This new edition of Law and Medical Ethics continues to chart the ever-widening field that the topics cover. The interplay between the health caring professions and the public during the period intervening since the last edition has, perhaps, been mainly dominated by wide-ranging changes in the administration of the National Health Service and of the professions themselves but these have been paralleled by important developments in medical jurisprudence.

Mason and McCall Smith's classic textbook discusses the relationship of medical practice and ethics with the operation of the law. The subjects covered include natural and assisted reproduction, the impact of modern genetics on medicine, medical confidentiality, consent to medical treatment, the use of resources and problems surrounding death in the new medical era. It is of significance to anyone with an interest in the ethical and legal practice of medicine.

Medical ethics and medical practice -- Public health and the state-patient relationship -- Health rights and obligations in the European Union -- Consent to treatment -- Liability for medical injury -- Medical confidentiality -- Genetic information and the law -- The management of infertility and childlessness -- The control of fertility -- Civil and criminal liability in reproductive medicine -- Health resources and dilemmas in treatment -- Treatment of the aged -- Mental health and human rights -- The body as (...) property -- Medical futility -- The diagnosis of death -- The donation of organs and transplantation -- Euthanasia and assistance in dying -- Biomedical human research and experimentation -- Research on children, fetuses and embryos. (shrink)

This paper traces the development of parental rights to accept or to refuse treatment for a defective newborn infant in the United Kingdom and in the United States of America; its main purpose is to explore the common trends from which an acceptable policy may be derived. It is probable that the British law on parental decision-making in respect of infants suffering from Down's syndrome is to be found in the civil case of In Re B rather than in the (...) criminal case of R v Arthur. United States court decisions are strongly influenced by constitutional law and reflect the right to personal privacy. The position on each side of the Atlantic seems very similar but this similarity includes a sense of uncertainty as to legal responsibility. There is a case for agreed guidelines and a suggested format is offered for consideration. (shrink)

Recent studies have provided evidence of associations between neurochemistry and reading (dis)ability (Pugh et al., 2014). Based on a long history of studies indicating that fluent reading entails the automatic convergence of the written and spoken forms of language and our recently proposed Neural Noise Hypothesis (Hancock et al., 2017), we hypothesized that individual differences in cross-modal integration would mediate, at least partially, the relationship between neurochemical concentrations and reading. Cross-modal integration was measured in 231 children using a two-alternative forced (...) choice cross-modal matching task with three language conditions (letters, words, and pseudowords) and two levels of difficulty within each language condition. Neurometabolite concentrations of Choline (Cho), Glutamate (Glu), gamma-Aminobutyric (GABA), and N- acetyl-aspartate (NAA) were then measured in a subset of this sample (n = 70) with Magnetic Resonance Spectroscopy (MRS). A structural equation mediation model revealed that the effect of cross-modal word matching mediated the relationship between increased Glu (which has been proposed to be an index of neural noise) and poorer reading ability. In addition, the effect of cross-modal word matching fully mediated a relationship between increased Cho and poorer reading ability. Multilevel mixed effects models confirmed that lower Cho predicted faster cross-modal matching reaction time, specifically in the hard word condition. These Cho... (shrink)

Principles of justice, David Estlund argues, cannot be falsified by people’s unwillingness to satisfy them. In his Utopophobia, Estlund rejects the view that justice must bend to human motivation to deliver practical implications for how institutions ought to function. In this paper, I argue that a substantive argument against such bending of justice principles must challenge the reasons for making these principles sensitive to motivational limitations. Estlund, however, provides no such challenge. His dispute with benders of justice is therefore a (...) verbal one over the true meaning of justice, which need not worry those with the intuition that justice should perform a function that requires bending. By focusing on John Rawls’s reasons for bending his justice principles, I point towards a substantive critique of bent justice. (shrink)

This chapter clarifies important component of alignment in character creation and development. It demonstrates an application of moral philosophy and introduces ethical dilemmas that allow players to make meaningful moral choices leads to a more rewarding gaming experience. The chapter highlights philosophy's most enduring and frustrating questions. According to Dungeons Dragons (DD), the alignment is an element of the player's character sheet that clarifies their worldview and moral outlook. It is also a category that can limit character class and an (...) aura that allows spells or abilities to detect a character's moral outlook – and if necessary “smite” that evil (or good) into oblivion. The DD attracts imaginative players. A party is likely be filled with virtuous paragons, nefarious knaves, and pragmatists. (shrink)

Public reason liberals expect individuals to have justificatory reasons for their views of certain political issues. This paper considers how groups can, and whether they should, give collective public reasons for their political decisions. A problem is that aggregating individuals’ consistent judgments on reasons and a decision can produce inconsistent collective judgments. The group will then fail to give a reason for its decision. The paper considers various solutions to this problem and defends a deliberative procedure by showing how it (...) incentivizes information sharing and leads to outcomes most acceptable to the group members. (shrink)

This chapter contains sections titled: Why a Philosophy of Fatherhood? Role Responsibilities Autonomy Autonomy and Fatherhood Conclusion Notes.

According to group-agent realism, treating groups as agents with their own intentional states, irreducible to those of the group members, helps us explain and predict the groups’ behavior. This pap...

A moralised conception of freedom is based on a normative theory. Understanding it therefore requires an analysis of this theory. In this paper, I show how republican freedom as non-domination is moralised, and why analysing this concept therefore involves identifying the basic components of the republican theory of justice. One of these components is the non-moralised pure negative conception of freedom as non-interference. Republicans therefore cannot keep insisting that their freedom concept conflicts with, and is superior to, this more basic (...) concept. I demonstrate how we can use pure negative freedom to formulate the republican theory more precisely. This exercise is more fruitful than the common focus on the alleged conflict between the two freedom concepts. (shrink)

_Practical Bioethics_ offers a mix of theory and readings, presented in a format that is succinct and approachable. Each chapter begins and ends with a case study, illustrating the core issues at play and emphasizing the practical nature of the dilemmas arising in medicine. Primary source texts are provided to flesh out the issues, and each of these is carefully edited and presented with interwoven explanatory comments to assist student readers. Throughout, J.K. Miles shows the importance of health-care ethics to (...) us all, whether we be medical providers, patients, or both. (shrink)

John Rawls thinks republicanism is compatible with his political liberalism. Philip Pettit insists that the two conflict in important ways. In this paper, I make sense of this dispute by employing David Chalmers’s method of elimination to reveal the meaning underlying key terms in Rawls’s political liberalism and Pettit’s republicanism. This procedure of disambiguating terms will show how the two theories defend the same institutional arrangement on the same grounds. The procedure thus vindicates Rawls’s view of the two theories being (...) compatible. The reason for this compatibility is that both theories are politicized—that is, they are constructed to attract the compliance of all reasonable members of a modern, pluralistic society. (shrink)

A longitudinal, epidemiological study was carried out in a rural area of Kenya with a population of about 28,000 between 1974 and 1980. Population registration during this time showed that population growth was very high between 1974 and 1978 (4·4% per year) and much lower in 1979 and 1980 (1·1%). Natural increase was nearly as high as in Kenya as a whole (3·7%) in this period. Fertility was somewhat lower than in all Kenya (the crude birth rate was 46 per (...) 1000) while mortality was substantially lower (7 per 1000). Evidence is presented supporting the argument that these low mortality rates are genuine. Levels of temporary and permanent migration are high and probably characteristic for many parts of Kenya. The change in population growth in 1979 and 1980 is probably due to changes in economic conditions leading in particular to less in-migration and to more out-migration. (shrink)

A set is said to be amorphous if it is infinite, but is not the disjoint union of two infinite subsets. Thus amorphous sets can exist only if the axiom of choice is false. We give a general study of the structure which an amorphous set can carry, with the object of eventually obtaining a complete classification. The principal types of amorphous set we distinguish are the following: amorphous sets not of projective type, either bounded or unbounded size of members (...) of partitions of the set into finite pieces), and amorphous sets of projective type, meaning that the set admits a non-degenerate pregeometry, over finite fields either of bounded cardinality or of unbounded cardinality. The hope is that all amorphous sets will be of one of these types. Examples of each sort are constructed, and a reconstruction result for bounded amorphous sets is presented, indicating that the amorphous sets of this kind constructed in the paper are the only possible ones. The final section examines some questions concerned with the resulting cardinal arithmetic. (shrink)

Originally published in 1926, this book attempts to state 'what has been believed with regard to God's incapacity for suffering'. Mozley charts the development of the doctrine from the Apostolic Fathers through the Reformation to the modern influence of metaphysical philosophy and concludes with six questions intended to prompt further theological discussion on this point. This book will be of value to anyone with an interest in the history of Christian theology.

This article revisits long-standing questions about consent, membership and emigration in Locke’s thought. Commentators such as A John Simmons have argued that Locke opens political membership to both express consenters and some kind of tacit consenters, and not just to the former, as some have suggested. Simmons’s reading seems to render Locke more sensible in that it does not exclude large numbers of people from membership or burden the few members with all the civic duties, and also in that it (...) allows at least tacit-consenting members the right to relocate, while this right is denied to express-consenting members. Against this reading, the article shows, by resolving seemingly conflicting claims in the text, that people become members only by express consent. It also responds to the criticism that the express-consent-only reading would limit membership to a few and so would render Locke’s account implausible from a practical point of view. The article then addresses the purported restriction Locke imposes on express consenters’ right to emigrate, arguing that the restriction concerns the change of membership and not the right to relocate. (shrink)

Recently, new developments took place in the Dutch debate on the legislation of euthanasia. After a brief account of that debate, the article discusses a new government proposal for legislation in this field, which was submitted to the Dutch parliament in November 1991. This proposal relates not only to euthanasia but also to some other medical decisions concerning the end of life. The author concludes that, for several reasons, it is unsatisfactory.

In this paper I describe and analyze an economic situation involving two competitive organizations. I put forth the argument that because of the systemic nature of decision making relative to managing the requirements of utilizing a descriptive equation that determines how many people an economic system can support, that even if all the players in the situation act ethically, the results will still be harmful, and necessarily so, to the system and to many innocent people. I will demonstrate that harming (...) innocent people is required and morally defensible given the choices available. The best one can do is slow down the increase in disutilities and possibly operate the system within a range of acceptable behavior that minimizes the resulting harm to innocent people, even if we cannot entirely remove this harm. In this context ethics becomes the study of the acceptable as opposed to the preferable. (shrink)

This paper examines mortality by cause of death in a rural area of Machakos district in Kenya. The cause-of-death data collected between 1975 and 1978 were likely to be of fairly good quality. The number of deaths was higher among infants and children. Infectious diseases and diseases of the respiratory system were the leading causes of death among children below 5 years of age. Next in prominence were the causes ascribed to congenital anomalies and perinatal conditions.Among adolescents and young adults, (...) injury and poisoning, together with tuberculosis and other infectious and parasitic diseases, were the leading causes of death. Degenerative diseases, especially diseases of the circulatory system and neoplasms and respiratory illness, were responsible for the majority of deaths among the older population. (shrink)

Recent scholarship on technology-induced ‘conceptual disruption’ has spotlighted the notion of a conceptual gap. Conceptual gaps have also been discussed in scholarship on epistemic injustice, yet up until now these bodies of work have remained disconnected. This article shows that ‘gaps’ of interest to both bodies of literature are closely related, and argues that a joint examination of conceptual disruption and epistemic injustice is fruitful for both fields. I argue that hermeneutical marginalization—a skewed division of hermeneutical resources, which serves to (...) diminish the experiences of marginalized folk—does not only transpire because of conceptual gaps, but also because of two other kinds of conceptual disruption: conceptual overlaps and conceptual misalignments. Hence, there are multiple kinds of conceptual disruption that can be usefully studied through the normative lens of epistemic injustice. Technology can play different roles vis-a-vis epistemic injustices, both as a causal trigger of conceptual disruption, but also as a mediator of hermeneutical resources. Its role is normatively significant, in particular because socially disruptive technologies can have different epistemic implications for different groups: they may amplify the epistemic resources of some groups, while diminishing those of others. (shrink)

The literature on collective action largely ignores the constraints that moral principle places on action-prompting intentions. Here I suggest that neither individualism nor holism can account for the generality of intentional contents demanded by universalizability principles, respect for persons, or proactive altruism. Utilitarian and communitarian ethics are criticized for nominalism with respect to social intentions. The failure of individualism and holism as grounds for moral theory is confirmed by comparing Tuomela's reductivist analysis of we-intentions with Gilbert's analysis of social facts. (...) Tuomela's account founders over intentions to cooperate, and Gilbert's cannot accommodate legitimate authority, vicarious agency, or group structure. (shrink)

Background: The American Medical Association, the British Medical Association and the Canadian Medical Association have guidelines that specifically discourage physicians from self-prescribing or prescribing to family members, but only the BMA addresses informal prescription requests between colleagues. Objective: To examine the practices of paediatric providers regarding self-prescribing, curbsiding colleagues, and prescribing and refusing to prescribe to friends and family. Methods: 1086 paediatricians listed from the American Academy of Paediatrics 2007 web-based directory were surveyed. Results: 44% of eligible survey respondents returned (...) usable surveys. Almost half of respondents had prescribed for themselves. An equal number had informally requested a prescription from a colleague. Three-quarters stated they had been asked to prescribe a prescription drug for a first-degree or second-degree relative, and 51% had been asked by their spouse. Eighty-six per cent stated that they had refused to write a prescription on at least one occasion for a friend or family member. The following reasons “strongly influenced” their decision to refuse a prescription request: outside of provider’s expertise ; patient’s need for his or her own physician ; not medically indicated ; need for a physical examination. Conclusion: These data confirm that most physicians have engaged in self-prescribing or curbside requests for prescriptions. It can be argued that curbsiding is more morally problematic than self-prescribing because it implicates a third party, and should be discouraged regardless of whether the requester is a colleague, family member or friend. (shrink)

_Despite advances in standard of living of the population, the condition of widows and divorced women remains deplorable in society. The situation is worse in developing nations with their unique social, cultural and economic milieu, which at times ignores the basic human rights of this vulnerable section of society. A gap exists in life expectancies of men and women in both developing and developed nations. This, coupled with greater remarriage rates in men, ensures that the number of widows continues to (...) exceed that of widowers. Moreover, with women becoming more educated, economically independent and aware of their rights, divorce rates are increasing along with associated psychological ramifications. The fact that widowed/divorced women suffer from varying psychological stressors is often ignored. It has been concluded in various studies that such stressors could be harbingers of psychiatric illnesses (e.g., depression, anxiety, substance dependence), and hence should be taken into account by treating physicians, social workers and others who come to the aid of such women. A change in mindset of the society is required before these women get their rightful place, for which a strong will is needed in the minds of the people, and in law-governing bodies._. (shrink)