ongoing care for patients with severe brain injuries and disorders, people who frequently resist the categorizations that well-organized health care systems prefer and that can dictate terms of patient management. (shrink)

Offers an outline for a new ethical practice - one responsive to the need for critical autonomy and grounded in a new sense of the human subject. The author demonstrates how difficult it is to give an account of oneself, and how this lack of self-transparency and narratibility is crucial to an ethical understanding of the human.

In lieu of an abstract, here is a brief excerpt of the content:Diacritics 31.4 (2001) 22-40 [Access article in PDF] Giving an Account of Oneself Judith Butler In recent years, the critique of poststructuralism, itself loquacious, has held that the postulation of a subject who is not self-grounding undermines the possibility of responsibility and, in particular, of giving an account of oneself. Critics have argued that the various critical reconsiderations of the subject, including those that do away with the theory (...) of the subject altogether, cannot provide the basis for an account of responsibility, that if we are, as it were, divided, ungrounded, or incoherent from the start, it will be impossible to ground a notion of personal or social responsibility on the basis of such a view. I would like to try to rebut this view in what follows, and to show how a theory of subject-formation that acknowledges the limits of self-knowledge can work in the service of a conception of ethics and, indeed, of responsibility. If the subject is opaque to itself, it is not therefore licensed to do what it wants or to ignore its relations to others. Indeed, if it is precisely by virtue of its relations to others that it is opaque to itself, and if those relations to others are precisely the venue for its ethical responsibility, then it may well follow that it is precisely by virtue of the subject's opacity to itself that it sustains some of its most important ethical bonds.In all the talk about the social construction of the subject, we have perhaps overlooked the fact that the very being of the self is dependent not just on the existence of the Other—in its singularity, as Levinas would have it, though surely that—but also on the possibility that the normative horizon within which the Other sees and listens and knows and recognizes is also subject to a critical opening. This opening calls into question the limits of established regimes of truth, where a certain risking of the self becomes, as Levinas claims, the sign of virtue [see Foucault]. Whether or not the Other is singular, the Other is recognized and confers recognition through a set of norms that govern recognizability. So whereas the Other may be singular, if not radically personal, the norms are to some extent impersonal and indifferent, and they introduce a disorientation of perspective for the subject in the midst of recognition as an encounter. For if I understand myself to be conferring recognition on you, for instance, then I take seriously that the recognition comes from me. But in the moment that I realize that the terms by which I confer recognition are not mine alone, that I did not singlehandedly make them, then I am, as it were, dispossessed by the language that I offer. In a sense, I submit to a norm of recognition when I offer recognition to you, so that I am both subjected to that norm and the agency of its use.As Hegel would have it, recognition cannot be unilaterally given. In the moment that I give it, I am potentially given it, and the form by which I offer it is one that potentially is given to me. In this sense, one might say, I can never offer it, in the Hegelian sense, as a pure offering, since I am receiving it, at least potentially and structurally, in the moment, in the act, of giving. We might ask, as Levinas surely has, what kind of gift this is that returns to me so quickly, that never really leaves my hands. Is it the case that recognition consists, as it does for Hegel, in a reciprocal act whereby I recognize that [End Page 22] the Other is structured in the same way that I am, and I recognize that the Other also makes, or can make, this very recognition of sameness? Or is there perhaps an encounter with alterity here that is not reducible to sameness? If it is the latter, how are we to understand this alterity? On the one hand, the Hegelian Other is always found outside, or at least... (shrink)