Il conflitto tra ragione e passioni nel pensiero morale, economico e politico di Bernard Mandeville

Effects of the conflict between reason and passion in Bernard Mandeville’s moral, economic and political thought My PhD dissertation focuses on Bernard Mandeville (1670-1732), a Dutch philosopher who moved to London in his late twenties. The aspect of Mandeville’s thought I take into account in my research is the conflicting relation between reason and passions, and the consequences that Mandeville’s view of this conflict has in the development of his theory of human nature which, I argue, is what grounds his moral, economic and, above all, political theory. According to Mandeville, reason is fundamentally weak. Passions influence with more strength human actions, and, eventually, are the ones which motivate them. The role of reason is merely instrumental, restricted to finding appropriate means in order to reach the desired ends, which are capricious and inconstant, since they all come from unstable passions. Reason cannot take decisions meant to act in the long term, pursuing an object which has not a selfish and temporary nature. There is no possibility, thus, that men’s actions aim just to achieve a good and just society, without their interests being directly involved. The basically selfish root of every desire leads Mandeville to claim that there is neither benevolence nor altruism which guides human behaviour. Hence he expresses a judgement on the moral character of human beings, always busy with their self-satisfaction, and hardly ever considering what would be good on a wider perspective, including other people’s sake. The anthropological features ascribed to men by Mandeville, are those which lead him to prefer a political system where governors are not supposed to have particular abilities, either from an intellectual or from a moral point of view, and peace and order are preserved by the bureaucratic machine, which is meant to work with the least effort on the part of the politicians, and no big harm can be done even by corrupted or wicked governors. This system is adopted with an eye at remedying human deficiencies: Mandeville takes into primary account, when he thinks of how to build a peaceful and functioning society, that everyone is concerned with his selfish interest, and that the rationality of a single politician, or of a group of them belonging to a same generation, cannot find a good “solution” to govern men able to last over the long period, and to work in different ages. This implies a refusal of the Hobbesian theory of the pactum subjectionis, which has the character of a rational and definitive choice, and leads Mandeville to consider the order which arises spontaneously, without any plan or rational intervention.

Psychobiological correlates of allostatic load

Introduction: The term Clinimetric was introduced by Feinstein in 1982, who first noticed that despite all the improvements in the assessment methods, a number of clinical phenomena were still unconsidered during the evaluation process. Yet today clinical phenomena, such as stress, relevant in diseases progression and course, are not completely evaluated. Only recently, according to the clinimetric approach, Fava and colleagues have introduced specific criteria for evaluating the allostatic overload in clinical setting. Methods: Participants were 240 blood donors recruited from May 2007 to December 2009 in 4 different blood Centers (AVIS) in Italy. Blood samples from each participant were collected for laboratory test the same day the self-rating instruments were administered (Psychosocial Index, Symptom Questionnaire, Psychological well-being scales, Temperament and Character inventory, Self-Report Altruism scale). The study explore different aspects describing sample characteristics and correlates of stress in the total sample (part I), new selection criteria applied to existing instruments to identify individuals reporting allostatic load (part II), and differences on biological correlates between subjects with vs without AL. Results: Significant differences according to gender and past illnesses have been found in different dimensions of well-being and distress. Further, distress was explained for more than 60% by 4 main factors such as anxiety, somatic symptoms, environmental mastery and persistence. According to the new criteria, 98 donors reported AL. Allostatic load individuals reported to engage in less altruistic behaviours. Also they differ in personality traits and characters from controls. In the last part, results showed significant differences among donors according to allostatic load on diverse biological parameters (RBC, MCV, immune essay). Conclusion: This study presents obvious limitations due to its preliminary nature. Further research are need to confirm that these new criteria may lead to identify high risk individuals reporting not only stressful situations but also vulnerabilities.

Il ruolo della Narrative in Medical Ethics, Medical Practice e Medical Education. Elementi di ricerca

La mia tesi di dottorato ha ad oggetto lo studio e l’analisi del ruolo della Narrative all’interno di tre ambiti, quali Medical Ethics, Clinical Practice e Medical Education. La tesi è strutturata in 4 capitoli: i primi tre vanno a comporre la parte teorica mentre nel quarto capitolo viene riportata una ricerca sul campo da me svolta negli Stati Uniti. Nel primo capitolo, analizzo il ruolo della narrative all’interno della Medical Ethics specificando che cosa si intenda con etica narrativa, quali sono le motivazione alla base del suo sviluppo e chi sono i suoi principali esponenti. In questo capitolo, inoltre, esamino i problemi che l’etica narrativa solleva suggerendo un nuovo modo in cui essa si integra alla riflessione bioetica. Il secondo capitolo è dedicato al contributo della narrative nella Medical Practice investigando sia le modalità attraverso le quali il paziente può avvalersi della narrazione per analizzare la sua esperienza di malattia sia la cosiddetta Medicina Narrativa. Il terzo capitolo è dedicato all'analisi delle Medical Humanities, ossia di quelle discipline che all’interno della Medical Education si stanno rivelando strumenti efficaci per una formazione più equilibrata e completa dei professionisti della salute. Il quarto capitolo, invece, è dedicato alla descrizione di una ricerca svolta presso l’University of California – Irvine . Durante questa esperienza ho frequentato i corsi del Program in Medical Humanities and Arts diretto dalla Prof.ssa J. Shapiro, (programma in vigore da 13 anni e implementato allo scopo di migliorare alcune competenze nei futuri medici quali: l'empatia, l’altruismo, la compassione e la predisposizione alla cura verso i pazienti, oltre che per affinare le comunicazione clinica e la capacità di osservazione) e intervistato gli studenti che hanno preso parte a queste lezioni.