Death of paradox

April 30, 2011


James Arthur Baldwin (August 2, 1924 – December 1, 1987) was an American novelist, writer, playwright, poet, essayist and civil rights activist. Baldwin described the ambiguous situation of black Americans in the 1950s as Kafkaesque. He predicted that American nation will be put to death by paradox, itself a paradox since Americans seemed intent on putting paradox to death. He then situates American author Richard Wright fictional character Bigger Thomas in Native Son (1940) as a character controlled, defined by hatred and fear as a descendant of Uncle Tom. Bigger Tom’s hatred and fear later drive him to murder and rape. Baldwin saw Richard Wright as the 1940s Negro novelist locked with the 19th century New England author in a deadly timeless battle. He decries the fact that Bigger Tom’s tragedy is that he has accepted a theology that situates him as subhuman eternally constrained to fight for his humanity. Baldwin then summarizes, “But our humanity is our burden, our life, we need not battle for it; we need only do what is infinitely more difficult, that is accept it. The failure of the protest novel lies in its rejection of life, the human being, the denial of beauty, dread, power, in its insistence that it is his categorization alone which is real and which cannot be transcended (Baldwin “Everybody’s Protest Novel” in Zero 1955: 58).”

1852 American author Harriet Beecher Stowe published her anti-slavery novel entitled Uncle Tom’s Cabin; or, Life Among the Lowly. Although some argued that the novel “helped lay the groundwork for the Civil War” (Will Kaufman) James Baldwin claimed that is reeked of self-righteousness and virtuous sentimentality. Baldwin argued that sentimentality is the mark of dishonesty which betray the sentamentalist’s aversion of experience, fear of life and an arid heart. Baldwin states that sentimentalism is a signal of secret and violent inhumanity, a mask for cruelty. Uncle Tom’s Cabin is a “catalogue of violence”. He described Harriet Beecher Stowe as an impassioned pampheteer not a novelist who wrote solely to reveal the immorality of slavery (Baldwin “Everybody’s Protest Novel” Zero 1955: 57).

1924 James Baldwin was born

1938 Shoghi Effendi (1938:36) Guardian of the Bahá’í Faith, wrote that racial prejudice was the most vital and challenging issue confronting the Americas.

“Freedom from racial prejudice, in any of its forms, should, at such a time as this when an increasingly large section of the human race is falling a victim to its devastating ferocity, be adopted as the watchword of the entire body of the…believers, in whichever state they reside, in whatever circles they move, whatever their age, traditions, tastes, and habits (1938:36).”

“The ceaseless exertions which this issue of paramount importance calls for, the sacrifices it must impose, the care and vigilance it demands, the moral courage and fortitude it requires, the tact and sympathy it necessitates, invest this problem…with an urgency and importance that cannot be overestimated (1938:34).”

” [Freedom from racial prejudice] should be deliberately cultivated through the various and everyday opportunities, no matter how insignificant, that present themselves, whether in their homes, their business offices, their schools and colleges, their social parties and recreation grounds, their Bahá’í meetings, conferences, conventions, summer schools and Assemblies (1938:36).”

1940 American author Richard Wright published Native Son. James Baldwin in his essay entitled “Everybody’s Protest Novel” (c. 1950s?: 54-59) published in Zero situated American author Richard Wright fictional character Bigger Thomas in Native Son (1940) as a character controlled, defined by hatred and fear as a descendant of Uncle Tom. Bigger Tom’s hatred and fear later drive him to murder and rape. Baldwin saw Richard Wright as the 1940s Negro novelist locked with the 19th century New England author in a deadly timeless battle. He decries the fact that Bigger Tom’s tragedy is that he has accepted a theology that situates him as subhuman eternally constrained to fight for his humanity. Native Son is number 71 on the American Library Association’s list of the 100 Most Frequently Challenged Books of 1990-2000. The Modern Library placed it number 20 on its list of the 100 best novels of the 20th Century. Time Magazine also included the novel in its TIME 100 Best English-language Novels from 1923 to 2005.

1941 Seventeen-year-old James Baldwin studied at The New School, Greenwich Village, New York City.

1948 James Baldwin lived in Paris, France and became involved in the cultural radicalism of the Left Bank. His work started to be published in literary anthologies, notably Zero.

1949-1956 Albert Benveniste and Themistocles and Hoetis were editors of Zero, Gotham Book Mart Selection. James Baldwin’s essay entitled “Everybody’s Protest Novel” (pp 54-59) was published in Zero. http://books.google.com/books?id=9wdVDKAZZFoC&pg=PP5&lpg=PP5&dq=New+York+Times+’Zero’+Themistocles+Hoetis&q=New+York+Times+’Zero’+Themistocles+Hoetis&hl=en#v=snippet&q=New%20York%20Times%20’Zero’%20Themistocles%20Hoetis&f=false

“It is the peculiar triumph of society – and its loss – that it is able to convince those people to whom it has given inferior status of the reality of this decree; it has the force and the weapons to translate its dictum into fact, so that the allegedly inferior are actually made so, insofar as the societal realities are concerned. This is a hidden phenomenon now than it was in the days of serfdom, but it is no less implacable. Now, as then, we find ourselves bound, first without, then within, by the nature of categorization. And escape is not effected through a bitter railing against this trap upon us. We take our shape, it is true, within and against that cage of reality bequeathed us at our birth; and yet it is precisely betrayed. Society is held together by our need; we bind it together with legend, myth, coercion, fearing that without it we will be hurled into that void, within which, like the earth before the Word was spoken, the foundations of society are hidden. From this void – ourselves – it is the function of society to protect us; but it is only this void, our unknown selves, demanding forever, a new act of creation, which can save us – “from the evil that is in the world.” With the same motion, at the same time, it is this toward which we endlessly struggle and from which, endlessly, we struggle to escape(Baldwin “Everybody’s Protest Novel” Zero 1955: 57).”

“It must be remembered that the oppressed and oppressor are bound within the same society; they accept the same criteria, they share the same beliefs, they both alike depend on the same reality. Within this cage it is (Baldwin “Everybody’s Protest Novel” Zero 1955: 57) romantic, more, meaningless, to speak of a “new” society as the desire of the oppressed, for that shivering independence on the props of reality wyhich he shares with the herrenvolk makes a truly “new” society impossible to conceive. What vengeance will be exacted; either there will be no oppressed at all or the oppressed and the oppressor will change places (Baldwin “Everybody’s Protest Novel” Zero 1955: 58).”

1955 James Baldwin published Notes of a Native Son. The title refers to Richard Wright’s 1940 protest novel entitled Native Son.

1963 James Baldwin’s book entitled The Fire Next Time was considered to be one of the most influential books about race relations. In it Baldwin predicted, “The Negroes of this country may never be able to rise to power, but they are very well placed indeed to precipitate chaos and ring down the curtain on the American dream.” Could he have imagined President Obama?

“James Baldwin’s collection of essays, The Fire Next Time, is considered one of the most influential books on race relations published during the 1960s. Divided into two sections, the book urges the politicization of both African Americans and European Americans on the issue of racism. Baldwin explains that the radicalism and militancy of many prominent African Americans is a reaction to feelings of alienation inspired by traditional American society. Originally published as two separate works – “Letter from a Region in My Mind” in The New Yorker and “A Letter to My Nephew” in the Progressive – the essays were retitled “Down at the Cross” and “My Dungeon Shook: Letter to My Nephew on the One Hundredth Anniversary of the Emancipation Proclamation” for their appearance in book form. Using rhetorical devices learned in his youth as a Pentecostal preacher and examples from his own life, Baldwin argues for an end to racism (Gale Free Resources).”

“In order to survive as a human, moving, moral weight in the world, America and all the Western nations will be forced to reexamine themselves and release themselves from many things that are now taken to be sacred, and to discard nearly all the assumptions that have been used to justify their lives and their anguish and their crimes so long (Baldwin).”

1979-1981 Atlanta Child Murders were a series of murders committed in Atlanta, Georgia, United States in which a minimum of twenty-eight African-American children, adolescents and adults were killed creating an atmosphere of panic and paranoia. James Baldwin documented these murders in his nonfiction book entitled The Evidence of Things Not Seen. Although Atlanta African American Wayne Williams was convicted of two murders and suspected to be guilty of more Baldwin criticized the “untidy” criminal investigation process and felt it was incomplete.

1987 James Baldwin died.

Who’s Who

James Arthur Baldwin (August 2, 1924 – December 1, 1987) was an American novelist, writer, playwright, poet, essayist and civil rights activist.

Webliography and Bibliography

Baldwin, James. 1962-11-17. “Letter From a Region of My Mind.The New Yorker. “Letter from a Region in My Mind.” p. 59.

Baldwin, James. 1963. “Down At the Cross; Letter From a Region of My Mind.” The Fire Next Time. Dial Press. USA.
Baldwin, James. 1963. The Fire Next Time. Dial Press. USA.
Baldwin, James. 1964. The Fire Next Time. Penguin Books. UK.


Charles Taylor’s book entitled The Ethics of Authenticity was first published in Canada under the name “The Malaise of Modernity” which was broadcast in November 1991 on the CBC’s Ideas series. By 2003 it was in its 11th printing.

Three Malaises of Modernity.

1. The first malaise concerns the dangers of individualism and the loss of meaning.

“. [...] The worry has been repeatedly expressed that the individual lost something important along with the larger social and cosmic horizons of action. Some have written of this as the loss of a heroic dimension to life.  People no longer have a sense of a higher purpose, of something worth dying for.  Alex de Tocqueville [author of Democracy in America] sometimes talked like this in the last century, referring to the “petits et vulgaires plaisirs” [“petty and vulgar pleasures”] that people tend to seek in the democratic age.  In another articulation, we suffer from a lack of passion.  Kierkegaard saw “the present age” in these terms. And Nietzsche’s “last men” are at the final nadir of this decline; they have no aspiration left in life but to a “pitiable comfort.” This loss of purpose was linked to a narrowing. People lost the broader vision because they focused on their individual lives. Democratic equality, says Tocqueville, draws the individual towards himself, “et menace de le renfermer enfin tout entier dans la solitude de son propre coeur” [“and threatens finally to enclose him entirely within the solitude of his own heart”].  In other words, the dark side of individualism is a centring on the self, which both flattens and narrows our lives, makes  them poorer in meaning, and less concerned with  others or society (Taylor, Charles. 1991. “Taylor 1991:4 .”

2. The second malaise is the disenchantment of the world.

“Once society no longer has a sacred structure, once social arrangements and modes of action are no longer grounded in the order of things or the will of God, they are in a sense up for grabs. They can be redesigned with their consequences for the happiness and well-being of individuals as our goal. The yardstick that henceforth applies is that of instrumental reason Taylor 1991:5 .”

3. The third malaise concerns the atomism of the self-absorbed individual who is so “enclosed in their own hearts” and comfortable in their own homes that they no longer participate actively in self-government. This results in an “immense tutelary power” of a mild and paternalistic government, democratic in form with periodic elections but in reality a form of soft despotism as predicted by Tocqueville. (Tocqueville 1835) cited in Taylor 1991:9 .

“After having thus successively taken each member of the community in its powerful grasp and fashioned him at will, the supreme power then extends its arm over the whole community. It covers the surface of society with a network of small complicated rules, minute and uniform, through which the most original minds and the most energetic characters cannot penetrate, to rise above the crowd. The will of man is not shattered, but softened, bent, and guided; men are seldom forced by it to act, but they are constantly restrained from acting. Such a power does not destroy, but it prevents existence; it does not tyrannize, but it compresses, enervates, extinguishes, and stupefies a people, till each nation is reduced to nothing better than a flock of timid and industrious animals, of which the government is the shepherd. I have always thought that servitude of the regular, quiet, and gentle kind which I have just described might be combined more easily than is commonly believed with some of the outward forms of freedom, and that it might even establish itself under the wing of the sovereignty of the people. Our contemporaries are constantly excited by two conflicting passions: they want to be led, and they wish to remain free. As they cannot destroy either the one or the other of these contrary propensities, they strive to satisfy them both at once. They devise a sole, tutelary, and all-powerful form of government, but elected by the people. They combine the principle of centralization and that of popular sovereignty; this gives them a respite: they console themselves for being in tutelage by the reflection that they have chosen their own guardians. Every man allows himself to be put in leading-strings, because he sees that it is not a person or a class of persons, but the people at large who hold the end of his chain (de Tocqueville 1835.” Democracy in America).”

de Tocqueville, Alexis. 1835. “What Sort of Despotism Democratic Nations Have to Fear.” Democracy in America.

Taylor, Charles. 1991. “Three Malaises.” The Ethics of Authenticity. Harvard University Press. pp. 1-12.


1785 German philosopher Immanuel Kant () in his publication entitled “Fundamental Principles of the Metaphysics of Morals” translated by Thomas Kingsmill Abbott

1839 According to Rifkin (EC 2009:346) it was the German philosopher, Arthur Schopenhauer , (1788 – 1860) who was the first to clearly define the empathic process. In his paper entitled On the Basis of Morality (Über die Grundlage der Moral) submitted to the Royal Danish Society of Scientific Studies, Schopenhauer argued against Kant’s purely rational-based, prescriptive ethics and offered an opposing description of the source and foundation of morals. Schopenhauer made the controversial claim that compassion animated by feelings and emotions formed the basis of morality.

links

http://www.gutenberg.org/cache/epub/11945/pg11945.html

http://www.archive.org/stream/basisofmorality00schoiala/basisofmorality00schoiala_djvu.txt


The Romantics argued that at the core of being there is an authentic self that is pure in nature, although corruptible by society. What made the Romantic era unique within the context of the evolutionary history of empathic consciousness is the great stress placed on what Rousseau, and later Wordsworth and Whitman, called the “Sentiment of Being.”

1755 In “Discourse on the Origins and Foundations of Inequality among Men” Rousseau argued that the noble savage man, alienated from others was more authentic than the hypocritical, servile social man who tells people what they want to hear. Kant developed the concept of the “enlarged mentality” – the ability to exercise empathy, to “stand up in the mind of others”.

“the savage lives within himself; the social man lives always outside himself; he knows how to live only in the opinion of others, it is, so to speak from their judgment along that he derives the sense of his own existence.”

The social man is someone who cares only about appearances. Rousseau abandoned Paris (and the modern age) for rural isolation claiming that even the politeness of the city promoted corruption. He concluded that,

“We have only a deceptive and frivolous outward appearance, honour without virtue, reason without wisdom, and pleasure without happiness. It suffices for me to to have proved that this is not the original state of man, and that it is only the spirit of society and the inequality it engenders which thus transform and corrupt all our natural inclinations.”

Rousseau sees human history as beginning with the struggle for mutual recognition that Hegel analyzed as the master-slave dialectic. Rousseau’s Sentiment of Being.”

1762 Rousseau’s self-help book on proper parenting entitled Emile was published.

1790s Rousseau’s self-help book on proper parenting entitled Emile rose in popularity at the dawn of the Romantic period. Romantics were attracted to Rousseau’s emphasis on nurturing the child’s natural instincts in direct opposition to John Locke’s assertion that children are born a tabula rasa, a blank slate. Rousseau argued that children who are naturally inclined towards the good and that childhood is a time for parents to honour and nurture their children so their naturally good instincts will develop (See Rifkin EC:354).

1790s Jane Austin introduced the two sisters Elinor and Marianne in her satire of dominant currents of the later 18th century entitled Sense and Sensibility (published in 1811). The reliable, predictable Elinor, who is the voice of reason, has a deep sense of responsibility, keeps her emotions in check, fulfills her social responsibilities but ultimately finds happiness when she discovers her inner sensibility and finally marries her true love. The overly emotional, romantic, Marianne is spontaneous to the point of being irresponsible represents the bleeding heart liberal governed entirely by passions and desires. She finds happiness when she balances her exercises more sense and reason in her decision-making and actions. keywords: ideological thinking. See Rifkin (EC:320).

1805 In The Prelude begun in his twenties by Romantic poet William Wordsworth (1770-1850)’s semi-autobiographical poem of his lifelong spiritual journey. early years spiritual autobiography, he associated the experience of beauty as transcending rational thought: Wordsworth’s “Sentiment of Being.” See Trilling 1972 Sincerity and Authenticity.

The song would speak
          Of that interminable building reared
          By observation of affinities
          In objects where no brotherhood exists
          To passive minds. My seventeenth year was come
          And, whether from this habit rooted now
          So deeply in my mind, or from excess
          In the great social principle of life
          Coercing all things into sympathy,                         390
          To unorganic natures were transferred
          My own enjoyments; or the power of truth
          Coming in revelation, did converse
          With things that really are; I, at this time,
          Saw blessings spread around me like a sea.
          Thus while the days flew by, and years passed on,
          From Nature and her overflowing soul,
          I had received so much, that all my thoughts
          Were steeped in feeling; I was only then
          Contented, when with bliss ineffable                       400
          I felt the sentiment of Being spread
          O'er all that moves and all that seemeth still;
          O'er all that, lost beyond the reach of thought
          And human knowledge, to the human eye
          Invisible, yet liveth to the heart;
          O'er all that leaps and runs, and shouts and sings,
          Or beats the gladsome air; o'er all that glides
          Beneath the wave, yea, in the wave itself,
          And mighty depth of waters. Wonder not
          If high the transport, great the joy I felt,               410
          Communing in this sort through earth and heaven
          With every form of creature, as it looked
          Towards the Uncreated with a countenance
          Of adoration, with an eye of love.
          One song they sang, and it was audible,
          Most audible, then, when the fleshly ear,
          O'ercome by humblest prelude of that strain
          Forgot her functions, and slept undisturbed.

Whitman “Sentiment of Being.”

1807 G.W.F. Hegel major philosophical work entitled  Phänomenologie des Geistes [Phenomenology of Mind, Phenomenology of Spirit] was published. Hegel traced the evolution of consciousness distinguishing between lower and higher levels of consciousness. In the section entitled “Self Consciousness > A: Independence and Dependence of Self-Consciousness > Lordship and Bondage” Hegel developed the Master-slave dialectic.

1870 In “St. Paul and Protestantism” Matthew Arnold (1822-1888) wrote,

Below the surface stream, shallow and light,
Of what we say and feel — below the stream,
As light, of what we think we feel, there flows
With noiseless current, strong, obscure and deep,
The central stream of what we feel indeed.

Trilling cited this in Sincerity and Authenticity (1972).

1968 Student uprisings at Columbia University, Trilling’s academic intellectuals community. The adversary culture, the cruder form of liberalism, asserted itself. Complex arena of mental struggles were forced into the arena of simple political struggles. Moral, psychological, social selves that we imagined ourselves possessing were split and fragmented and a “dissociation of sensibility” took over. Wordsworth and Rousseau are crucial to Trlling in Sincerity and Authenticity.

1972 Trilling, Lionel. 1969-70. Sincerity and Authenticity. Charles Eliot Norton Lectures at Harvard published in 1972. “It comprises a history of the elaborate development of mind and self since Shakespeare, a brief consideration of certain literary texts he sees as central, a polemical refutation of some prophets of our time, and an authorial credo that conceals hope about literature while it counsels stoic resignation about life. And as his last argument with the forceful reality of death, it is also Trilling’s attempt to discover a means by which estrangement of self from self might at last be resolved. Trilling’s authentic authenticity is perhaps best embodied in Conrad of Heart of Darkness. Lesser authenticities Chace, William M. Lionel Trilling, criticism and politics. Lionel Trilling makes the point that authenticity is not to be confused with sincerity, which is being true to one’s social self. Authenticity runs deeper-it is, in the words of Trilling, a “primitive” strength that is continually compromised by society. Maintaining one’s core authenticity, for Rousseau and the Romantics, required a life of personal suffering and constant attention and sympathy to the plight of others. Only the alientated could enter into this world (Rifkin EC:350).

Sartre, the French existential philosopher of the mid-twentieth century, defined the sentiment of being as the place where

“each of us finds himself as well as the others. The common place belongs to me; in me, it

 

 

1990 Kenneth D. Bailey defined social entropy  as “a measure of social system structure, having both theoretical and statistical interpretations, i.e. society (macrosocietal variables) measured in terms of how the individual functions in society (microsocietal variables); also related to social equilibrium” in his publication entitled Social Entropy Theory. (State University of New York Press).

1999 In their publication entitled A Primer of Jungian Psychology  , (New York: Meridian), Calvin S. Hall and J. Vernon described “psychological entropy as the distribution of energy in the psyche, which tends to seek equilibrium or balance among all the structures of the psyche.”

Robinson, Jeffrey Cane. The current of romantic passion.


A Note on the author of The Varieties of Religious Experience

“The road by which William James (1842-1910) arrived at his position of leadership among American philosophers was, during his childhood, youth and early maturity, quite as circuitous and unpredictable as were his father’s ideas on the training of his children. That Swedenborgian theologian foresaw neither the career of novelist for his son Henry, nor that of pragmatist philosopher for the older William. The father’s migrations between New York, Europe and Newport meant that William’s education had variety if it did not have fixed direction. From 13 to 18 he studied in Europe and returned to Newport, Rhode Island, to study painting under the guidance of John La Farge. After a year, he gave up art for science and entered Harvard University, where his most influential teachers were Louis Agassiz and Charles W. Eliot. In 1863, William James began the study of medicine, and in 1865 he joined an expedition to the Amazon. Before long, he wrote: “If there is anything I hate, it is collecting.” His studies constantly interrupted by ill health, James returned to Germany and began hearing lectures and reading voluminously in philosophy. He won his medical degree at Harvard in 1870 (28-years-old). For four years he was an invalid in Cambridge, but finally, in 1873, he passed his gravest physical and spiritual crises and began the career by which he was to influence so profoundly generations of American students. From 1880 (38) to 1907() he was successively assistant professor of philosophy, professor of psychology and professor of philosophy at Harvard. In 1890, the publication of his Principles of Psychology brought him the acknowledged leadership in the field of functional psychology. The selection of William James to deliver the Gifford lectures in Edinburgh was at once a tribute to him and a reward for the university that sponsored the undertaking. These lectures, collected in this volume, have since become famous as the standard scientific work on the psychology of the religious impulse. Death ended his career on August 27th, 1910 (Gutenberg project).”

August 26, 2009


The concept of hyphen-ethics is most relevant in the field of bioethics where health care issues are inextricably linked with the market and the perceived needs of the health industry (medical professionals, pharmaceutical companies, fund-raising organizations such as cancer research fund-raisers) to enjoy economic health. It is not just about caring for the human need for well-being or even a freedom from suffering although this is the subject of current debates on universal health care. Who will decide what is a human need and what is a want in terms of defining basic, adequate, essential and/or discretional health care access. When and where do health resources end? What are the ends of medicine? What is the nature of medicine? What are the limits to imposed regulations and health care?

The calm witness in the debate on universal health care, a man married to a long-term cancer survivor, is concerned that proposed federal regulations, would deprive him of the current level of health care services his family needs. In a closer reading of his family’s story, his wife’s free access to a $60,000 treatment was through an act of philanthropy on the part of the treatment providers. Would this be affected by providing access to others who are lacking insurance or who have inadequate insurance? Her other medical bills were paid through his work plan. But what if he, like so many others today, suddenly no longer had an employer who provided a health plan? Perhaps what he is really expressing is gratitude for what he was able to receive and hope that others will be as fortunate when faced with a family health crisis.

In 1981 philosopher Amy Gutmann published an article entitled, “For and Against Equal Access to Health Care” in the Milbank Memorial Fund Quarterly. When the article was reprinted in 1999, the editors described how, “The Gutmann piece was written long before the failure of the Clinton plan but it still remains a classic argument for a national or universal health care system. A principal feature of her argument is that a one-class health care system, one for the rich, the middle classes and poor alike, promotes a health care system that caters to the needs of the better off as well as the poor, and this will strengthen the overall system level of benefits. Gutmann for practical political reasons acknowledges that a one-class system could not go so far as to forbid the rich from purchasing more health care outside the system, spending out of-pocket (Beauchamp; Steinbock 1999:253).”

“I suspect that no philosophical argument can provide us with a cogent principle by which we can draw a line within the enormous group of goods that can improve health or extend life prospects of individuals . . . The remaining question of establishing a precise level of priorities among health care and other goods is appropriately left to democratic decision-making (Gutmann 1981: 542-60)

Because of his close advisory position with President Obama on health care issues, Ezekiel J. Emanuel’s opinions are being scrutinized. In his article (1996-11/12) entitled “Where Civic Republicanism and Deliberative Democracy Meet,” seems to misinterpret Gutmann’s arguments as extremely dangerous moral skepticism. Emanuel assumed that she concluded, that there can be no principled mechanism to define basic health care services and, therefore, that the efforts to ensure universal access will always founder on the fear that guaranteeing any health care to all citizens means guaranteeing all available services. It suggests we should just give up on a just allocation of health care resources because we can never succeed (Emanuel 1996:13).” Emanuel misread her carefully worded debate in which she succinctly summarizes various perspectives on access to health care in the pre-Clinton health care debate period. In one scenario she traces the unintended consequences of imposed universal access in an imperfect world and goes on to suggest a pragmatic solution. In fact Gutmann concludes, “I began by arguing that a principle of equal access to health care was at best an ideal toward which our society might strive. I shall end by qualifying that statement. A sufficiently high level of public provision of health care for all citizens and a sufficiently elastic supply of health care would significantly reduce the threat to universal provision of quality health care of a private market in extra health care goods, just as a very high level of police protection and education reduces the inequalities of opportunity resulting from purchase of private bodyguards or of private school education by the rich. In the best of all imaginable worlds of egalitarian justice, the equal access principle would be sufficiently supported by other egalitarian social and economic institutions that a market in health care would complement rather than undercut the goals of equal respect and opportunity. But philosophers ought to resist basing their political recommendations solely upon a model of the best of all imaginable worlds (Gutmann 1999 [1981:253]).”

Emanuel (1996:13)

suggests that, “Regardless, a refined view has emerged that begins to overlap between liberalism and communitarianism. This overlap inspires hope for making progress on the just allocation of health care resources. This refined view distinguishes issues within the political sphere into four types: (1) issues related to constitutional rights and liberties; (2) issues related to opportunities, including health care and education; (3) issues related to the distribution of wealth such as tax policies; and (4) other political matters that may not be matters of justice but are matters of common good, such as environmental policies and defense politicies. While there still may be disagreement about the need for a neutral justification for rights and liberties, there is consensus between communitarians and liberals that policies regarding opportunities, wealth, and matters of the common good can only be justified by appeal to a particular conception of the good. As Rawls has put it:

Public reason does not apply to all political questions but only to those involving what we may call “constitutional essentials.”3 (Emanuel 1996:13).”

TBC

1960s the dominant social issue of the 1960s and 1970s was that of justice and equality. Given that context, it was hardly surprising that the field of bioethics saw a great surge of writing and debate on issues of justice and health care.(Daniels, Emanuel and Jennings 1996).

1970s the dominant social issue of the 1960s and 1970s was that of justice and equality. Given that context, it was hardly surprising that the field of bioethics saw a great surge of writing and debate on issues of justice and health care.(Daniels, Emanuel and Jennings 1996).

1972 John Rawls’ 1972 study A Theory of Justice “was not only a powerful work in its own right but perfectly in step with the times. Given that context, it was hardly surprising that the field of bioethics saw a great surge of writing and debate on issues of justice and health care. That was, and still is, a central topic. Far less important for many years was any serious discussion of the ends of medicine. To be sure, there was and is a field known as the philosophy of medicine that has given considerable attention to the nature of medicine. But the discussion in that field – which was often technical and historical in any case, self-consciously academic and scholarly – proceeded independently of the interest in health care equality. And vice-versa. In retrospect, that seems an odd bifurcation. How is it possible to have a full examination of a field as dynamic and fast-changing as health care without – simultaneous – asking some basic questions about what health care is supposed to give us and do for us? Norman Daniels, in his fine work on justice and health care, has come as close as anyone to attempting to find the specific link between the ends of health care and fair access to it. By his use of the concept of species-typical functioning as the goal of medicine he has sought to (Daniels, Emanuel and Jennings 1996).

1981 Philosopher Amy Gutmann published an article entitled, “For and Against Equal Access to Health Care” in the  Milbank Memorial Fund Quarterly. “The Gutmann piece was written long before the failure of the Clinton plan but it still remains a classic argument for a national or universal health care system. A principal feature of her argument is that a one-class health care system, one for the rich, the middle classes and poor alike, promotes a health care system that caters to the needs of the better off as well as the poor, and this will strengthen the overall system level of benefits. Gutmann for practical political reasons acknowledges that a one-class system could not go so far as to forbid the rich from purchasing more health care outside the system, spending out of-pocket (Beauchamp; Steinbock 1999:253).”

“I suspect that no philosophical argument can provide us with a cogent principle by which we can draw a line within the enormous group of goods that can improve health or extend life prospects of individuals . . . The remaining question of establishing a precise level of priorities among health care and other goods is appropriately left to democratic decision-making (Gutmann 1981: 542-60)

1996 Norman Daniels, Ezekiel J. Emanuel and Bruce Jennings co-authored the Hastings Center Report entitled “Is Justice Enough? Ends and Means in Bioethics. “There call be little doubt that the dominant social issue of the 1960s and 1970s was that of justice and equality. It inspired the development of many fresh welfare policies and was a potent motivating force in the advent of Medicare and Medicaid, both thought (mistakenly as it turned out) to be the forerunners of universal health care. John Rawls’ 1972 study A Theory of Justice was not only a powerful work in its own right but perfectly in step with the times. Given that context, it was hardly surprising that the field of bioethics saw a great surge of writing and debate on issues of justice and health care. That was, and still is, a central topic. Far less important for many years was any serious discussion of the ends of medicine. To be sure, there was and is a field known as the philosophy of medicine that has given considerable attention to the nature of medicine. But the discussion in that field – which was often technical and historical in any case, self-consciously academic and scholarly – proceeded independently of the interest in health care equality. And vice-versa. In retrospect, that seems an odd bifurcation. How is it possible to have a full examination of a field as dynamic and fast-changing as health care without – simultaneous – asking some basic questions about what health care is supposed to give us and do for us? Norman Daniels, in his fine work on justice and health care, has come as close as anyone to attempting to find the specific link between the ends of health care and fair access to it. By his use of the concept of species-typical functioning as the goal of medicine he has sought to (Daniels, Emanuel and Jennings 1996).

1996-11/12 Ezekiel J. Emanuel’s article entitled “Where Civic Republicanism and Deliberative Democracy Meet,” cautioned that Gutmann and Daniels’ moral skepticism was extremely dangerous. [I]t suggests that there can be no principled mechanism to define basic health care services and, therefore, that the efforts to ensure universal access will always founder on the fear that guaranteeing any health care to all citizens means guaranteeing all available services. It suggests we should just give up on a just allocation of health care resources because we can never succeed (Emanuel 1996:13).”

1999 “Most books about ethics and health focus on issues arising from individual patients and their relationships with doctors and other health professionals. More and more, however, ethical issues are challenges that face entire communities, not just individual patients. This book is an edited collection of readings that addresses these public health challenges. Many of the issues considered, such as policy for alcohol and other drugs, newly emergent epidemics, and violence prevention, are public health concerns beyond the purview of traditional bioethics. Others, such as access to health care, managed care, reproductive technologies, and genetic testing, are covered in bioethics texts, but here they are approached from the distinct viewpoint of public health. The book makes explicit the community perspective of public health, as well as the field’s emphasis on prevention. It examines the conceptual issues raised by the public health perspective (i.e., what is meant by community, the common good, and individual autonomy) as well as the policies that can be developed when health problems are approached in population-based, preventive terms.” Amazon abstract of: Beauchamp, Dan E.; Steinbock, Bonnie. 1999. New Ethics for the Public’s Health. Oxford University Press. This book includes the

Limited preview – 1999 – 382 pages

2001 In his controversial article entitled “Terminating Life-Sustaining Treatment of the Demented,” Dan Callahan (Callahan 2001:93) claimed that euthanasia is necessary for patients suffering from terminal illness. Opponents claim that euthanasia is immoral and violates reason.

2009-07-17 Senator Edward Kennedy (1932-2009): “We will end the disgrace of America as the only major industrialized nation in the world that doesn’t guarantee health care for all of its people (Kennedy Newsweek).”

“Is there a relationship between defects in our medical ethics and the reason the United States has repeatedly failed to enact universal health coverage? I will begin to suggest an answer to this question by clarifying the locus of allocating decisions. The allocation of health care resources can occur on three levels. The social or, in the economist’s language, the macro level entails the proportion of the gross national product (GNP) allocated to health care. The patient, or micro, level entails determining which individual patients will receive specific medical services; that is, whether Mrs. White should receive this available liver for transplantation. Finally, there is an intermediate level called the service or medical level that entails determining what health care services will be guaranteed to each citizen. These socially guaranteed services have been called “basic” or “essential” medical services or what the President’s Commission designated as “adequate health care.” Clearly, these three levels are connected. A larger proportion of the GNP going to health permits coverage of more services. Similarly, as demonstrated by the end-stage renal disease program, providing specific services to a wider range of patients causes upward pressure on the proportion of the GNP going to health care and/or reduces the range of services covered as part of basic medical services. Despite these connections, these three levels are conceptually distinct.(Emanuel 1996:12)”

“The fundamental challenge to theories of distributive justice for health care is to develop a principled mechanism for defining what fragment of the vast universe of technically available, effective medical care services is basic and will be guaranteed socially and what services are discretionary and will not be guaranteed socially. Such an approach accepts a two-tiered health system- some citizens will receive only basic services while others will receive both basic and discretionary health services. Within the discretionary tier, some citizens will receive few discretionary services, and other richer citizens will receive almost all available services, creating a multiple-tiered system (Emanuel 1996:12).”

“Underlying the repeated failure of attempts to provide universal health care coverage in the United States is the failure to develop a principled mechanism for characterizing basic health services. Americans fear that is society guarantees certain services as “basic,” the range of services guaranteed will expand to include all-or almost all- available services (except for cosmetic surgery and therapies that have not been proven effective or proven ineffective). So rather than risk the bankruptcy of having nearly every medical service socially guaranteed to all citizens, Americans have been willing to tolerate a system in which the well insured receive a wide range of medical services with some apparently basic services uncovered; Medicare beneficiaries receive fewer services with some discretionary services covered and some services that intuitively seem basic uncovered; Medicaid beneficiaries and uninsured persons receive far fewer services (Emanuel 1996:12).”

“On this view, the reason the United States has failed to enact universal health coverage is not primarily political or economic; the real reason is ethical- it is a failure to provide a philosophically defensible and practical mechanism to distinguish basic from discretionary health care services. What is the reason for this failure of medical ethics?(Emanuel 1996:12).”

“There are two opposing explanations. One explanation points to the inherent limits of ethics. Some philosophers, such as Amy Gutmann and Norman Daniels, argue that we lack sufficiently detailed ethical intuitions and principles to establish priorities among the vast array of health care services. Every time we try to define basic services our intuition “runs out.” As Gutmann once wrote:

I suspect that no philosophical argument can provide us with a cogent principle by which we can draw a line within the enormous group of goods that can improve health or extend life prospects of individuals . . . The remaining question of establishing a precise level of priorities among health care and other goods is appropriately left to democratic decision-making1

(Emanuel 1996:12).”

“Taken at face value, this moral skepticism is extremely dangerous; it suggests that there can be no principled mechanism to define basic health care services and, therefore, that the efforts to ensure universal access will always founder on the fear that guaranteeing any health care to all citizens means guaranteeing all available services. It suggests we should just give up on a just allocation of health care resources because we can never succeed (Emanuel 1996:13).”

“The second explanation holds the problem with definining basic health care services is not a general lapse of ethics, but a specific lapse of liberal political philosophy that informs our political discourse, including the allocation of health care resources. The problem is that priorities among health care services can be established only by invoking a conception of the good, but this is not possible within the framework of liberal political philosophy. Liberalism divides moral issues into three spheres: the political, social, and domestic. It then holds that within the political sphere, laws and policies cannot be justified by appeals to the good. To jusify laws by appealing to the good would violate the principle of neutrality and be coercive, imposing one conception of the good on citizens who do not necessarily affirm that conception of the good. But without appealing to a conception of the good, it is argued, we can never establish priorites among health care services and define basic medical services. This is Dan Callahan’s view with which I agree:2

. . . there can be no full discussion of equality in health care without an equally full discussion on the substantive goods and goals that medicine and health care should pursue . . . [U]nless there can be a discussion of the goals of medicine in the future as rich as that of justice and health has been, the latter problem will simply not admit of any meaningful solution (Emanuel 1996:13).”

[In his controversial article entitled "Terminating Life-Sustaining Treatment of the Demented," Dan Callahan (Callahan 2001:93) claimed that euthanasia is necessary for patients suffering from terminal illness. Opponents claim that euthanasia is immoral and violates reason.]

“Fortunately, many including many liberals, have come to view as mistaken a liberalism with such a strong principle of neutrality and avoidance of the public good. Some think the change a result of the critique provided by communitarianism; others see it as a clarification of basic liberal philosophy. Regardless, a refined view has emerged that begins to overlap between liberalism and communitarianism. This overlap inspires hope for making progress on the just allocation of health care resources. This refined view distinguishes issues within the political sphere into four types: (1) issues related to constitutional rights and liberties; (2) issues related to opportunities, including health care and education; (3) issues related to the distribution of wealth such as tax policies; and (4) other political matters that may not be matters of justice but are matters of common good, such as environmental policies and defense politicies. While there still may be disagreement about the need for a neutral justification for rights and liberties, there is consensus between communitarians and liberals that policies regarding opportunities, wealth, and matters of the common good can only be justified by appeal to a particular conception of the good. As Rawls has put it:

Public reason does not apply to all political questions but only to those involving what we may call “constitutional essentials.”3 (Emanuel 1996:13).”

More expansively, Brian Barry has written:

Examples of issues that fall outside [the principle of neutrality include] two distinct kinds of items. One set of items (tax and property laws) contains matters that are in principle within the realm of “justice as fairness” but are subject to reasonable disagreement about the implications of justice . . . The other set . . . contains issues that in the nature of the case cannot be resolved without giving priority to one conception of the good over others . . . There is no room for a complaint of discrimination simply on the ground that the policy by its nature suits those with one conception of the good more than it suits those with some different one. This is unavoidable.4 (Emanuel 1996:13).”

“Thus it seems there is a growing agreement between liberals, communitarians, and others that many political matters, including matters of justice- and specifically, the just allocation of health care resources- can be addressed only by invoking a particular conception of the good (Emanuel 1996:13).”

“We may go even further. Without overstating it (and without fully defending it) not only is there a consensus about the need for a conception of the good, there may even be a consensus about the particular conception of the good that should inform policies on these nonconstitutional political issues. Communitarians endorse civic republicanism and a growing number of liberals endorse some version of deliberate democracy. Both envision a need for citizens who are independent and responsible and for public forums that present citizens with opportunities to enter into public deliberations on social policies (Emanuel 1996:13).”

“This civic republican deliberative democratic conception of the good provides both procedural and substantive insights for developing a just allocation of health care resources. Procedurally, it suggests the need for public forums to deliberate about which health services should be considered basic and should be socially guaranteed. Substantively, it suggests services that promote the continuation of the polity- those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations- are to be socially guaranteed as basic. Conversely, servuces provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia [13] [In his controversial article entitled "Terminating Life-Sustaining Treatment of the Demented," Dan Callahan (Callahan 2001:93) claimed that euthanasia is necessary for patients suffering from terminal illness. Opponents claim that euthanasia is immoral and violates reason]. A less obvious example is guaranteeing neuropyschological services to ensure children with learning disabilities can read and learn to reason (Emanuel 1996:14).”

“Clearly, more needs to be done to elucidate what specific health care services are basic; however, the overlap between liberalism and communitarianism points to a way of introducing the good back into medical ethics and devising a principled way of distinguishing basic from discretionary health care services. Perhaps using this progress in political philosophy we can address Dan’s challenge, begin to discuss the goods and goals of medicine (Emanuel 1996:14).”

References

Callahan, Dan. 2001. “Terminating Life-Sustaining Treatment of the Demented.” Bioethics Ed. John Harris. New York: Oxford University Press. p. 93.

Gutman, Amy. 1981. “For and Against Equal Access to Health Care.” Milbank Memorial Fund Quarterly. 59:542-60.

Emanuel, Ezekiel J. 1991. The Ends of Human Life. Cambridge, Mass: Harvard University Press. Chapter 4.

Norman Daniels , Ezekiel J. Emanuel , Bruce Jennings. 1996. “Is Justice Enough? Ends and Means in Bioethics.” The Hastings Center Report. 26.

Rawls, John. 1993. Political Liberalism. New York: Columbia University Press. p. 214.

Barry, Brian. 1995. Justice as Impartiality. New York: Oxford University Press. pp. 144-145.

Emanuel, Ezekiel J. 1996-11/12. “Where Civic Republicanism and Deliberative Democracy Meet.” Hastings Centre Report. November-December.

Beauchamp, Dan E.; Steinbock, Bonnie. 1999. New Ethics for the Public’s Health. Oxford University Press.

An ethics of happiness

August 11, 2009


“Les humains doivent se reconnaître dans leur humanité commune, en même temps que reconnaître leur diversité tant individuelle que culturelle (Edgar Morin).”

Le Mouvement Humanisation considère le sous-développement humain comme De plus en plus de personnes s’inquiètent de l’état actuel de l’humanité et de la planète.
http://mouvementhumanisation.org/

Timeline
2001-12-11 le Mouvement Humanisation fut légalement reconnu par le Gouvernement du Québec comme un organisme sans but lucratif. http://www.mouvementhumanisation.org/mouvement/historique/

Series of lectures on Shaw Tv August 2009L’éthique du bonheur:

“Une conférence dans laquelle Gaston Marcotte (professeur associé, Faculté des sciences de l’éducation, Université Laval et président fondateur du Mouvement Humanisation) propose une éthique du bonheur susceptible d’unir les humains dans un projet commun capable de transcender les différences culturelles.” canal savoir Shaw

418 656-3202 ou 1 877 785-2825, poste 3202

http://www.distance.ulaval.ca

distance@bfad.ulaval.ca
contact: Jean-Benoît Caron

l’horaire : 514 987-6633 ou 1 888 640-2626

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