This first volume contains discussions of the brain, methods for analyzing behavior, thought, consciousness, attention, association, time, and memory.

This volume provides a lucid and distinct introduction to multiculturalism and the philosophy of social science.

Inappropriate health care is an escalating and expensive problem. It affects high income, middle income, and low income countries and wastes billions of dollars annually as well as harming individuals and communities. Inappropriate care refers to both the overuse and underuse of tests and treatments and, ironically, can occur concurrently within the same health system. Even though patient-centred care is still the prevailing ethos, specifying where patients should be situated geographically has not required health professionals to consider the preferences, values, (...) and priorities of patients when making treatment decisions. Patient-perspective care demands that the decisions health professionals make are in the service of patient's goals. Health care, ultimately, is helping individuals to live the lives they would wish for themselves. In order to meet this imperative, health professionals must work towards understanding what their patients would like to achieve through their engagement with health services. This book details the extent and scope of inappropriate care and how we have arrived in this position. The necessity for patient-perspective care is outlined and provides a theoretical framework that explains why patient-perspective care is so critical. The implications of this theory are then explored and specific strategies for moving towards a patient-perspective approach are discussed. This book is entirely original and describes a novel, fresh approach to delivering health services. Many long-standing and expensive problems such as missed appointments will disappear and patients will be more satisfied with the treatments they receive. Health services generally will be more efficient and effective leading to more sustainable and affordable health care. (shrink)

In recent times, daily, ordinary medical practices have incontrovertibly been developing under the condition of complexity. Complexity jeopardizes the moral core of practicing medicine: helping people, with their illnesses and suffering, in a medically competent way. Practical wisdom has been proposed as part of the solution to navigate complexity, aiming at the provision of morally good care. Practical wisdom should help practitioners to maneuver in complexity, where the presupposed linear ways of operating prove to be insufficient. However, this solution is (...) unsatisfactory, because the proposed versions of practical wisdom are too individualistic of nature, while physicians are continuously operating in varying teams, and dealing with complicated technologies and pressing structures. A second point of critique is, that these versions are theory based, and thus insufficiently attuned to the actual context of everyday medical practices. Now, our proposal is to use an approach of practical wisdom that enables medical practices to counter the complexity issue and to re-invent the moral core of medical practicing as well. This implies a practice oriented approach, as thematized by practice theory, qualitative empirical research from the inside, and abduction from actual performed practical wisdom towards an apt understanding of phronèsis. (shrink)

This paper proposes a new perspective on the methodology of qualitative inquiry in ethics, especially the interaction between empirical work and theory development, and introduces standards to evaluate the quality of this inquiry and its findings. The kind of qualitative inquiry the authors are proposing brings to light what participants in practices of care and welfare do and refrain from doing, and what they undergo, in order to offer ‘stepping stones’, political-ethical insights that originate in the practice studied and enable (...) practitioners to deal with newly emerging moral issues. As the authors’ aim is to study real-life complexity of inevitably morally imprinted care processes, their empirical material typically consists of extensive and comprehensive descriptions of exemplary cases. For their research aim the number of cases is not decisive, as long as the rigorous analysis of the cases studied provides innovative theoretical insights into the practice studied. Another quality criterion of what they propose that should be called ‘N=N case studies’ is the approval the findings receive from the participants in the practice studied. (shrink)

Addressing the matter of attention from a phenomenological perspective as it bears on the problem of becoming aware, I draw on Edmund Husserl''s analyses and distinctions that mark his genetic phenomenology. I describe several experiential levels of affective force and modes of attentiveness, ranging from what I call dispositional orientation and passive discernment to so-called higher levels of attentiveness in cognitive interest, judicative objectivation, and conceptualization. These modes of attentiveness can be understood as motivating a still more active mode of (...) reflective attention, i.e., philosophical attentiveness, and to this extent, even it would be subject to varying influences of affection. What role, if any, does affection play in a peculiar kind of reflective attention that is phenomenological? I conclude by briefly considering phenomenological reflective attentiveness and its relation to affection. (shrink)

This article focuses on emergence in social systems. The author begins by proposing a new tool to explore the mechanisms of social emergence: multi agent–based computer simulation. He then draws on philosophy of mind to develop an account of social emergence that raises potential problems for the methodological individualism of both social mechanism and of multi agent simulation. He then draws on various complexity concepts to propose a set of criteria whereby one can determine whether a given social mechanism generates (...) emergent properties, in the sense that their explanation cannot be reduced to a mechanistic account of individuals and their interactions. This combined account helps to resolve the competing claims of methodological individualists and social realists. The author’s conclusion is that the scope of mechanistic explanation may be limited due to the extreme complexity of many social systems. Key Words: emergence • mechanism • computer simulation • methodological individualism • social realism. (shrink)

The purpose of this article is to shape a theoretical framework of attentiveness in care, which may function as a background to study attentiveness in a health care setting empirically. More insight into the functions, forms, and aspects of attentiveness in a particular health care setting is important, as there is a lack of indicators and criteria that enable a sharp picture of the caring side of health provision. The concept of attentiveness and its relation to care have seldom been (...) examined thoroughly and broadly. This article argues that attentiveness is constitutive for good care, as it can create a space in which a relationship may arise. (shrink)

In terms of intervening in embodied experience, medical treatment is wonder-full in its ambition and its metaphysical presumption; yet, wonder’s role in clinical medicine has received little philosophical attention. In this paper, I propose, to doctors and others in routine clinical life, the value of an openness to wonder and to the sense of wonder. Key to this is the identity of the central ethical challenges facing most clinicians, which is not the high-tech drama of the popular conceptions of medical (...) ethics but, rather, the routine of patients’ undramatic but unremitting demands for the clinician’s time and respectful attention. Wonder (conceived as an intense and transfiguring attentiveness) is a ubiquitous ethical source, an alternative to the more familiar respect for rational autonomy, a source of renewal galvanizing diagnostic imagination, and a timely recalling of the embodied agency of both patient and clinician. (shrink)

To explore whether market reforms in a health care system affect medical professional ethics of hospital-based specialists on the one hand and physicians in independent practices on the other. Qualitative interviews with 27 surgeons and 28 general practitioners in The Netherlands, held 2–3 years after a major overhaul of the Dutch health care system involving several market reforms. Surgeons now regularly advertise their work (while this was forbidden in the past) and pay more attention to patients with relatively minor afflictions, (...) thus deviating from codes of ethics that oblige physicians to treat each other as brothers and to treat patients according to medical need. Dutch GPs have abandoned their traditional reticence and their fear of medicalization. They now seem to treat more in accordance with patients’ preferences and less in accordance with medical need. Market reforms do affect medical professional principles, and it is doubtful whether these changes were intended when Dutch policy makers decided to introduce market elements in the health care system. Policy makers in other countries considering similar reforms should pay attention to these results. (shrink)

Emerging from thought-provoking discussions and correspondence Simone Weil had with the Reverend Father Perrin, this classic collection of essays contains her most profound meditations on the relationship of human life to the realm of the transcendant.An enlightening introduction by Leslie Fiedler examines Weil's extraordinary roles as a philosophy teacher turned mystic. "One of the most neglected resources of our century ", Waiting for God will continue to influence spiritual and political thought for centuries to come.

First Published in 1993. Routledge is an imprint of Taylor & Francis, an informa company.

Introduction : facets of the alien -- The human as a liminal being -- Between pathos and response -- Response to the alien -- Corporeal experience between selfhood and otherness -- Thresholds of attention -- Between cultures.

In this new introduction to a classic philosophical text, David Stern examines Wittgenstein's Philosophical Investigations. He gives particular attention to both the arguments of the Investigations and the way in which the work is written, and especially to the role of dialogue in the book. While he concentrates on helping the reader to arrive at his or her own interpretation of the primary text, he also provides guidance to the unusually wide range of existing interpretations, and to the reasons why (...) the Investigations have inspired such a diversity of readings. Following closely the text of the Investigations and meant to be read alongside it, this survey is accessible to readers with no previous background in philosophy. It is well-suited to university-level courses on Wittgenstein, but can also be read with profit by students in other disciplines. (shrink)

Paul Ricoeur has been hailed as one of the most important thinkers of the century. Oneself as Another, the clearest account of his "philosophical ethics," substantiates this position and lays the groundwork for a metaphysics of morals.

The idea of perfection.--On God and Good.--The sovereignty of good over other concepts.

"The medical establishment has become a major threat to health. The disabling impact of professional control over medicine has reached the proportions of an epidemic. Iatrogenesis, the name for this new epidemic, comes from iatros, the Greek word for physician, and genesis, meaning origin. Discussion of the disease of medical progress has moved up on the agendas of medical conferences, researchers concentrate on the sick-making powers of diagnosis and therapy, and reports on paradoxical damage caused by cures for sickness take (...) up increasing space in medical dope-sheets [...] The public has been alerted to the perplexity and uncertainty of the best among its hygienic caretakers [...] This book argues that panic is out of place. Thoughtful public discussion of the iatrogenic pandemic, beginning with an insistence upon demystification of all medical matters, will not be dangerous to the commonweal."-- from Introduction. (shrink)

For the first time, this book classifies how attention shifts, and argues that self-awareness, reflection, and even morality, are best thought of as dynamic...

Semiotics, the theory of sign and meaning, may help physicians complement the project of interpreting signs and symptoms into diagnoses. A sign stands for something. We communicate indirectly through signs, and make sense of our world by interpreting signs into meaning. Thus, through association and inference, we transform flowers into love, Othello into jealousy, and chest pain into heart attack. Medical semiotics is part of general semiotics, which means the study of life of signs within society. With special reference to (...) a case story, elements from general semiotics, together with two theoreticians of equal importance, the Swiss linguist Ferdinand de Saussure and the American logician Charles Sanders Peirce, are presented. Two different modes of understanding clinical medicine are contrasted to illustrate the external link between what we believe or suggest, on the one hand, and the external reality on the other hand. (shrink)