Drawing on postmodernist analyses, Leaky Bodies and Boundaries presents a feminist investigation into the marginalization of women within western discourse that denies both female moral agency and bodylines. With reference to contemporary and historical issues in biomedicine, the book argues that the boundaries of both the subject and the body are no longer secure. The aim is both to valorize women and to suggest that "leakiness" may be the very ground for a postmodern feminist ethic. The contribution made by Margrit (...) Shildrick is to go beyond modernist feminisms to radically displace the mechanisms by which women are devalued. The anxiety that postmodernism cannot yield an ethics, nor advance feminist concerns is addressed. (shrink)

Here is a thoroughly updated edition of a classic in palliative medicine. Two new chapters have been added to the 1991 edition, along with a new preface summarizing where progress has been made and where it has not in the area of pain management. This book addresses the timely issue of doctor-patient relationships arguing that the patient, not the disease, should be the central focus of medicine. Included are a number of compelling patient narratives. Praise for the first edition "Well (...) written. . .should be read by everyone in medical practice or considering a career in medicine."---JAMA. "Memorable passages, important ideas, and critical analysis. This is a book that clinicians and educators should read."---New England Journal of Medicine. (shrink)

Evidence-based medicine was developed to ensure that health-care decisions are based on the best available research evidence. Making this evidence available to patients is supposed to increase their autonomy by putting them in a position to make better-informed choices. In this paper, I draw on work in feminist bioethics to critique EBM’s approach to involving patients in decision making, in which patients are asked merely to select their preferences among various possible treatment outcomes but are not encouraged to actively contend (...) with the effects of illness on their lives as a whole. (shrink)

In this book, which remained unfinished at his death, Husserl attempts to forge a union between phenomenology and existentialism.

The pregnant subject has a unique experience of her body. The dichotomy between self and other, self and world, breaks down. She can experience a positive narcissism and sense of process. Some conceptualizations and practices of contemporary medicine, however, can alienate the pregnant subject from this bodily experience. Keywords: Embodiment, Split Subjectivity CiteULike Connotea Del.icio.us What's this?

This paper explores the relationship between concepts of probability and hermeneutics. It seeks to examine the relationship between subjective (Bayesian) views of probability and hermeneutic descriptions of understanding. It is argued that Gadamer'saccount of the prejudicial nature of understanding, derived from Heidegger'sanalysis of foreunderstanding, offers a provocative model of clinical reasoning. The implications of this model for evidence-based medicine are discussed in conclusion.

Book reviewed in this article: The Meaning of Illness. By S. Kay Toombs.

: Responding to Silvia Stoller's comments on "Domination and Dialogue in Merleau-Ponty's Phenomenology of Perception" (Sullivan 1997), I argue that while phenomenology has much to offer feminism, feminists should be wary of Merleau-Ponty's notion of projective intentionality because of the ethical solipsism that it tends to involve. I also take the opportunity to clarify the concept of hypothetical construction introduced in the earlier paper, in particular the transformative relationship that it has to pre-reflective experience.

Responding to Silvia Stoller's comments on “Domination and Dialogue in Merleau-Ponty's Phenomenology of Perception”, I argue that while phenomenology has much to offer feminism, feminists should be wary of Merleau-Ponty's notion of projective intentionality because of the ethical solipsism that it tends to involve. I also take the opportunity to clarify the concept of hypothetical construction introduced in the earlier paper, in particular the transformative relationship that it has to pre-reflective experience.

Feminist philosophers of technoscience have long argued that it is vital that we question biomedical and scientific claims to an immaterial and disembodied objectivity, and also, more specifically, that we disable the conception of medical visualising technologies as neutral or transparent conduits to the “fact” of the body. In this paper we suggest that corporeal feminism is well situated to provide such a critique. Feminist phenomenologists over the past decade have theorised embodiment in a number of critical ways, many deriving (...) concepts from the work of Merleau-Ponty, and emphasising the pliability and diversity of our body images and corporeal schematics. Others such as Elizabeth Wilson, Cathy Waldby and Drew Leder have considered the interdependence of our inner biology or viscerality with the socio-cultural inscriptions of embodiment. In this paper, these adaptations of phenomenology, and their account of the specificity and depth of embodied being, will be discussed and applied to the discourse of biomedicine and the apparatus of magnetic resonance imaging (MRI). Indo-Pacific Journal of Phenomenology , Volume 6, Edition 1 May 2006. (shrink)

In Telling Flesh, Vicki Kirby addresses a major theoretical issue at the intersection of the social sciences and feminist theory -- the separation of nature from culture. Kirby focuses particularly on postmodern approaches to corporeality, and explores how these approaches confine the body within questions about meaning and interpretation. Kirby explores the implications of this containment in the work of Jane Gallop, Judith Butler, and Drucilla Cornell, as well as in recent cyber-criticism. By analysing the inadvertent repetition of the nature/culture (...) division in this work, Kirby offers a powerful reassessment of dualism itself. (shrink)

Because “evidence” is at issue in evidence-based medicine (EBM), the critical responses to the movement have taken up themes from post-positivist philosophy of science to demonstrate the untenability of the objectivist account of evidence. While these post-positivist critiques seem largely correct, I propose that when they focus their analyses on what counts as evidence, the critics miss important and desirable pragmatic features of the evidence-based approach. This article redirects critical attention toward EBM’s rigid hierarchy of evidence as the culprit of (...) its objectionable epistemic practices. It reframes the EBM discourse in light of a distinction between objectivist and pragmatic epistemology, which allows for a more nuanced analysis of EBM than previously offered: one that is not either/or in its evaluation of the decision-making technology as either iconoclastic or creedal. -/- . (shrink)

Part philosophical meditation, part cultural critique, The Body in Pain is a profoundly original study that has already stirred excitement in a wide range of intellectual circles. The book is an analysis of physical suffering and its relation to the numerous vocabularies and cultural forces--literary, political, philosophical, medical, religious--that confront it.Elaine Scarry bases her study on a wide range of sources: literature and art, medical case histories, documents on torture compiled by Amnesty International, legal transcripts of personal injury trials, and (...) military and strategic writings by such figures as Clausewitz, Churchill, Liddell Hart, and Kissinger, She weaves these into her discussion with an eloquence, humanity, and insight that recall the writings of Hannah Arendt and Jean-Paul Sartre.Scarry begins with the fact of pain's inexpressibility. Not only is physical pain enormously difficult to describe in words--confronted with it, Virginia Woolf once noted, "language runs dry"--it also actively destroys language, reducing sufferers in the most extreme instances to an inarticulate state of cries and moans. Scarry analyzes the political ramifications of deliberately inflicted pain, specifically in the cases of torture and warfare, and shows how to be fictive. From these actions of "unmaking" Scarry turns finally to the actions of "making"--the examples of artistic and cultural creation that work against pain and the debased uses that are made of it. Challenging and inventive, The Body in Pain is landmark work that promises to spark widespread debate. (shrink)

Ethics and the Clinical Encounter explores the moral dimensions of clinical medicine and the phenomenon of illness, to determine what ethics must be in order to be fully responsive to clinical encounters. Written in a lively and conversational style with minimal technical terminology, and enhanced by actual experience or real clinical situations, this volume lays out a clinical ethics methodology both in practical and theoretical terms. Here's what the experts had to say: Professor Zaner has provided us with a remarkably (...) lucid and trenchant discussion of the interface of philosophy and the field of medicine. He brings into play an extraordinary range of historial knowledge, extensive observations based on firsthand experience with medical practices, and an acute sense of philosophical argumentation. This is a work that will be an exemplary and indispensable text in the philosophy of medicine for years to come. -- Calvin Schrag... it is a highly original contribution usable in a number of fields.... It really has no competition.... The genius of Zaner's approach is to ground ethics from the 'bottom up' and to direct us to the concrete particulars of therapeutic encounters wherein lie moral and ethical matters... meaty, challenging, and ultimately rewarding.... -- Paul R. Dokecki Richard M. Zaner founded the Center for Clinical and Research Ethics at Vanderbilt University Medical Center. Having established Vanderbilt's first Hospital Ethics Committee (1985), he served as co-chair of VUMC's Ethics Committee since its inception in 1990. Zaner has published five original books, edited ten, and translated four more, and has published more than 100 sections of books and professional journals. (shrink)

Part philosophical meditation, part cultural critique, The Body in Pain is a profoundly original study that has already stirred excitement in a wide range of intellectual circles. The book is an analysis of physical suffering and its relation to the numerous vacabularies and cultural forces--literary, political, philosophical, medical, religious--that confront it. Elaine Scarry bases her study on a wide range of sources: literature and art, medical case histories, documents on torture compiled by Amnesty International, legal transcripts of personal injury trials, (...) and military and strategic writings by such figures as Clausewitz, Churchill, Liddell Hart, and Kissinger, She weaves these into her discussion with an eloquence, humanity, and insight that recall the writings of Hannah Arendt and Jean-Paul Sartre. Scarry begins with the fact of pain's inexpressibility. Not only is physical pain enormously difficult to describe in words--confronted with it, Virginia Woolf once noted, "language runs dry"--it also actively destroys language, reducing sufferers in the most extreme instances to an inatriculate state of cries and moans. Scarry analyzes the political ramifications of deliberately inflicted pain, specifically in the cases of torture and warfare, and shows how to be fictive. From these actions of "unmaking" Scarry turns finally to the actions of "making"--the examples of artistic and cultural creation that work against pain and the debased uses that are made of it. Challenging and inventive, The Body in Pain is landmark work that promises to spark widespread debate. About the Author: Elaine Scarry is Associate Professor of English at the University of Pennsylvania. (shrink)

The Visible Human Project examines how the VHP provides visual access to every organ of the body, viewable from every angle and capable of being manipulated to simulate living processes like respiration.

In this age of DNA computers and artificial intelligence, information is becoming disembodied even as the "bodies" that once carried it vanish into virtuality. While some marvel at these changes, envisioning consciousness downloaded into a computer or humans "beamed" _Star Trek_-style, others view them with horror, seeing monsters brooding in the machines. In _How We Became Posthuman,_ N. Katherine Hayles separates hype from fact, investigating the fate of embodiment in an information age. Hayles relates three interwoven stories: how information lost (...) its body, that is, how it came to be conceptualized as an entity separate from the material forms that carry it; the cultural and technological construction of the cyborg; and the dismantling of the liberal humanist "subject" in cybernetic discourse, along with the emergence of the "posthuman." Ranging widely across the history of technology, cultural studies, and literary criticism, Hayles shows what had to be erased, forgotten, and elided to conceive of information as a disembodied entity. Thus she moves from the post-World War II Macy Conferences on cybernetics to the 1952 novel _Limbo_ by cybernetics aficionado Bernard Wolfe; from the concept of self-making to Philip K. Dick's literary explorations of hallucination and reality; and from artificial life to postmodern novels exploring the implications of seeing humans as cybernetic systems. Although becoming posthuman can be nightmarish, Hayles shows how it can also be liberating. From the birth of cybernetics to artificial life, _How We Became Posthuman_ provides an indispensable account of how we arrived in our virtual age, and of where we might go from here. (shrink)

We are even less aware of our internal organs and the physiological processes that keep us alive. In this fascinating work, Drew Leder examines all the ways in which the body is absent—forgotten, alien, uncontrollable, obscured.

A radically subversive critique brings to the fore the masculine ideology implicit in psychoanalytic theory and in Western discourse in general: woman is defined as a disadvantaged man, a male construct with no status of her own.

the Logische Untersuchungen,l phenomenology has been conceived as a substratum of empirical psychology, as a sphere comprising "imma nental" descriptions of psychical mental processes, a sphere compris ing descriptions that - so the immanence in question is understood - are strictly confined within the bounds of internal experience. It 2 would seem that my protest against this conception has been oflittle avail; and the added explanations, which sharply pinpointed at least some chief points of difference, either have not been understood (...) or have been heedlessly pushed aside. Thus the replies directed against my criticism of psychological method are also quite negative because they miss the straightforward sense of my presentation. My criticism of psychological method did not at all deny the value of modern psychology, did not at all disparage the experimental work done by eminent men. Rather it laid bare certain, in the literal sense, radical defects of method upon the removal of which, in my opinion, must depend an elevation of psychology to a higher scientific level and an extraordinary amplification ofits field of work. Later an occasion will be found to say a few words about the unnecessary defences of psychology against my supposed "attacks. (shrink)

"The location of the author’s investigations, the body itself rather than the sphere of subjective representations of self and of function in cultures, is wholly new.... I believe this work will be a landmark in future feminist thinking." —Alphonso Lingis "This is a text of rare erudition and intellectual force. It will not only introduce feminists to an enriching set of theoretical perspectives but sets a high critical standard for feminist dialogues on the status of the body." —Judith Butler Volatile (...) Bodies demonstrates that the sexually specific body is socially constructed: biology or nature is not opposed to or in conflict with culture. Human biology is inherently social and has no pure or natural "origin" outside of culture. Being the raw material of social and cultural organization, it is "incomplete" and thus subject to the endless rewriting and social inscription that constitute all sign systems. Examining the theories of Freud, Lacan, Merleau-Ponty, Foucault, Deleuze, Derrida, etc. on the subject of the body, Elizabeth Grosz concludes that the body they theorize is male. These thinkers are not providing an account of "human" corporeality but of male corporeality. Grosz then turns to corporeal experiences unique to women—menstruation, pregnancy, childbirth, lactation, menopause. Her examination of female experience lays the groundwork for developing theories of sexed corporeality rather than merely rectifying flawed models of male theorists. (shrink)

The evidence-based medicine (EBM) movement is touted as a new paradigm in medical education and practice, a description that carries with it an enthusiasm for science that has not been seen since logical positivism flourished (circa 1920–1950). At the same time, the term ‘‘evidence-based medicine’’ has a ring of obviousness to it, as few physicians, one suspects, would claim that they do not attempt to base their clinical decision-making on available evidence. However, the apparent obviousness of EBM can and should (...) be challenged on the grounds of how ‘evidence’ has been problematised in the philosophy of science. EBM enthusiasm, it follows, ought to be tempered. The post-positivist, feminist, and phenomenological philosophies of science that are examined in this paper contest the seemingly unproblematic nature of evidence that underlies EBM by emphasizing different features of the social nature of science. The appeal to the authority of evidence that characterizes evidence-based practices does not increase objectivity but rather obscures the subjective elements that inescapably enter all forms of human inquiry. The seeming common sense of EBM only occurs because of its assumed removal from the social context of medical practice. In the current age where the institutional power of medicine is suspect, a model that represents biomedicine as politically disinterested or merely scientific should give pause. (shrink)

This paper suggests that the paradigm of lived body (as it is developed in the works of Merleau-Ponty, Sartre and Zaner) provides important insights into the experience of illness. In particular it is noted that, as embodied persons, we experience illness primarily as a disruption of lived body rather than as a dysfunction of biological body. An account is given of the manner in which such fundamental features of embodiment as bodily intentionality, primary meaning, contextural organization, body image, gestural display, (...) lived spatiality and temporality, are disrupted in illness causing a concurrent disorganization of the patient's self and world. The paradigm of lived body has important applications for medical practice. It provides a fuller account of illness than does the prevailing reductionist Cartesian paradigm of body, more directly addresses the existential predicament of illness, and orients the clinical focus around the personhood of the patient. (shrink)