Refusal of organ donation is common, and becoming more frequent. In Australia refusal by families occurred in 56% of cases in 1995 in New South Wales, and had risen to 82% in 1999, becoming the most important determinant of the country's very low organ donation rate .Leading causes of refusal, identified in many studies, include the lack of understanding by families of brain death and its implications, and subsequent reluctance to relegate the body to purely instrumental status. It is an (...) interesting paradox that surveys of the public continue to show considerable support for organ donation programmes—in theory we will, in practice we won't .In this paper we propose that the Australian community may, for good reason, distrust the concept of and criteria for “whole brain death”, and the equation of this new concept with death of the human being. We suggest that irreversible loss of circulation should be reinstated as the major defining characteristic of death, but that brain-dead, heart-beating entities remain suitable organ donors despite being alive by this criterion. This presents a major challenge to the “dead donor rule”, and would require review of current transplantation legislation. Brain dead entities are suitable donors because of irreversible loss of personhood, accurately and robustly defined by the current brain stem criteria."Even the dead are not terminally ill any more.". (shrink)

At 2.00 am on the morning of May 24, 1995 the Northern Territory Legislative Assembly Australia passed the Rights of the Terminally Ill Act by the narrow margin of 15 votes to 10. The act permits a terminally ill patient of sound mind and over the age of 18 years, and who is either in pain or suffering, or distress, to request a medical practitioner to assist the patient to terminate his or her life. Thus, Australia can lay claim to (...) being the first country in the world to legalise voluntary active euthanasia. The Northern Territory's act has prompted Australia-wide community reaction, particularly in South Australia, Tasmania and the Australian Capital Territory where proposals to legalise euthanasia have already been defeated on the floor of parliament. In New South Wales (NSW) the AIDS Council of NSW has prepared draft euthanasia legislation to be introduced into the Upper House as a Private Member's Bill some time in 1996. In this paper, we focus on a brief description of events as they occurred and on the arguments for and against the legalisation of euthanasia which have appeared in the media. (shrink)

Ethical reasoning and decision-making may be thought of as 'professional skills', and in this sense are as relevant to efficient clinical practice as the biomedical and clinical sciences are to the diagnosis of a patient's problem. Despite this, however, undergraduate medical programmes in ethics tend to focus on the teaching of bioethical theories, concepts and/or prominent ethical issues such as IVF and euthanasia, rather than the use of such ethics knowledge (theories, principles, concepts, rules) to clinical practice. Not surprisingly, many (...) students and clinicians experience considerable difficulty in using what they know about ethics to help them make competent ethical decisions in their day-to-day clinical practice. This paper describes the development of a seminar programme for teaching senior medical students a more systematic approach to ethical reasoning and analysis and clinical decision-making. (shrink)

Why do we persist in the relentless pursuit of artificial nourishment and other treatments to maintain a permanently unconscious existence? In facing the future, if not the present world-wide reality of a huge number of persistent vegetative state (PVS) patients, will they be treated because of our ethical commitment to their humanity, or because of an ethical paralysis in the face of biotechnical progress? The PVS patient is cut off from the normal patterns of human connection and communication, with a (...) life unlike other forms of human existence. Why the struggle to justify ending a life which, it is said, has suffered an irreversible loss of the content of consciousness? Elsewhere, the authors have addressed the ethical controversies and confusion engendered by ambiguous terminology, misuse of medical facts and the differing interpretations of what constitutes 'effective' treatment: in particular, the issue of whether in fact artificial nutrition and hydration is a medical treatment, or simply part of the obligatory care owed to all patients, permanently unconscious or not. In this paper, we intend to argue that recent analyses of medical futility, its meaning and ethical implications, despite an absence of public consensus, permit some tentative re-evaluation of our ethical obligations to the PVS patient. (shrink)

Recent literature has highlighted issues of racial discrimination in medicine. In order to explore the sometimes subtle influence of racial determinants in decisions about resource allocation, we present the case of a 53-year-old Australian Aboriginal woman with end-stage renal failure. The epidemiology of renal failure in the Australian Aboriginal population and amongst other indigenous peoples is discussed. We show that the use of utilitarian outcome criteria for resource allocation may embody subtle racial discrimination where consideration is not given to issues (...) of justice, race, culture and gender. It is only where the processes by which resources are allocated are transparent, clearly defined and based upon consultation with individual patients that issues and justice are likely to be adequately addressed. (shrink)

At the University of Newcastle, health law and ethics is taught and assessed in each year of the five-year curriculum. However, the critical question for assessment remains: 'Does teaching ethics have a measurable effect on the clinical activity of medical students who have had such courses?' Those responsible for teaching confront this question each year they sit down to construct their assessment tools. Should they assess what the student knows? Should they assess the student's moral reasoning, that is, what decisions (...) the student makes, and, how these decisions are justified, or should they assess what the student actually does when dealing with patients in the clinical setting, and how he or she does it? From 1982 to 1991, assessment at Newcastle was primarily aimed at determining the quality of the students' ethics knowledge base. This paper describes the strengths and limitations of a purely knowledge-based method of evaluation and why in 1992, we are now attempting to redefine and assess, what we call 'clinical ethical competence' in terms of how students actually apply this knowledge base in a controlled clinical context. (shrink)

In this Symposium on the Ethics and Epistemology of Big Data, we present four perspectives on the ways in which the rapid growth in size of research databanks—i.e. their shift into the realm of “big data”—has changed their moral, socio-political, and epistemic status. While there is clearly something different about “big data” databanks, we encourage readers to place the arguments presented in this Symposium in the context of longstanding debates about the ethics, politics, and epistemology of biobank, database, genetic, and (...) epidemiological research. (shrink)

In this Symposium on the Ethics and Epistemology of Big Data, we present four perspectives on the ways in which the rapid growth in size of research databanks—i.e. their shift into the realm of “big data”—has changed their moral, socio-political, and epistemic status. While there is clearly something different about “big data” databanks, we encourage readers to place the arguments presented in this Symposium in the context of longstanding debates about the ethics, politics, and epistemology of biobank, database, genetic, and (...) epidemiological research. (shrink)

Biomedical innovation and translation are increasingly emphasizing research using “big data.” The hope is that big data methods will both speed up research and make its results more applicable to “real-world” patients and health services. While big data research has been embraced by scientists, politicians, industry, and the public, numerous ethical, organizational, and technical/methodological concerns have also been raised. With respect to technical and methodological concerns, there is a view that these will be resolved through sophisticated information technologies, predictive algorithms, (...) and data analysis techniques. While such advances will likely go some way towards resolving technical and methodological issues, we believe that the epistemological issues raised by big data research have important ethical implications and raise questions about the very possibility of big data research achieving its goals. (shrink)

الفكر، والتَّفكير، والتَّفكُّر، والتَّدبُّر، والتَّذكُّر،... مفاهيمُ أساسية رافقت الوجود الإنساني، منذ بدء الخليقة، وسوف تبقى معه إلى نهايتها، دون أن تثبت مادتها وموضوعاتها ومستوياتها عند حد معين، في حياة الفرد البشري أو الجيل البشري. فكيف يمكن لكتاب أن يستقصي ذلك؟! هذا الكتاب إذاً، مدخل إلى الفكر وحسب؛ مدخل في مفاهيمه ومستوياته وخرائطه... تضمن تجوالاً فكرياً: في موضوع الفكر؛ وفي مصادره في الأصول والتراث والخبرة المعاصرة، وموضوعاته، وأدواته، ونصيب أصناف أهله منه، والمؤسسات المتخصصة فيه، وعلاقته بالعلم جملة، وبالعلوم النفسية والتربوية والاجتماعية (...) واللغوية والسياسية... وهو كذلك مدخل إلى عملية البناء الفكري؛ كيف تبدأ، ثم تتواصل مرحلة بعد أخرى؟ وكيف تترقى من مستوى إلى آخر؟ وكيف تتنوع في المحتوى الذي تبنيه؟ وهو قبل ذلك وبعده، أسئلة كثيرة، وإجابات قليلة؛ فقيمةُ التَّفكُّر في إثارة الأسئلة لا تقلُّ عن التفكر في البحث عن إجاباتها، وبعض الإجابات عارضة مؤقتة، تتغير وتتعمق مع مزيد من الفكْر والذِّكْر، والتَّفكُّر والتَّذكُّر. قد يجد القارئ في الكتاب بعض مواطن المتعة والطرافة، لكنه سوف يجد كذلك مواطن كثيرة تضطره إلى التَّفكُّر والتَّدبُّر، فإذا نجح الكتاب في الأمرين، فذلك ما كان يهدف إليه!. (shrink)

Ghazzālī, 1058-1111; Kīmiyā-yi saʻādat -Criticism and interpretation ; Ghazzālī, Aḥmad ibn Muḥammad, -1126; Savāniḥ -Criticism and interpretation ; Ghazzālī, Aḥmad ibn Muḥammad, -1126; Baḥr al-muḥabbat fī asrār al-muvaddat fītafsīr Sūrah-i Yūsuf -Criticism.

The vacuum structure for the massive charged scalar field in the region of two parallel, infinitely long and thin solenoids confining the fluxesn 1 andn 2 is studied. By using the Green function method, it is found that the vacuum expectation value of the system's energy has a finite mutual interaction term depending on the distance a between the solenoids, which implies an attractive force per unit length given by F n1n2 =−(ℏc/π2)(n 1 n 2)2/a 3.

The first comprehensive treatment of the relationship between biblical interpretation and Christian ethics.