This is the first volume to systematically explore the range of contemporary thought concerning the body and draw out its crucial implications for medicine.

Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

In At the Will of the Body , Arthur Frank told the story of his own illnesses, heart attack and cancer. That book ended by describing the existence of a "remission society," whose members all live with some form of illness or disability. The Wounded Storyteller is their collective portrait. Ill people are more than victims of disease or patients of medicine they are wounded storytellers. People tell stories to make sense of their suffering when they turn their diseases into (...) stories, they find healing. Drawing on the work of authors such as Oliver Sacks, Anatole Broyard, Norman Cousins, and Audre Lorde, as well as from people he met during the years he spent among different illness groups, Frank recounts a stirring collection of illness stories, ranging from the well-known--Gilda Radner's battle with ovarian cancer--to the private testimonials of people with cancer, chronic fatigue syndrome, and disabilties. Their stories are more than accounts of personal suffering: they abound with moral choices and point to a social ethic. Frank identifies three basic narratives of illness in restitution, chaos, and quest. Restitution narratives anticipate getting well again and give prominence to the technology of cure. In chaos narratives, illness seems to stretch on forever, with no respite or redeeming insights. Quest narratives are about finding that insight as illness is transformed into a means for the ill person to become someone new. (shrink)

Almost everyone who has a limb amputated will experience a phantom limb--the vivid impression that the limb is not only still present, but in some cases, painful. There is now a wealth of empirical evidence demonstrating changes in cortical topography in primates following deafferentation or amputation, and this review will attempt to relate these in a systematic way to the clinical phenomenology of phantom limbs. With the advent of non-invasive imaging techniques such as MEG (magnetoencephalogram) and functional MRI, topographical reorganization (...) can also be demonstrated in humans, so that it is now possible to track perceptual changes and changes in cortical topography in individual patients. We suggest, therefore, that these patients provide a valuable opportunity not only for exploring neural plasticity in the adult human brain but also for understanding the relationship between the activity of sensory neurons and conscious experience. We conclude with a theory of phantom limbs, some striking demonstrations of phantoms induced in normal subjects, and some remarks about the relevance of these phenomena to the question of how the brain constructs a 'body image.'. (shrink)

Book reviewed in this article: Principles of Biomedical Ethics. By Tom L. Beauchamp and James F. Childress.

In line with some recent studies that emphasize the importance of embodied meanings in social interaction and face-to-face communication, this study recognizes the significance of the body in human meaning-making processes and contributes to the emerging studies that explore the relation of the body, self, and social interaction. Unlike studies that analyze the body as a symbol or text disconnected from the actual body (i.e., a representation), this study does not separate appearance from the body. Rather, this research explores embodied (...) appearance and shows how a nonconforming appearance might highlight the body's presence in interaction, making it a focal point of attention in contrast to the taken-for-grantedness of our bodies in everyday life. I examine the reported experiences of some breast cancer survivors to find the implications of changes in physical appearance due to radiation, chemotherapy, or surgery, for survivors and their interactions with others. (shrink)

First Published in 1999. Routledge is an imprint of Taylor & Francis, an informa company.

How the Body Shapes the Mind is an interdisciplinary work that addresses philosophical questions by appealing to evidence found in experimental psychology, neuroscience, studies of pathologies, and developmental psychology. There is a growing consensus across these disciplines that the contribution of embodiment to cognition is inescapable. Because this insight has been developed across a variety of disciplines, however, there is still a need to develop a common vocabulary that is capable of integrating discussions of brain mechanisms in neuroscience, behavioural expressions (...) in psychology, design concerns in artificial intelligence and robotics, and debates about embodied experience in the phenomenology and philosophy of mind. Shaun Gallagher's book aims to contribute to the formulation of that common vocabulary and to develop a conceptual framework that will avoid both the overly reductionistic approaches that explain everything in terms of bottom-up neuronal mechanisms, and inflationistic approaches that explain everything in terms of Cartesian, top-down cognitive states. Gallagher pursues two basic sets of questions. The first set consists of questions about the phenomenal aspects of the structure of experience, and specifically the relatively regular and constant features that we find in the content of our experience. If throughout conscious experience there is a constant reference to one's own body, even if this is a recessive or marginal awareness, then that reference constitutes a structural feature of the phenomenal field of consciousness, part of a framework that is likely to determine or influence all other aspects of experience. The second set of questions concerns aspects of the structure of experience that are more hidden, those that may be more difficult to get at because they happen before we know it. They do not normally enter into the content of experience in an explicit way, and are often inaccessible to reflective consciousness. To what extent, and in what ways, are consciousness and cognitive processes, which include experiences related to perception, memory, imagination, belief, judgement, and so forth, shaped or structured by the fact that they are embodied in this way? (shrink)

As is made plain in the critical apparatus and editorial matter appended to the original German publication of Hussed's Ideas II, I this is a text with a history. It underwent revision after revision, spanning almost 20 years in one of the most fertile periods of the philosopher's life. The book owes its form to the work of many hands, and its unity is one that has been imposed on it. Yet there is nothing here that cannot be traced back (...) to Hussed himself. Indeed, the final" clean copy" for publication, prepared by an assistant, was completely reviewed by the master three times and emended by him in detail on each occasion. Nevertheless, in the end the work was in fact not submitted for publication, and after Hussed's pen last touched the manuscript in 1928 it was set aside until posthumously edited and published by the Hussed-Archives in 1952. The story of the composition of Ideas II begins with the "pencil manuscript" of 1912. This is the ultimate textual source for both Ideas II and Ideas III. 2 It has been preserved as a folio of 84 sheets in very dense shorthand of the Gabelsberger system, written mostly with a pencil. It was composed by Hussed "in one stroke" immediately after the completion of I Edmund Husser!: Ideen zu einer reinen Phiinomenologie und phiinomenologischen Philosophie. Zweites Buch: Phiinomenologische Untersuchungen zur Konstitution. Edited by Marly Biemel. The Hague: Martinus NijhofT, 1952 (Husserliana IV). (shrink)

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

Advance directives for psychiatric care are the subject of debate in a number of Western societies. By using psychiatric advance directives , it would be possible for mentally ill persons who are competent and with their disease in remission, and who want timely intervention in case of future mental crisis, to give prior authorisation to treatment at a later time when they are incompetent, have become non-compliant, and are refusing care. Thus the devastating consequences of recurrent psychosis could be minimised.Ulysses (...) contracts raise a number of ethical questions. In this article the central issues of concern and debate are discussed from a narrative perspective. Ulysses contracts are viewed as elements of an ongoing narrative in which patient and doctor try to make sense of and get a hold on the recurrent crises inherent in the patient's psychiatric condition. (shrink)

What sort of ethics do we need? Rosalyn Diprose argues that the usual approaches to ethics both perpetuate and remain blind to the mechanisms of the subordination of women. In _Bodies of Women: Ethics, Embodiment and Sexual Differences_, she claims that injustice against women is found in the social discourses and practices which both evaluate and constitute their modes of embodiment as improper in relation to men. Diprose critically analyses the attempts in both feminist and non-feminist ethics to recognise the (...) role of sexual difference and the biomedical discourses whose descriptions mask a constitution and regulation of the 'body'. Her critiques draw on insights from Anglophone feminist theory and continental philosophy, and are supported by critical readings of Irigaray, Cornell and Fraser, Hegel, Nietzsche, Merleau-Ponty, Derrida and Foucault. What emerges is a new ethics of sexual difference which not only better locates the mechanisms of discrimination but also provides the means to subvert them. (shrink)

In this article, we present an analysis of bodily integrity in hand transplants from a phenomenological narrative perspective, while drawing on two contrasting case stories. We consider bodily integrity as the subjective bodily experience of wholeness which, instead of referring to actual bodily intactness, involves a positive identification with one’s physical body. Bodily mutilations, such as the loss of a hand, may severely affect one’s bodily integrity. A possible restoration of one’s experience of wholeness requires a process of re-identification. Medical (...) interventions, such as a hand transplant, may improve the possibility of a successful re-identification. However, since the experience of wholeness does not refer simply to physical intactness or impairment, the choice for medical intervention should not be based merely upon the degree of physical mutilation. It should also be based upon the degree to which a person fails in re-identifying with his or her mutilated body. We argue that a normalizing operation is only ethically justifiable if the intervention enables the person to be the body he or she has. (shrink)

This article provides a phenomenological analysis of the difference between self-recognition and recognition of another, while referring to some contemporary neuroscientific studies on the rubber hand illusion. It examines the difference between these two forms of recognition on the basis of Husserl’s and Merleau-Ponty’s work. It argues that both phenomenologies, despite their different views on inter-subjectivity, allow for the specificity of recognition of another. In explaining self-recognition, however, Husserl’s account seems less convincing. Research concerning the rubber hand illusion has confirmed (...) that self-recognition involves more than an immediate experience of oneself. Merleau-Ponty’s later work, describing self-recognition as the result of assimilative identification, will be used to explain the possibility of illusion between one’s “hereness” and “thereness”. The possibility of this illusion is inherent to self-recognition, while it is lacking in recognition of another. (shrink)

The article’s aim is to explore human hand allograft recipients’ postoperative experience of disownership and their gradual experience of their new hand as theirs, with the aid of the work of the French phenomenologist Maurice Merleau-Ponty. Many have used a Merleau-Pontinian perspective in the analysis of embodiment. Far fewer have used it in medico-ethical analysis. Drew Leder’s phenomenologically based ethics of organ donation and organ sale is an exception to this tendency. The article’s second aim is to examine Leder’s phenomenologically (...) based ethics of organ donation and organ sale. Though I find parts of Leder’s approach promising, I also elaborate a line of reasoning that draws on Merleau-Ponty, that does allow us to argue for certain kinds of organ donation and against organ sale—and that avoids some of the problems with Leder’s approach. This alternative route builds on the concept of the integrity of the body-subject. (shrink)