The purpose of this paper is to propose a model of clinical-ethical decision making which will assist the health care professional to arrive at an ethically defensible judgment. The model highlights the integration between ethics and decision making, whereby ethics as a systematic analytic tool bring to bear the positive aspects of the decision making process. The model is composed of three major elements. The ethical component, the decision making component and the contextual component. The latter incorporates the relational aspects (...) between the provider and the patient and the organizational structure. The model suggests that in order to arrive at an ethically, justifiable sound decision one make reference to those three elements. (shrink)

The moral justification of intellectual property is often called into question when placed in the context of pharmaceutical patents and global health concerns. The theoretical accounts of both John Rawls and Robert Nozick provide an excellent ethical framework from which such questions can be clarified. While Nozick upholds an individuals right to intellectual property, based upon its conformation with Lockean notions of property and Nozicks ideas of just acquisition and transfer, Rawls emphasizes the importance of basic liberties, such as an (...) individuals right to health, superceding such secondary rights as intellectual property rights. From a policy perspective, patent protection for pharmaceutical products necessarily entails the balancing of corporate intellectual property interests and public interests in healthcare. The moral dilemma that occurs when these two interests clash is not easily resolved. Aside from corporate and public interests, the state maintains an interest in creating and preserving policies that regulate the moral dilemma itself. This paper analyzes the economic and ethical factors surrounding the production and distribution of the anti-HIV medication, AZT. Potential policy implications and recommendations are also discussed. (shrink)

This paper investigates connections between procreative ethics and the ethics of suicide and euthanasia. While there are good reasons for distinguishing between lives worth starting and lives worth continuing, I argue that those reasons provide no reason for denying that there is a relationship between procreative and end of life ethics. Regarding euthanasia/assisted suicide, we might think it too demanding to ask parents to help euthanize their terminally ill, suffering child, but had the parents not procreated, thereby exposing their child (...) to life's risks, their child wouldn't need euthanizing. If you need help killing yourself, shouldn't your parents, who got you into life in the first place – without your consent – help you out of it? Yet knowing that your parents would help you kill yourself may increase your desire to die. A conundrum. Regarding suicide, the fact that we are forced into life should bolster the right to suicide, even for reasons that others might find wanting. The ways in which we are brought into life have moral implications for the ways in which we are entitled to get out of it. (shrink)

En este libro se recopilan escritos producidos por el profesor García Amado durante los últimos años. La temática es muy variada: teoría de la argumentación jurídica y de la decisión judicial, interpretación del Derecho, crítica del neoconstitucionalismo y examen de sus raíces doctrinales, debates a propósito de Kelsen y el positivismo, puesta en cuestión de la enseñanza del Derecho y de sus reformas actuales, reflexiones sobre tendencias del Derecho penal contemporáneo, balance de algunos autores y temas de la filosofía (...) política de nuestro tiempo, Derecho y cine, etc. Todo ello con el estilo habitual del autor polémico, provocativo y con cierta ironía e irreverancia. (shrink)

The ArgumentThe remarkable progress in modern genetic technology enables the identification of genes causing devastating diseases and thereby the development of tools for prenatal diagnosis and carrier detection. To implement the results of genetic research in traditional societies, where genetic diseases are more prevalent due to inbreeding, necessitates a culturally appropriate approach that also promotes traditional and societal values important to the relevant community. This paper presents our experience with implementing the results of modern genetic research among the traditional community (...) of the Negev Bedouin of Israel. Although the benefit of using those results for the prevention of genetic diseases seems obvious, successful implementation relies on a carefully designed educational program aimed at changing culturally related attitudes and perceptions. Such a program should attend to the needs of the community and be sensitive to its traditional values. (shrink)

This paper suggests that medical education should redirect resources to values education, specifically developing new strategies to improve the process of clarification of values. The author suggests using the values journal method which is based on a systematic record of students' personal value systems reflected in their stories and life experience; and on their responses to case presentation. Generating a personal values journal helps students define who they are, what their social and professional roles are, what their expectations are and (...) where they are going. Keeping values journals promotes students' decision-making capacity, and equips them with the necessary skills to teach their future patients how to generate their own value systems. The development of a well defined values journal is a preparatory stage for active participation in clinical conferences or group discussion, and for effective communal dialogue among the group's members. (shrink)

BackgroundVaccination against human papillomavirus (HPV) is a pivotal tool for preventing a significant cause of cervical cancer. One particular culturally recognized context associated with negative attitudes toward the HPV vaccine is the religiousness of parents. However, relatively speaking, there remains a scarcity of studies that have focused specifically on religious groups, especially non-Christian groups. PurposeTo better understand the basis for members of an ultra-Orthodox Jewish community to object to the HPV vaccine and how such objections can and cannot be reduced, (...) thereby improving cultural competence—namely, the cultural understanding and ethical addressing of HPV vaccination refusal. MethodsThis qualitative study conducted semi-structured interviews with ten Israeli ultra-Orthodox mothers who are opposed to administering the HPV vaccine to their daughters. The content analysis addressed these results and extracted the major issues arising from these particular interviews. ResultsFour main novel insights were found pertaining to the negative stance toward HPV vaccination among mothers in an ultra-Orthodox Jewish community: (a) lack of knowledge about the HPV vaccine is not part of the reasoning against it; (b) rabbinical authority might have a lesser influence than expected for the moderation of HPV vaccine refusal; (c) complicated viewpoints regarding childhood vaccination may be the larger non-moderating context for HPV vaccination refusal; and (d) cultural competence is important for the ability to change the negative attitudes toward HPV vaccination. ConclusionsThe study may improve cultural competence regarding HPV vaccination and contribute to decreasing objections to the HPV vaccine in ultra-Orthodox communities. (shrink)

Teleological theories of reason and value, upon which all reasons are fundamentally reasons to realize states of affairs that are in some respect best, cannot account for the intuition that victims in non-identity cases have been wronged. Many philosophers, however, reject such theories in favor of alternatives that recognize fundamentally non-teleological reasons, second-personal reasons that reflect a moral significance each person has that is not grounded in the teleologist’s appeal to outcomes. Such deontological accounts appear to be better positioned to (...) identify the wrong committed against non-identity victims because a person wrongs another on such accounts if she violates his second-personal claims -- overall benefit to victims presents no obstacle to the identification of second-personal wrongdoing. Derek Parfit argues that non-identity is a problem for these deontological theories as well because the alleged victims are properly understood as consenting to the action in question, thereby waiving any such second-personal claim. But his arguments misrepresent the role of consent on such theories by articulating it through appeal to the very teleological theory of reasons that their advocates dismiss as inadequate. Properly understood, Parfit’s appeal to consent understood as retroactive endorsement only provides the answer on such deontological accounts to the question of whether, given that the non-identity victim is second-personally wronged, he is nonetheless better off existing. Indeed, it becomes clear that it is teleological theories for which non-identity poses a particular problem: they cannot -- while their deontological counterparts can – account for the intuition that non-identity victims have been wronged. (shrink)

O conhecimento cientifico; Natureza do conhecimento cientifico; O metodo cientifico; A pesquisa: nocoes gerais; Fases de uma pesquisa; Como proceder a investigacao; Como transmitir os conhecimentos adquiridos; Tecnicas especiais.

Having children is probably as old as the first successful organism. It is often done thoughtlessly. This book is an argument for giving procreating some serious thought, and a theory of how, when, and why procreation may be permissible.Rivka Weinberg begins with an analysis of the kind of act procreativity is and why we might be justifiably motivated to engage in it. She then proceeds to argue that, by virtue of our ownership and control of the hazardous material that (...) is our gametes, we are parentally responsible for the risks we take with our gametes and for the persons that develop when we engage in activity that allows our gametes to unite with others and develop into persons. Further argument establishes that when done respectfully, and in cases where the child's chances of leading a life of human flourishing are high, procreation may be permissible. Along the way, Weinberg argues that the non-identity problem is a curiously common mistake. Arguments intending to show that procreation is impermissible because life is bad for people and imposed on them without their consent are shown to have serious flaws. Yet because they leave us with lingering concerns, Weinberg argues that although procreation is permissible under certain conditions, it is not only a welfare risk but also a moral risk. Still, it is a risk that is often permissible for us to take and impose, given our high level of legitimate interest in procreativity. In order to ascertain when the procreative risk is permissible to impose, contractualist principles are proposed to fairly attend to the interests prospective parents have in procreating and the interests future people have in a life of human flourishing. The principles are assessed on their own merits and in comparison with rival principles. They are then applied to a wide variety of procreative cases. (shrink)

Cet exercice historiographique se propose de suivre le cheminement du thème des femmes - femmes nobles aux XIe et XIIe siècles : - dans l’œuvre de Georges Duby, plus précisément dans son cours, son séminaire et ses publications. Trois phases peuvent être identifiées entre 1953 (année de la parution de sa thèse sur le Mâconnais) et 1996 (année de la publication de la trilogie Dames du XIIe siècle, année de sa mort). 1) 1953-1973 : les questions liées à la condition (...) féminine ont d’abord existé à l’état de questions éparses formulées dans les écrits sur l’aristocratie. 2) 1973-1980 : elles se dessinent plus fermement, avec l’enquête sur les structures familiales et le mariage. 3) 1980-1996 : elles se dégagent du thème de la parenté pour occuper la place centrale, et sont étudiées dans deux directions : la condition des femmes et la sainteté féminine. (shrink)

Cet exercice historiographique se propose de suivre le cheminement du thème des femmes - femmes nobles aux XIe et XIIe siècles : - dans l’œuvre de Georges Duby, plus précisément dans son cours, son séminaire et ses publications. Trois phases peuvent être identifiées entre 1953 (année de la parution de sa thèse sur le Mâconnais) et 1996 (année de la publication de la trilogie Dames du XIIe siècle, année de sa mort). 1) 1953-1973 : les questions liées à la condition (...) féminine ont d’abord existé à l’état de questions éparses formulées dans les écrits sur l’aristocratie. 2) 1973-1980 : elles se dessinent plus fermement, avec l’enquête sur les structures familiales et le mariage. 3) 1980-1996 : elles se dégagent du thème de la parenté pour occuper la place centrale, et sont étudiées dans deux directions : la condition des femmes et la sainteté féminine. (shrink)

Parmi les séminaires que Georges Duby dirigea toute sa vie, ceux de Sénanque occupent une place particulière. Pendant trois ans, entre 1981 et 1983, il réunit des universitaires et des chercheurs autour de questions spécifiquement liées à l’histoire de la vie privée. L’Association des Amis de Sénanque (et en son sein le Cercle d’Etudes Médiévales) assurait la bonne organisation matérielle. Son directeur, Emmanuel Muheim, accueillait dans l’abbaye cistercienne provençale, pendant quelques jour..

Parmi les séminaires que Georges Duby dirigea toute sa vie, ceux de Sénanque occupent une place particulière. Pendant trois ans, entre 1981 et 1983, il réunit des universitaires et des chercheurs autour de questions spécifiquement liées à l’histoire de la vie privée. L’Association des Amis de Sénanque (et en son sein le Cercle d’Etudes Médiévales) assurait la bonne organisation matérielle. Son directeur, Emmanuel Muheim, accueillait dans l’abbaye cistercienne provençale, pendant quelques jour...

La Transición constituye una etapa clave en la configuración del presente histórico del alumnado y su comprensión, por ello, su inclusión en el proceso de enseñanza-aprendizaje adquiere un interés particular. El presente trabajo tiene como objetivo analizar cómo se articula la enseñanza de esta etapa histórica en los libros de texto. El marco de estudio se acota a los manuales de 2º de Bachillerato en Galicia, sobre los que se realiza un análisis didáctico e historiográfico. El estudio recoge, en el (...) campo didáctico, una falta generalizada de adaptación a las particularidades de la Historia del presente, sin apostar por un aprendizaje significativo. En el historiográfico se revela la misma carencia, así como la hegemonía del relato tradicional, caracterizado por el consenso y la Historia política, personalista, determinista y positiva, sin problematización ni alusión a las propuestas alternativas, el conflicto o la correlación de fuerzas. (shrink)

Sperm donation is a widely accepted and increasingly common practice. In the standard case, a sperm donor sells sperm to an agency, waives his parental rights, and is absolved of parental responsibility. We tend to assume that this involves no problematic abandonment of parental responsibility. If we regard the donor as having parental responsibilities at all, we may think that his parental responsibilities are transferred to the sperm recipients. But, if a man creates a child accidentally, via contraception failure, we (...) tend to assume that the man does indeed have parental responsibilities. Assessing these contrasting conclusions requires a theory of parental responsibility. I analyze prevalent theories of what makes someone parentally responsible and show that none of these theories can withstand scrutiny. I propose a new theory of parental responsibility, which, I argue, is more plausible than the alternatives. My theory of parental responsibility is based on our ownership and control over hazardous materials, namely, our gametes. I show that neither my theory, nor the theories I reject, can support our contrasting intuitions. I conclude that sperm donors are fathers, with parental responsibility. I argue that the alternative conclusion, that neither sperm donors nor accidental fathers are parentally responsible for their resulting offspring, is less plausible. I then consider whether parental responsibility can be transferred and argue that it is far from clear that it can. Finally, I address objections and consider some practical implications of these views. (shrink)

Philosophers concerned with procreative ethics have long been puzzled by Parfit’s Non-Identity Problem (NIP). Various solutions have been proposed, but I argue that we have not solved the problem on its own narrow person-affecting terms, i.e., in terms of the identified individuals affected by procreative decisions and acts, especially future children. Thus, the core problem remains unsolved. This is a nagging concern for all who hold the common intuition that actions that harm no one are permissible. I argue against Harmon’s (...) and Woodward’s direct, narrow person-affecting solutions, and in favor of a new solution to the NIP. My solution, or, rather, dissolution, is based on the argument that merely possible people, i.e., hypothetical people who could possibly, but will not actually, exist, are morally irrelevant. I show that the NIP only arises when we concern ourselves with merely possible people. Once we are careful to restrict our concerns to only those that do or will exist, the NIP is dissolved. (shrink)

Life is pointless. That’s not okay. I show that. I argue that a point is a valued end and that, as agents, it makes sense for us to want our efforts and enterprises to have a point. Valued ends provide justifying reasons for our acts, efforts, and projects. I further argue that ends lie separate from the acts and enterprises for which they provide a point. Since there can be no end external to one’s entire life since one’s life includes (...) all of one’s ends, leading and living one’s life as a whole cannot have a point. Finally, I argue that since we live our lives and structure our living­a­human­life efforts both in parts and as a whole, it is fitting to be sad to recognize that leading and living a life is pointless. My discussion helps make sense of the literature that frequently talks around this topic but often does so vaguely and indirectly. (shrink)

Life stinks. Mel Brooks knew it, David Benatar knows it,1 and so do I. Even when life does not stink so badly, there’s always the chance that it will begin to do so. Nonexistence, on the other hand, is odor free. Whereas being brought into existence can be harmful, or at least bad, nonexistence cannot be harmful or bad. Even if life is not clearly bad, it is at the very least extremely risky. David Benatar argues, somewhat notoriously, that since (...) it is better never to exist, one is harmed by being brought into existence and, therefore, procreation is likely always wrong and certainly always morally problematic. (shrink)

One might think that parental obligation to children ends with the end of childhood. I argue that if we consider why parents are obligated to their children, we will see that this view is false. Creating children exposes them to life’s risks. When we expose others to risks, we are often obligated to minimize damages and compensate for harms. Life’s risks last a lifetime, therefore parental obligation to one’s children does too. Grown children’s autonomy, and grown children’s independent responsibility for (...) some of their own problems, can sometimes limit what parental responsibility demands of parents but it doesn’t do away with the responsibility. I argue that my conclusions are not as counterintuitive as they might initially seem. I also consider the implications that parental obligation to grown children might have on the oft assumed obligation that grown children have to care for their parents. (shrink)

The ArgumentIn this paper, I argue that the most significant contribution of the Jesuits to early modern science consists in the introduction of a new “image of knowledge.”In contradistinction to traditional Scholasticism, this image of knowledge allows for the possibility of a science of hypothetical entities.This problem became crucial in two specific areas. In astronomy, knowledge of mathematical entities of unclear ontological status was nevertheless proclaimed certain. In theology, God's knowledge of the future acts of man, logically considered as future (...) contingents, was also proclaimed certain. In both cases the concept of certain knowledge of hypothetical entities was problematic and challenged a central premise of the accepted canons of logic, i.e., that the objects of true knowledge must be real objects.The main argument of this paper is that the practical orientation of the Jesuit cultural milieu enabled Jesuit scientists and theologians to ignore accepted logical considerations and to modify traditional Thomist images of knowledge. Nevertheless, this modification was not so radical as to change the contemporary organization of knowledge. This was due to the peculiar status of the Jesuits within the church establishment, which exposed them to harsh criticism and created a deep need for legitimation. Thus, the limitations of Jesuit scientific culture are accounted for in institutional, rather than in logical terms. (shrink)

Una teoría iusmoralista no puede dejar de basarse en el objetivismo moral, mientras que una teoría iuspositivista puede ser defendida por objetivistas y no objetivistas. Se examinan las consecuencias que el iusmoralismo tiene para la teoría de la validez de las normas jurídicas y para su aplicabilidad en los casos concretos y se revisan las asimetrías y aporías a que conduce cualquier teoría iusmoralista. Finalmente, se subraya que los iusmoralistas discrepan entre sí radicalmente sobre los contenidos de la moral verdadera (...) y del derecho justo y que sólo un enfoque iuspositivista es compatible con el estado constitucional y democrático de derecho. (shrink)

In formulating procreative principles, it makes sense to begin by thinking about whose interests ought to matter to us. Obviously, we care about those who exist. Less obviously, but still uncontroversially, we care about those who will exist. Ought we to care about those who might possibly, but will not actually, exist? Recently, unusual positions have been taken regarding merely possible people and the non-identity problem. David Velleman argues that what might have happened to you – an existent person – (...) often doesn't merit moral consideration since the alternative person one would have been had what might have happened actually happened is a merely possible person about whom one has no reason to care. He argues that his way of thinking can eliminate the non-identity problem. Caspar Hare argues that merely possible people have interests and are morally relevant. He argues that we can solve the non-identity problem by rejecting the view that merely possible people are morally irrelevant. Both Hare and Velleman argue that focusing on one's de dicto rather than on one's de re children can help us avoid the non-identity problem. I analyze the role that merely possible, nonexistent hypothetical entities ought to play in our moral reasoning, especially with regard to procreation. I refute both Velleman's and Hare's views and demonstrate the difficulties we encounter when we try to apply their views to common non-identity cases. I conclude with the common-sense view regarding who matters, morally: only those who do, did, or will exist. (shrink)

The ArgumentThis paper, an attempt at an institutional history of ideas, compares patterns of reproduction of scientific knowledge in Catholic and Protestant educational institutions. Franciscus Eschinardus'Cursus Physico-Mathematicusand Jean-Robert Chouet'sSyntagma Physicumare examined for the strategies which allow for accommodation of new contents and new practices within traditional institutional frameworks. The texts manifest two different styles of inquiry about nature, each adapted to the peculiar constraints implied by its environment. The interpretative drive of Eschinardus and a whole group of “modern astronomers” is (...) here seen as pushing beyond the traditional task of “saving the phenomena,” towards celestial hermeneutics which is thoroughly experimental and mathematical. In spite of the insistence on physical interpretation of celestial phenomena, Eschinardus' astronomical discourse is yet constrained by a complex game of intellectual-political considerations. Commitment to the Thomistic organization of knowledge, which sets a boundary between a science of motion and the “geometry of heavens”, suppresses any impulse to ask about the mechanical causes of celestial appearances. The Copernican cosmology is thus rejected qua an attempt to cross this guarded boundary. Chouet in Geneva, by contrast, frees himself from these constraints on the organization of natural knowledge. By strictly separating philosophy from theology, he can combine physics and astronomy, favor a Copernican cosmology and adopt a Cartesian mechanistic worldview. Moreover, unlike the Jesuit Eschinardus, Chouet seeks toexplainnatural phenomena in terms of causes, rather than justinterpretthem. Yet he does so within a philosophical discourse largely scholastic in nature, which best suits the conservative institutional framework in which he teaches. Whereas the Jesuit Eschinardus employs a new type of discourse without severing his links with the traditional Thomistic worldview, the Calvinist Chouet adopts a new Cartesian worldview and adapts it to a largely traditional type of discourse. (shrink)