272 research outputs found
Spinoza’s Curious Defense of Toleration
In this essay I consider what grounds Spinoza’s defense of the freedom to philosophize, considering why Spinoza doesn’t think that we should attempt to snuff out irrationality and dissolution with the law’s iron fist. In the first section I show that Spinoza eschews skeptical, pluralistic, and rights-based arguments for toleration. I then delineate the prudential, anticlerical roots of Spinoza’s defense, before turning in the final section to consider just how far and when toleration contributes to the guiding norms of governance: peace and empowerment. Once we see how the defense of toleration is anchored in these norms, we form a clearer picture of Spinoza as a liberal perfectionist for whom the bounds of political toleration depends on pragmatic and circumstance-specific assessments of what conduces to the flourishing of the state. This will help to illuminate what is distinctive—and, perhaps, distinctively commendable—about Spinoza’s form of liberalism
Benedict Spinoza: Epistemic Democrat
In this paper, I maintain—contrary to those commentators who regard him as a principled republican—that at the core of Spinoza’s political theory is an instrumental, rather than an intrinsic, defense of democratic procedures. Specifically, Spinoza embraces democratic decision procedures primarily because they tend to result in better decisions, defined relative to a procedure-independent standard of correctness or goodness. In contemporary terms, Spinoza embraces an epistemic defense of democracy. I examine Spinoza’s defense of collective governance, showing not only how it differs from other accounts of his time but also how it might contribute to current debates about the epistemic standing of popular governing bodies. In the opening section I defend the thesis that has been contested in recent years that Spinoza was, in fact, a consistent democrat. The second section focuses on procedural (i.e., intrinsic) defenses of democracy, paying particular attention to the republican version of proceduralism that was prominent in Spinoza’s time. And in the final section I present my case for reading Spinoza as an epistemic democrat, comparing his epistemic defense with contemporary versions. What we find are not only striking anticipations of contemporary arguments, but also largely neglected lines of argumentation that reveal both the potential epistemic advantages and disadvantages of democracy
Pilot Study Of A Somatosensory Intervention To Improve Medical Adherence In Patients With Uncontrolled Hypertension
Background
Essential hypertension is the most common primary diagnosis in the US, with myriad and
serious sequelae inflicting significant morbidity upon individuals and economic losses
upon society. Estimates of adherence to prescribed medication regimens range from 20%
to 60%. Because hypertension is largely asymptomatic, patients may underestimate both
the benefits of adherence and the costs of nonadherence. This novel educational
intervention seeks to encourage adherent behavior by providing patients with a conscious
manifestation of their disease severity through manipulation of pressurized balls.
Methods
Randomized controlled pilot trial of patients under treatment for hypertension with SBP
≥140mmHg or DBP ≥90mmHg at index visit, selected by convenience sample at a VA
Primary Care Clinic. Baseline clinical, demographic, medication taking habits and
motivation data obtained by surveys and chart abstraction. All subjects received a short
talk on the dangers of hypertension. Intervention Group subjects simultaneously
squeezed rubber balls in each hand filled to air pressures differing by the same amount
that their current SBP exceeded 120mmHg. Followup medication taking habits,
motivation, medication possession ratios and blood pressure measurements were
determined by telephone survey, pharmacy and clinical records over 90-, 180-, 270- and
360-day time periods. Feasibility of a larger study was determined by structured
interviews with a physician and nurse who employed the intervention in clinical practice.
Results
Thirty subjects were enrolled into Intervention and Control Groups of equal size.
Immediate motivational impact by 7-point scale significantly favored the Intervention
(6.3, p \u3c 0.001 vs 4.3, p = 0.164). Change in self-reported adherence on an 8-point scale
at 90-days favored the Intervention but was not significant (0.5, p = 0.372 vs -0.1, p =
0.798). Change in 360-day medication possession ratio favored the Intervention and
approached significance (11.3%, p = 0.088 vs 0.7%, p = 0.934). Both Groups
demonstrated clinically relevant improvements in MAP with greater magnitude, duration
and significance for the Intervention Group through 360 days (-12.2mmHg, p = 0.008 vs
-6.0mmHg, p = 0.164). Larger improvements in adherence were significantly associated
with greater baseline motivation and immediate motivational impact from the
intervention while longer disease experiences were associated with less improvement.
Clinicians reported favorable reception from their patients and felt that the intervention
represented a simple and helpful tool that they would use in everyday practice.
Conclusions
The results of this pilot trial suggest that a novel, brief educational intervention designed
to provide a somatosensory manifestation of an otherwise asymptomatic disease process
may show promise in promoting adherent behavior and clinically useful reductions in
blood pressure in patients with poorly controlled hypertension. A larger study appears
feasible and is required to confirm and investigate the statistical significance of these
results
'Stop Being So Judgmental!’: A Spinozist Model of Personal Tolerance
This chapter considers the challenges to, and the resources for, cultivating a
personal capacity for tolerance, according to the writings of Benedict Spinoza
(1632–1677). After articulating two main components of personal tolerance, I
examine the features of Spinoza’s theory of cognition that make the cultivation of
tolerance so difficult. This is followed by an analysis of Spinoza’s account of
overcoming intolerant tendencies. Ultimately, I argue that the capacity of individuals
to be tolerant depends crucially on the establishment of conditions of
trust, conditions that are conspicuously lacking in many modern democracies
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