Mike W. Martin

Responsibility for Health and Blaming Victims

If we are responsible for taking care of our health, are we blameworthy when we become sick because we failed to meet that responsibility? Or is it immoral to blame the victim of sickness? A moral perspective that is sensitive to therapeutic concerns will downplay blame, but banishing all blame is neither feasible nor desirable. We need to understand the ambiguities surrounding moral responsibility in four contexts: (1) preventing sickness, (2) assigning financial liabilities for health care costs, (3) giving meaning to human suffering, and (4) interacting with health care professionals. We also need to distinguish different kinds of blame, explore the interplay of justice and compassion in avoiding unjustified blaming of victims, and work toward a unified moral-therapeutic perspective that encourages individuals to accept responsibility while avoiding destructive forms of blaming.

Happiness and the good life

Preface 1. Loving Life 2. Valuing Happiness 3. Betting on Virtue 4. Authenticity 5. Happily Self-Deceived 6. Suffering in Happy Lives 7. Paradoxes of Happiness 8. Happy to Help 9. Shared Pursuits in Love 10. Balancing Work and Leisure 11. Simplicity 12. Felicity in Frankenstein 13. Personal and Political Bibliography Index

Alcoholism as Sickness and Wrongdoing

It is now commonplace to call persons sick when their wrongdoing becomes entrenched, extensive, and extreme. This mixing of moral and therapeutic categories seems incoherent if we uncritically embrace a morality-therapy dichotomy: Behavioral problems like alcoholism are either moral or therapeutic matters, but not both. This paper dissolves the dichotomy by arguing that chronically abusive drinking is simultaneously a sickness and wrongdoing. Alcoholism is at least partly a self-inflicted impairment of responsible agency that has unhealthy consequences and usually requires therapeutic interventions. Morality and therapy are not inherently opposed. Morality enjoins compassionate helping and nonjudgemental therapy, and therapy is rooted in moral values of caring and respect. The polarized positions of Herbert Fingarette in Heavy Drinking and George E. Vaillant in The Natural History of Alcoholism are reconciled by paying close attention to their accounts of the condition, causes, consequences, and cure of alcoholism.

On the Evolution of Depression

IN “DEPRESSION AS A MIND–BODY PROBLEM,” Walter Glannon outlines a psychosocial-physiological explanation of depression as a psychological response to chronic stress—today, especially social stress—in which cortisol imbalances disrupt neurotransmitters. Accordingly, treatment for depression should combine psychopharmacology and psychotherapy—a valuable reminder in light of the current restrictions on funding for health care (Hobson and Leonard 2001). My comments focus, however, on Glannon’s objections to evolutionary theorists who explain our capacity for depression as adaptive to the natural and social environment. His objections are implausible because he fails to distinguish depression as a mood and a disorder.

Personal Ideals and Professional Responsibilities

The concept of role responsibilities has been central to professional ethics during the past two decades.1 Responsibilities are obligations which call for intelligence and good judgment2, and professional role responsibilities are those minimum responsibilities which all practitioners acquire upon entry into a profession. Some are attached to all professions: for example, obligations to respect client autonomy, maintain confidentiality, be truthful, and serve the public good. Others are connected to particular professions, such as the obligations of health professionals to promote health and the responsibilities of attorneys to protect legal rights.

Professional Autonomy and Employers’ Authority

Need for establishing authority arises in circumstances where unrestrained individual discretion in decision-making conflicts with a desired degree of social organization and order. Accordingly, submitting to authority typically involves a willingness to accept some policies and directives that on their own merits one may find inadequate. Even to submit to the authority of a basketball referee requires playing by occasionally bad or even outrageous rulings. Similarly, an employee who regards the employer as having legitimate authority over him or her acknowledges the necessity to adhere to at least some of the employer’s orders and the company’s regulations whose rationale may be found wanting. Doing so voluntarily is part of being a faithful agent and trustee of the employer. Presumably this holds true for the many areas of business operations that affect the safety, health, and welfare of the general public. Many employees, however, are also members of a profession. As such, they are generally regarded as obligated to exercise their independent skilled judgment in a manner they calculate will avoid harm and promote the good of the public.

Albert Schweitzer’s Legacy for Education: Reverence for Life

claims, none of these are ‘independent variables’ in history; to treat them as such runs the risk of exempting them ‘from historical scrutiny’ (p. 226), a temptation that should be avoided. This volume effectively opens up and catalyses dialogue concerning the history of education, not just within the USA and between the USA and other countries, but across the globe. As such it will be of interest to those who are involved in the field, whatever their historical period or areas of specific interest. For those whose specialisms correspond with the spaces, theories, approaches and characters covered by this book, there will be even more to gain. Some might find it an unsettling read, whilst for others it will be reassuring. For all, I suggest that the volume contains as many solutions as it does problematisations; invitations to see the history of education differently abound. Let the dialogue that Popkewitz has initiated continue and develop.

Eyes on the Prize

All members of the Jefferson Community are invited to celebrate the legacy and accomplishments of Dr. Martin Luther King, Jr. at the third annual JAASS Scholarship Banquet. Students from all Philadelphia Public High Schools were invited to write an essay entitled “What can we do as a society to further the legacy of Dr. Martin Luther King, Jr.?” and the winners will be in attendance to recite their essays. The afternoon’s keynote speaker will be Dr. Valerie Armstead, Department of Anesthesiology.