Abstract
Lester Embree, my good friend and longtime co-worker in the trenches of phenomenological inquiry, has long held the conviction that phenomenology, understood as the rigorous discipline Husserl and others held it ought to be, quite naturally has substantial, multiple relationships with other disciplines, sciences, and human enterprises. In pursuit of that, a great many of his labors have been devoted to demonstrating those concrete relationships, while, at the same time, exploring the terrain on his own. In particular, inspired by Aron Gurwitsch and Alfred Schutz, he has energetically addressed many of the questions at the heart of the human sciences.
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- 1.
Paul Ramsey, “The Indignity of ‘Death with Dignity,’” Hastings Center Report 2, p. 59.
- 2.
Richard M. Zaner, The Problem of Embodiment, The Hague: Martinus Nijhoff, 1964 (2nd edition, 1971).
- 3.
“The Other Descartes and Medicine,” in S. Skousgaard (ed.), Phenomenology and the Understanding of Human Destiny. Washington, DC: University Press of America/Center for Advanced Research in Phenomenology, Inc., 1981, pp. 93–117; also Chapter 6, “The Anatomist’s Conceit, the Body’s Cunning,” of my book, Ethics and the Clinical Encounter. Englewood Cliffs, NJ: Prentice-Hall, 1988. Republished by Academic Renewal Press, 2002.
- 4.
Ibid., pp. 106–26.
- 5.
See, e.g., “Finessing Nature,” in Verna Gehring (ed.), Genetic Prospects: Essays on Biotechnology, Ethics and Public Policy, Intro. William A. Galston, New York: Rowman, Littlefield Pub., Inc., 2003, 63–74; “Visions and Re-visions: Life and the Accident of Birth”, The University of Scranton conference, ‘Genetic Engineering and the Future of Human Nature,’ April 6–8, 2001, in Harold W. Baillie and Timothy K. Casey (eds.), Is Human Nature Obsolete? Genetics, Bioengineering, and the Future of the Human Condition, Boston, MA: MIT Press, 2005, pp. 177–207; and “Envisioning Power, Revisioning Life: Prominent Issues for a Phenomenology of Medicine,” in Steven Crowell, Lester Embree and Samuel J. Julian (eds.), The Reach of Reflection: Issues for Phenomenology’s Second Century, Electron Press, Vol. 3, online publication available at: http://ww.phenomenologycenter.org, 2001.
- 6.
When I joined the faculty at School of Medicine at the then newly established State University of New York at Stony Brook, where I started and directed one of the first programs of Humanities in Medicine.
- 7.
As he said of his efforts to grasp the inner core of “science,” so I knew I had to make the same effort to understand clinical and research medicine. See Edmund Husserl, Cartesian Meditations, The Hague: Martinus Nijhoff, 1960, p. 1.
- 8.
I was not a little stunned, for, as I quickly learned, this was the first time that a philosopher faced the odd task of setting up a clinical service, with hospital appointment included. There were neither models nor rules to govern such a thing. So, bull by the horns and such, after many discussions and meetings, the Director of the hospital simply wrote a memo one day and declared that I was an “ethicist” for the hospital and clinics – a term as sibilant to pronounce as it turned out to be awkward to practice.
- 9.
Richard M. Zaner, Troubled Voices, Cleveland, OH: Pilgrim Press, 1993.
- 10.
Richard M. Zaner, Conversations on the Edge, Washington, DC: Georgetown University Press, 2004.
- 11.
See, for example, “The Phenomenon of Trust in the Patient–Physician Relationship,” in E. D. Pellegrino (ed.), Ethics, Trust, and the Professions: Philosophical and Cultural Aspects. Washington, DC: Georgetown University Press, 1991, pp. 45–67; “Illness and the Other,” in G. P. McKenny and J. R. Sande (eds.), Theological Analyses of the Clinical Encounter, Theology and Medicine Series. Boston: Kluwer Academic Publishers, 1994, pp. 185–201; “Benefit and Mischief: Toward a Phenomenology of Medicine,” in Florinda Martins and Adelino Cardoso (eds.), A Felicidade na Fenomenologia da Vida: Colóquio Internacional Michel Henry, Lisboa: Centro de Filosofia da Universidade de Lisboa, 2006, pp. 71–84; and “Thinking About Medicine,” in A. Kay Toombs (ed.), Handbook of Phenomenology and Medicine, Dordrecht/Boston/London: Kluwer Academic Publishers, 2001, pp. 127–44.
- 12.
See Max Scheler, Pl Heath (trans.), W. Stark (intro.), The Nature of Sympathy, New Haven: Yale University Press, 1957, esp. pp. 239–40, 260–64. See also Richard M. Zaner, The Context of Self, Athens, OH: Ohio University Press, 1981, esp. Chapters 9 and 10.
- 13.
See Kurt Wolff, Surrender and Catch: Experience and Inquiry Today, Boston & Dordrecht: D. Reidel Publishing Co., 1976; also my review-essay, “The Disciplining of Reason’s Cunning: Kurt Wolff’s Surrender and Catch,” Human Studies 4: 4 (1981), pp. 365–89.
- 14.
Scheler, The Nature of Sympathy, op. cit., p. 239.
- 15.
Ibid., pp. 239–40.
- 16.
Just this I attempted to delineate, not altogether accurately or completely, in my Context of Self, op. cit., esp. pp. 204–10.
- 17.
Soren Kierkegaard, in Howard V. Hong and Edna H. Hong (ed. and trans.), Concluding Unscientific Postscript to Philosophical Fragments, Princeton: Princeton University Press, 1992.
- 18.
See Edmund D. Pellegrino, “The Most Humane of the Sciences, the Most Scientific of the Humanities,” in his book, Humanism and the Physician, Knoxville, TN: University of Tennessee Press, 1979.
- 19.
Numerous reports on the clinical trial, run by Amgen, are available. A few are: “GDNF – University of Kentucky Study Shows Effectiveness Of Experimental Parkinson’s Drug, Karla Ward, Lexington Herald-Leader/Macon Telegraph, GA, June 4, 2004; “Study Adds to Dispute Over Drug by Amgen,” Denise Gellene. Los Angeles Times, July 2, 2005 Business Desk; Part C; Pg. 1; “Drug reverses Parkinson’s brain damage,” Ian Sample, The Guardian (London), July 2, 2005, Guardian Home Pages, Pg. 10; “Researchers: Parkinson’s drug was effective,” Associated Press, July 2, 2005; “Renewed hope for Parkinson’s patients,” Innovations Report, University of Bristol. (UK), July 1, 2005. The initial scientific study was: “Direct brain infusion of glial cell line derived neurotrophic factor in Parkinson disease,” Steven S. Gill, Nikunj K. Patel, Gary R. Hotton, Karen O’Sullivan, Renée McCarter, Martin-Bunnage, David J. Brooks, Clive N. Svendsen & Peter Heywood, Nature Medicine 9 (2003), 589–595.
- 20.
The court case was subsequently denied by one judge, and is reported in, for instance, “More Sue for Access to Amgen Drug; Patients in the latest suit say they were promised the experimental Parkinson’s medicine beyond the trial period,” by Denise Gellene. Los Angeles Times, June 23, 2005, Part C; Pg. 2; “Judge rejects appeal for Amgen drug by clinical trial patients,” Erin McClam. The Associated Press State & Local Wire, June 9, 2005, Business News.
- 21.
Sometimes permitted, but only in carefully selected patients and under special conditions.
- 22.
Other important research is going on in other countries as well. See especially, the report by Roberta Neiger, “Israeli therapy uses adult stem cells to treat Parkinson’s Disease,” March 27, 2005, ISRAEL21C; see the website: http://www.israel21c.org. This experiment is directly with stem cells, is funded by Brainstorm Cell Therapeutics, and is being conducted by Prof. Eldad Melamed, Head of Neurology of the Rabin Medical Center and member of the Michael J. Fox Foundation for Parkinson’s Research, together with Tel Aviv University cell biologists, Dr. Daniel Offen and Dr. Yosef Levy. The company’s proprietary technology – NurOwn – has been proven capable of generating neuron-like cells derived from human bone marrow. The cells produce dopamine which can them be implanted into the PD patients. It is to be tested on monkeys in 2006, with human clinical trials scheduled for the following year. “Using the patient’s own bone marrow to supply dopamine-producing cells circumvents problems of immunity and compatibility, so it is safer than using cells from an outside source,” says one of the experimenters, Dr. Yaffa Beck, and she continued, “In this field, the right people have come together at the right time – and more than that, we’re Jewish,” she adds, referring to the Jewish tradition in which embryos are not considered to be human beings until they are born. This is in sharp contrast to one Christian view, which commonly holds that personhood starts at the moment of conception.
- 23.
Levodopa ((3,4-dihydroxy-L-phenylalanine) is an amino acid precursor of dopamine with antiparkinsonian properties. It is converted to dopamine by DOPA decarboxylase and can cross the blood-brain barrier. When in the brain, levodopa is decarboxylated to dopamine and stimulates the dopaminergic receptors, thereby compensating for the depleted supply of endogenous dopamine seen in Parkinson’s disease. To assure that adequate concentrations of levodopa reach the central nervous system, it is administered with carbidopa, a decarboxylase inhibitor that does not cross the blood–brain barrier, thereby diminishing the decarboxylation and inactivation of levodopa in peripheral tissues and increasing the delivery of dopamine to the CNS. is known to be involved in the biosynthesis of dopamine, which functions as a neurotransmitter to increase its levels in the brain, thus counteracting the typical loss of dopamine in patients with Parkinson’s. See National Cancer Institutes of the National Institutes of Health (NIH), online at http://www.cancer.gov/Templates/drugdictionary.aspx?CdrID=42622.
- 24.
In a pallidotomy, the surgeon destroys a tiny part of the globus pallidus by creating a scar. This reduces the brain activity in that area, which may help relieve movement symptoms such as tremor and stiffness (rigidity).
- 25.
C. R. Freed, Journal of Neurology, 2003; 250 Supplement 3: iii 47–50. The article suggests that transplants of neuronal stem cells called neuronal progenitor cells (i.e. cells that have already differentiated into nervous tissue cells, but that have the potential to differentiate further into highly specialized neurons) have been unsuccessful in the past, because no more than 4.2% developed into mature neurons and the percentage that developed into mature dopaminergic neurons useful for the treatment of Parkinson’s disease was even lower. Now a group of Japanese researchers has found how to modify these cells by introducing a gene called the von Hippel-Lindau tumor suppressor gene, which increases their development into mature dopaminergic neurons up to 42%. Of the eight rats affected by experimentally induced parkinsonism, three were completely cured by this therapy. The Japanese researchers believe that their efforts constitute a valid therapeutic approach to Parkinson’s disease that should be developed further for therapeutic use in man. See Yamada H et al. Annals of Neurology l (2003); 54: 352–9.
- 26.
A genetic link was recently discovered, through studies of an Italian family going back to the eighteenth century, I think, looking at the DNA gathered from a large number of them, comparing those with Parkinson’s with those in the same family that don’t have it. The link was located along the long arm of chromosome 4.
- 27.
See, for instance, R. D. Truog, C. B. Berde, C. Mitchell, H. E. Grier, “Barbiturates in the care of the terminally ill.” New England Journal of Medicine 1992; 327:1678–82; B. R. Ferrell, M. Rhiner. “High-tech comfort: ethical issues in cancer pain management for the 1990s,” Journal of Clinical Ethics. 2 (1992), 108–12; also Richard M. Zaner, “Ethical Issues in Cancer Pain Management,” in W. C. V. Parriss (ed.), Cancer Pain Management: Principles and Practice, Stoneham, MA: Butterworth-Heineman, Pubs., 1997, 531–8.
- 28.
Truog et al., ibid.
- 29.
I’ve told the story of my mother several times: Ethics and the Clinical Encounter, op. cit., pp. 225–42; also, as a lengthy narrative in my last book, Conversations on the Edge, op. cit., pp. 111–41.
- 30.
See above, Footnotes 4, 5 and 7. At the Department of Pharmacology of the University of Peking, neural stem cells obtained from rat embryos were cultured in vitro. Forty mice were included in the study: 10 controls were given saline solution and 30 were given MPTP (a neurotoxin that kills the neurons in the substantia nigra which degenerate in Parkinson’s disease). Out of these 30 animals, 10 received also saline solution; neural stem cells were transplanted into the striatum of the other 20 mice, in 10 only on one side, in the other 10 on both sides. The neural stem cells survived and differentiated into astrocytes (support cells) and into dopaminergic neurons i.e. into true nerve cells that began to produce dopamine, the neurotransmitter that is lacking in Parkinson’s disease. Researchers at the Memorial Sloan-Kettering Cancer Center at New York succeeded in developing a cloning technique for stem cells. Clones can then be induced to differentiate into all kinds of highly specialized cerebral cells, including dopaminergic neurons. Dopaminergic neurons were transplanted into 6 mice with experimentally induced parkinsonism. Symptoms improved and postmortem examinations revealed that the transplanted cells had formed healthy colonies in the brain. The next step will be to create individual cell lines for each mouse (with the same genetic make-up and therefore without the problem of rejection) and to transplant them with the intent of curing the disease.
- 31.
Which I learned from the fine book by Jan H. Van den Berg, Medical Power and Medical Ethics, New York: W. W. Norton and Co., Inc., 1978.
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Zaner, R.M. (2010). A Phenomenological Reflection Conducted Through Narrative: An Essay in Honor of Lester Embree. In: Nenon, T., Blosser, P. (eds) Advancing Phenomenology. Contributions To Phenomenology, vol 62. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-9286-1_17
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