医疗纠纷泛化原因多视角分析

随着社会的发展,医疗纠纷日趋增多,成为各卫生部门的最大难题,是继医疗改革之后的又一备受社会各界关注的热门话题,医患关系成为社会最不和谐的声音。医患关系是在社会政治、经济、文化、法律等因素共同作用,围绕“治病”所形成的道德、诚信、契约、经济利益关系,通过分析现代医患关系的变化,探讨医疗纠纷增多的原因。     

Acting for reasons: Reply to Dancy

This paper argues that we need to distinguish between two different ideas of a reason: first, the idea of a premise or assumption, from which a person’s action or deliberation can proceed; second, the idea of a fact by which a person can be guided, when he modifies his thought or behaviour in some way. It argues further that if we have the first idea in mind, one can act for the reason that p regardless of whether it is the case that p, and regardless of whether one believes that p. But if we have the second idea in mind, one cannot act for the reason that p unless one knows that p. The last part of the paper briefly indicates how the second idea of a reason can contribute to a larger argument, showing that it is better to conceive of knowledge as a kind of ability than as a kind of belief.     

Philosophy—what is to be done?

Philosophical thinking, in the historically original sense, is simply the human mind in operation, unaided by anything supernatural and unfettered by any human authority or any procedure for reaching some pre-given end. This means that “philosophy” originally included far more than it does now, including all the natural sciences, as well as rational reflection on society, history, and art. What this means for us now is that philosophy must be an essentially outward-facing discipline, open to others. Most importantly, it needs now to be open to the sciences, to practical social reflection, and to its own history. But what philosophy brings to all its reflections is above all a spirit of critical reflection, respect for evidence and argument, and a ruthless honesty that demands of people that they form their beliefs and views of life according to the best reasons and information they have, rather than forming their views according to their wishes or prejudices, or letting them be dictated by authorities or social traditions. In this sense, we are living in an unphilosophical, or even anti-philosophical, age, but this makes it all the more important for philosophy to continue to do its work.     

Philosophy, the “unknown knowns,” and the public use of reason

There are not only true or false solutions, there are also false questions. The task of philosophy is not to provide answers or solutions, but to submit to critical analysis the questions themselves, to make us see how the very way we perceive a problem is an obstacle to its solution. This holds especially for today’s public debates on ecological threats, on lack of faith, on democracy and the “war on terror”, in which the “unknown knowns”, the silent presuppositions we are not aware of, determine our acts.     

PHILOSOPHY,MYTH, AND THE “SIGNIFICANCE” OF SPECULATIVE THOUGHT

Abstract: A close examination of the relation between philosophy and myth reveals important functional parallels in some of their basic means of operation that helps shed some light on philosophy's overall task. A crucial aspect of the structural similarity between philosophy and myth is the generation of what Hans Blumenberg calls “significance.” I argue that the preservation and enhancement of significance (through a strong affinity to myth) is an essential and overlooked aspect of philosophy's task, one best accomplished through the world‐orienting work of speculative philosophy. By weaving the fragmented insights, criticisms, lessons, and methods of the more “specialized” analytic, pragmatic, critical, postmodern, deconstructivist, and other methods of thought together in a systematic way, speculative philosophy may be able to provide us with the kind of world orientation needed for developing a healthier, richer, more profound understanding of ourselves and our proper place within the world.     

The possibility of pragmatic reasons for belief and the wrong kind of reasons problem

In this paper I argue against the stronger of the two views concerning the right and wrong kind of reasons for belief, i.e. the view that the only genuine normative reasons for belief are evidential. The project in this paper is primarily negative, but with an ultimately positive aim. That aim is to leave room for the possibility that there are genuine pragmatic reasons for belief. Work is required to make room for this view, because evidentialism of a strict variety remains the default view in much of the debate concerning normative reasons for belief. Strict versions of evidentialism are inconsistent with the view that there are genuine pragmatic reasons for belief.

Correct Responses and the Priority of the Normative

The ‘Wrong Kind of Reason’ problem for buck-passing theories (theories which hold that the normative is explanatorily or conceptually prior to the evaluative) is to explain why the existence of pragmatic or strategic reasons for some response to an object does not suffice to ground evaluative claims about that object. The only workable reply seems to be to deny that there are reasons of the ‘wrong kind’ for responses, and to argue that these are really reasons for wanting, trying, or intending to have that response. In support of this, it is pointed out that awareness of pragmatic or strategic considerations, unlike awareness of reasons of the ‘right kind’, are never sufficient by themselves to produce the responses for which they are reasons. I argue that this phenomenon cannot be used as a criterion for distinguishing reasons-for-a-response from reasons-for-wanting-to-have-a-response. I subsequently investigate the possibility of basing this distinction on a claim that the responses in question (e.g. admiration or desire) are themselves inherently normative; I conclude that this approach is also unsuccessful. Hence, the ‘direct response’ phenomenon cannot be used to rule out the possibility of pragmatic or strategic reasons for responses; and the rejection of such reasons therefore cannot be used to circumvent the Wrong Kind of Reason Problem.

Freedom and Practical Reason

Practical reasons, roughly, are reasons to have our desires and goals, and to do what might secure these goals. I argue for the view that lack of freedom to do otherwise undermines the truth of judgments of practical reason. Thus, assuming that determinism expunges alternative possibilities, determinism undercuts the truth of such judgments. I propose, in addition, that if practical reason is associated with various values in a specified way, then determinism precludes such values owing to determinism's imperiling practical reason.

Categorical and Agent-neutral Reasons in Kantian Justifications of Morality

The dispute between Kantians and Humeans over whether practical reason can justify moral reasons for all agents is often characterized as a debate over whether reasons are hypothetical or categorical. Instead, this debate must be understood in terms of the distinction between agent-neutral and agent-relative reasons. This paper considers Alan Gewirth’s Reason and Morality as a case study of a Kantian justification of morality focused on deriving categorical reasons from hypothetical reasons. The case study demonstrates first, the possibility of categorical agent-relative reasons, and second, that inattention to this possibility has caused considerable confusion in the debate between Kantians and Humeans.

RELIGIOUS REASONS AND POLITICAL ARGUMENTATION

In Evangelium Vitae Pope John Paul II calls for a renewal of culture to combat the culture of death. He criticizes various aspects of a pluralistic, liberal society—a type of society that he claims is based on moral relativism and a view of democracy that becomes a substitute for moral law. He maintains that such a view trivializes moral choice. In this essay I argue that John Rawls's notion of a liberal society as an overlapping consensus of comprehensive doctrines can avoid relativism while allowing for reasonable debate among opposed positions. While Rawls maintains that comprehensive doctrines, including religions, should employ a form of public reason that is not a unique feature of any one comprehensive doctrine, I argue that this requirement is too strong. One is often justified in appealing to features of comprehensive doctrines other than one's own, features that are unique to the doctrines themselves. Such an appeal does not pretend to be neutral as public reason would seem to be. In the final section of the paper I discuss some suggestions made by the Pope regarding actions in civil society that are independent of debates about legal change and suggest some ways in which they might contribute to desired cultural transformation.