Clinical ethics support, including ethics consultation, has become established in the field of medical practice throughout the world. This practice has been regarded as useful, most notably in the UK and the USA, in solving ethical problems encountered by both medical practitioners and those who receive medical treatment. In Japan, however, few services are available to respond to everyday clinical ethical issues, although a variety of difficult ethical problems arise daily in the medical field: termination of life support, euthanasia and (...) questions about patient autonomy. In light of these conditions, a group of 17 volunteer educators and researchers from the area of biomedical ethics, including the authors, have formed the Clinical Ethics Support and Education Project, and began providing Japan’s first small team clinical ethics consultation service in October, 2006. Members include scholars of biomedical ethics, scholars of philosophy and ethics, legal professionals and legal scholars, nurses and doctors, consisting of five women and 12 men. Consultation teams, made up of a small number of members, were organised each time a request for consultation was received. Over approximately 15 months (October 2006–December 2007), the programme received 22 consultation requests from medical practitioners and medical institutions, and three from the families of patients. In this paper, we will discuss the status of our consultation service and examples of consultation cases we have handled. In addition, we will examine the process of evaluating small team clinical ethics consultation services, as well as the strengths and weakness of such programmes. (shrink)

Despite the end of the Cold War and the ascendancy of liberal democracy celebrated by Francis Fukuyama as “the end of history”, a growing number of scholars and political activists point to its inherent shortcomings. However, they have tended to dismiss it on the basis of one or two of its salient weaknesses. While this is a justifiable way to proceed, it denies the searching reader an opportunity to see the broad basis for the growing rejection of liberal democracy (...) among African political theorists. Consequently, in this article, I argue that from an African perspective, the almost hegemonic status of liberal democracy can be challenged on at least five grounds, namely, logical inconsistency, impracticability due to the largely communalistic outlook of many africans, inconsistency between affirmation and action, violation of the right to ethnic identity, and the moral imperative to assert the right to cultural emancipation. -/- I conclude by calling upon African and Africanist political theorists to utilise indigenous African political thought, coupled with emancipatory aspects of political thought from other parts of the world, to design practicable models of democracy for contemporary African states. I further conclude that in order to promote genuine inter-cultural dialogue on democratisation, people from Western cultures ought to acknowledge the equality of all cultures, and to recognise that systems of governance are part and parcel of those cultures. (shrink)

Does the philosophy of history have a future? In 1949 Karl Jaspers, echoing Hegel, still identified history as the “great question” in philosophy; but in 1966 Karl Löwith observed that the philosophy of history had been reduced to little more than “epochal consciousness.” During the 1970s analytical philosophers endorsed the critical-speculative distinction of C. D. Broad and the question of universal history was effectively bracketed. Post-structuralists and feminists during the 70s and 80s endorsed the observation of Michel Foucault that history (...) is “the Western myth” and, more recently in 1989, Francis Fukuyama proclaimed the “end of history.” In this essay I explore some of the developments contributing to the marginalization of the philosophy of history during the latter half of the twentieth century. Following this, I offer some comments regarding the persistence of the question of universal history. (shrink)

Bu çalışma ilkin, ütopyacı düşünceye karşı istikrarlı bir muhalefet yürüten liberal düşüncenin sağ kanadındaki Karl Popper ve Francis Fukuyama gibi kanonik isimlerin yaklaşımlarının, zamanın sosyo-ekonomik gelişmelerinin katkısıyla genel siyaset düşüncesinin ana akımına bürünmesi sürecini ve ütopyaya ilişkin fikirlerini değerlendirecektir. Bir kez müesses nizam haline geldiği vakit menşeindeki ütopyacı niteliklerin hilafına değişimin ancak tedricen olması gerektiğini ve aksini savunan siyasal tavır alışların da yersiz radikalizmle malul siyaset dışı yönelimler olduğunu iddia eden ana akım liberal çizginin savunucuları olarak Popper ve (...) class='Hi'>Fukuyama, bu çizgilerini radikal bir antikomünizmle taçlandırmışlardır. Aynı çizgide bu kez liberal düşüncenin sol cenahındaki sol-sosyalist fikri inkişaf döneminin ürünü çaplı toplumsal değişim taleplerini, radikal diye tabir ederek neredeyse affedilmez birer kusur gibi kabul eden kimi sol liberal feminist yaklaşımlar ile yenilginin sözde faturasını bu radikalizme keserek siyasal faaliyetini melankolik bir yazıklanmanın ötesine geçiremeyen birtakım liberal sol tavırların bu süreçteki rolü tartışılacaktır. Sonuç itibarıyla bu çalışma, çoğunlukla itham biçiminde zikredilen ütopyacılık tabirini, bu menfi kullanımın nesnesi olmaktan kurtarmak için alternatif ve daha iyi bir yaşama dair yolların çeşitlenmesinin önemli bir başlangıç noktası olarak bir paye gibi kabullenip sahiplenen Ernst Bloch’un umut mefhumu üzerinden yepyeni bir ontolojik ve epistemolojik inşaya tabi tutarak, ütopyacılığın bir tür iade-i itibarına odaklanacaktır. (shrink)

In a sense, all technology is biotechnology: machines interacting with human organisms. Technology is designed to overcome the frailties and limitations of human beings in a state of nature -- to make us faster, stronger, longer-lived, smarter, happier. And all technology raises questions about its real contribution to human welfare: are our lives really better for the existence of the automobile, television, nuclear power? These questions are ethical and political, as well as medical; and they even reach to the philosophical (...) and spiritual. On the whole, we seem pretty well adapted to our technology, at least on the face of it -- but there have always been doubts about whether the human soul thrives best in the oppressively technological world we have created for ourselves. (I am continually struck by how much time I have to spend fixing the machines that supposedly improve my life.). (shrink)

Ever since its first publication in 1992, The End of History and the Last Man has provoked controversy and debate. Francis Fukuyama's prescient analysis of religious fundamentalism, politics, scientific progress, ethical codes, and war is as essential for a world fighting fundamentalist terrorists as it was for the end of the Cold War. Now updated with a new afterword, The End of History and the Last Man is a modern classic.

Francis Fukuyama is one of the most significant political theorists of the past thirty years. Bursting into public awareness in 1989 with his provocative thesis about "the end of history," Fukuyama has made fascinating contributions to a wide range of subjects - the importance of trust in societies, the potential dangers of biotechnology, the development of political authority and the modern state, and most recently, the role of identity in politics. This book records a series of conversations with (...) Fukuyama in which he discusses his background and its role in shaping his thinking, the context and genesis of his major works, and his thoughts in light of the dramatic developments of the past decade, especially the rise of populism around the world. The result is a fascinating picture of a major intellectual. The book both provides an overview of Fukuyama's thought and reveals new insights into his best-known work. This book also allows readers to trace the themes which have animated Fukuyama's entire intellectual career. (shrink)

Francis Fukuyama's controversial new book, Our Posthuman Future: Consequences of the Biotechnology Revolution, has elicited varied reactions, but like it or not, it seems likely to be influential. Here are three opinions. —Ed.

In the past thirty years, the United States has undergone a profound transformation in its social structure: Crime has increased, trust has declined, families have broken down, and individualism has triumphed over community. Has the Great Disruption of recent decades rent the fabric of American society irreparably? In this brilliant and sweeping work of social, economic, and moral analysis, Francis Fukuyama shows that even as the old order has broken apart, a new social order is already taking its place. (...) The Great Disruption forges a new model for understanding the Great Reconstruction that is under way. (shrink)

The argument contained in The End of History and the Last Man consists of an empirical part and a normative part: critics have confused the two and their proper relationship. The assertion that we have reached the "end of history" is not a statement about the empirical condition of the world, but a normative argument concerning the justice or adequacy of liberal democratic political institutions. The normative judgment is critically dependent on empirical evidence concerning, for example, the workability of capitalist (...) and socialist economic systems, but ultimately rests on supra-empirical grounds. The empirical part concerns whether there is something like the Hegelian-Marxist concept of History as a coherent, directional evolution of human societies taken as a whole. The answer to this is yes, and lies in the phenomenon of economic modernization based on the directional unfolding of modern natural science. The latter has unified mankind to an unprecedented degree, and gives us a basis for believing that there will be a gradual spread of democratic capitalist institutions over time. This empirical conclusion, however, does no more than give us hope that there is a progressive character to world history, and does not prove the normative case. The normative grounding of modern liberal democracy has indeed been put in jeopardy by the philosophical "crisis of modernity" inaugurated by Nietzsche and Heidegger. Contemporary postmodernist critiques of the possibility of such a grounding have not, however, adequately come to terms with the destructive consequences of their views for liberal democratic societies. This aporia, discussed most seriously in the Strauss-Kojève debate, is the central intellectual issue of our age. (shrink)

Writing from a scientifically and philosophically informed perspective, the authors provide a critical overview of the conceptual difficulties encountered in many current neuroscientific and psychological theories.

BackgroundNo laws or official guidelines govern voluntary assisted dying (VAD) in Japan. A legislative bill on the termination of life-sustaining measures has yet to be sent to deliberations for legislation, due to strong opposition that has prevented it from being submitted to the Diet. However, Japan has recently witnessed several cases involving VAD.Main textAgainst this backdrop, we argue that Japan should begin discussion on VAD legislation, referring to the Voluntary Assisted Dying Act 2017 (VADA2017), which was established in 2017 in (...) Victoria, Australia. VADA2017 puts in place a wide range of stringent safeguards and is considered worldwide to be the safest and most conservative policy on a physician offering assisted dying based on the patient’s premeditated request. We consider what opposing opinions from society would arise in response to the VADA2017. Among these will include arguments against VAD itself, those against the validation of this act, and opinions that oppose even the initiation of the dialogue on VAD.ConclusionsWe conclude that to protect the right to life among those placed in vulnerable positions and, at the same time, to respect decision-making of those who wish for immediate death due to unbearable suffering, the dialogue must immediately begin with that on introducing a policy more conservative than that of the VADA2017, which solidly considers arguments against VAD. (shrink)

Hello, my name is Francis Fukuyama and I am delighted to be able to participate in this symposium at EAFIT, on The End of History? I am a Senior fellow at Stanford University and in the summer of 1989, I published an article in the journal The National Interest titled The End of History? 30 years have passed since the publication of this article and this was a good opportunity to reflect on what has happened to the state of (...) global democracy and global politics in those three decades. (shrink)

Objective: This study examined the process through which elderly patients with new-onset acute leukemia make treatment decisions from the time of diagnosis, in order to identify factors influencing this decision-making process in Japan. Methods: Semi-structured interviews were conducted with twenty-two elderly patients with leukemia. The data were analyzed using the modified grounded theory approach. Results: The process of decision-making in elderly patients with leukemia includes three stages: Initial reactions at diagnosis, change in attitudes, and entrusting the physician with the treatment (...) plan. Initial reactions at diagnosis were affected by interactions with others that brought peace of mind to the patients. Change in attitudes was affected by encouragement from others to undergo treatment and their own motivation to face treatment. Patients came to entrust their treatment plan completely to their physician, because they wanted to feel relief and did not want to have to grapple with difficult medical information that was relevant to decision-making about their disease and treatment options. Conclusions: The process of decision-making in elderly patients with leukemia is affected by several factors and included three stages. Our present study findings can provide suggestions on how medical professionals might better support the process of decision-making in elderly patients with leukemia. (shrink)

No laws or official guidelines govern medical assistance for dying in Japan. However, over the past several years, cases of assisted suicide or voluntary euthanasia, rarely disclosed until recently, have occurred in close succession. Inspired by these events, ethical, legal, and social debates on a patient’s right to die have arisen in Japan, as it has in many other countries. Several surveys of Japanese people’s attitudes towards voluntary assisted dying suggest that a certain number of Japanese prefer active euthanasia. Against (...) this background, it is important to discuss voluntary assisted dying cases in Japan and the Japanese views on them and to consider their implications. We review three recent Japanese voluntary assisted dying cases and discuss the various objections to voluntary assisted dying that have been published in response to these in various media outlets. Our counterarguments include the double suffering of people who are unable to give up their desire to die, individuality of death, variability of culture, problem of being an annoyance to (burden on) others, a slippery slope argument supporting voluntary assisted dying, and unfair claims about responsibility and excessive burden on people who are unable to give up their desire to die. We also point out the psychocultural and social problems in Japanese society that these objections reflect, and argue that voluntary assisted dying can be ethically acceptable under certain conditions. We conclude that Japanese society must change in order to enable those who sincerely wish to die to do so in a better way. (shrink)

A long-standing theme in discussion of perception and thought has been that our primary cognitive contact with individual objects and events in the world derives from our perceptual contact with them. When I look at a duck in front of me, I am not merely presented with the fact that there is at least one duck in the area, rather I seem to be presented withthisthing (as one might put it from my perspective) in front of me, which looks to (...) me to be a duck. Furthermore, such a perception would seem to put me in a position not merely to make the existential judgment that there is some duck or other present, but rather to make a singular, demonstrative judgment, that that is a duck. My grounds for an existential judgment in this case derives from my apprehension of the demonstrative thought and not vice versa. (shrink)

This book defends antitheodicism, arguing that theodicies, seeking to excuse God for evil and suffering in the world, fail to ethically acknowledge the victims of suffering. The authors argue for this view using literary and philosophical resources, commencing with Immanuel Kant's 1791 "Theodicy Essay" and its reading of the Book of Job. Three important twentieth century antitheodicist positions are explored, including "Jewish" post-Holocaust ethical antitheodicism, Wittgensteinian antitheodicism exemplified by D.Z. Phillips and pragmatist antitheodicism defended by William James. The authors argue (...) that these approaches to evil and suffering are fundamentally Kantian. Literary works such as Franz Kafka'sThe Trial, Samuel Beckett's Waiting for Godot, and George Orwell's Nineteen Eighty-Four, are examined in order to crucially advance the philosophical case for antitheodicism. (shrink)

In his last book, David Armstrong sets out his metaphysical system in a set of concise and lively chapters each dealing with one aspect of the world. He begins with the assumption that all that exists is the physical world of space-time. On this foundation he constructs a coherent metaphysical scheme that gives plausible answers to many of the great problems of metaphysics. He gives accounts of properties, relations, and particulars; laws of nature; modality; abstract objects such as numbers; and (...) time and mind. (shrink)

Is consciousness a purely physical phenomenon? Most contemporary philosophers and theorists hold that it is, and take this to be supported by modern science. But a significant minority endorse non-physicalist theories such as dualism, idealism and panpsychism, among other reasons because it may seem impossible to fully explain consciousness, or capture what it's like to be in conscious states (such as seeing red, or being in pain), in physical terms. This Element will introduce the main non-physicalist theories of consciousness and (...) explain the most important arguments for them, and consider how they each respond to the scientific and other arguments in support of physicalism. This title is also available as Open Access on Cambridge Core. (shrink)

Western democracy is now at a critical juncture. Some worry that power has been wrested from the people and placed in the hands of a small political elite. Others argue that the democratic system gives too much power to a populace that is largely ill-informed and easily swayed by demagogues. This classic study of democratic principles is thus now more relevant than ever. A renowned historian of antiquity and political philosophy, Sir M.I. Finley offers a comparative analysis of Greek and (...) modern conceptions of democracy. As he puts the ancient Greeks in dialogue with their contemporary counterparts, Finley tackles some of the most pressing issues of our day, including public apathy, partisanship, consensus politics, distrust of professional politicians, and the limits of free speech. Including three lectures that Finley delivered at Rutgers University, plus two additional essays that further illuminate his thinking, _Democracy Ancient and Modern _explores the dramatic differences between the close-knit civil society of the ancient Greeks and our own atomized mass societies. By mapping out democracy’s past and its present manifestations, this book helps us plot a course for democracy’s future. (shrink)

Patient families sometimes ask health professionals, ‘What would you do if this were your family member?’ The purpose of this paper is to examine appropriate responses to this Question. Health professionals may say, ‘It all depends on the patient's wishes’, or ‘I don't know what is best, because my family is different from yours in many ways’. Some may believe that the most favourable course of action is the same regardless of who the patient is and explain this to the (...) patient's family, while others may refuse to answer the Question saying it is personal, or argue that such a Question should neither be asked nor answered because it is unreasonable and unprofessional to do so. We believe that, in principle, health professionals should give an honest answer as to what they would do if the patient was their family member, recognising and empathising with the fact that the patient's family is in a difficult and vulnerable position, and that their circumstances forced them to ask such a Question. Moreover, personal and emotional views of health professionals regarding treatment options may help the patient's family make important decisions. An honest answer will help strengthen the trusting relationship between health professionals and the patient's family and support their decision-making. (shrink)

This book presents a collection of essays on institutional theory written by the German sociologist and Weber-expert M. Rainer Lepsius. Based on Weber's work, the author develops concepts of institutional theory, which he subsequently applies to topics such as National Socialism, democratization processes, German unification, and the institutionalization of the European Union. By showing how charismatic leadership can under certain circumstances threaten democratic structures and curtail individual freedoms, and by analyzing the structural and cultural conditions under which people develop trust (...) in political and social structures and ultimately come to support and comply with them, the author provides a sound analytical understanding of the development of democratic institutions and a democratic political culture. This collection of essays was edited, translated and commented on by Claus Wendt. (shrink)

The Ismaili Imam and Imamat -- Ethical foundations -- Tradition and modernity -- The ethos of modernism -- Pluralism and cosmopolitan ethics -- Cohesion within the Umma -- Islam and the West -- Cultivating and enabling environment -- Living the ethics of Islam -- Global convergence.

The socialist construction in Vietnam, aspect of human role.

The given is the state of a mind in its primary engagement with the world. A satisfactory epistemology—one, it turns out, that is foundationalist and includes a naïve realist view of perception—requires a certain account of the given. Moreover, knowledge based on the given requires both a particular view of the world itself and a heterodox account of judgment. These admittedly controversial claims are supported by basic ontological considerations. I begin, then, with two contradictory views of the world per se (...) and the structure one experiences. I draw out the consequences of these two views for what intentionality is. The two views yield incompatible accounts of the given. The definitive spontaneity of the one account, and passivity of the other, can be understood in terms of the structure (or lack thereof) in the given. In defense of the claim that a structured given is not an apt epistemic basis, I examine an attempt to found an epistemology on such an account in light of the so-called myth of the given. I maintain that the given, if it is to provide some justification for taking the world to be a particular way, must be unstructured. To support this, I first discuss a significant problem with traditional foundationalism. I then argue that a satisfactory (foundationalist) epistemology requires the rejection of the orthodox propositional view of judgment in favor of a non-propositional, reistic view. (shrink)

: The technologies at the intersection of assisted reproduction and genetics call for a new regulatory approach, say Franco Furger and Francis Fukuyama, authors of the recent report Beyond Bioethics. In the essay below they map out their recommendation. In the following essays, James Fossett argues that regulation is likelier—and would be better—at the state level, Leonard Fleck calls for more robust public involvement, and John Robertson recommends sticking with the status quo. Turning from procedural to substantive issues, Josephine (...) Johnston takes up Furger and Fukuyama’s suggestion that children have a right to a traditional genetic parentage. (shrink)