This chapter first analyses pessimism about the human condition, arguing that it has both an evaluative and a psychological component. As an evaluative thesis, the chapter proposes a standard by which human lives are to be assessed, and says that a human life is worth living if and only if it has certain features. Its psychological component asserts that something inheres in all or nearly all human beings that will always prevent their lives from having those valuable features. The discussion (...) then turns to happiness, the best form of consciousness, eudaimonia, Schopenhauer's and Plato's complaints about the human situation, and life's brevity. (shrink)

This chapter contains sections titled: Justified and Compensated Suffering and Death Afterlife A Theistic Variation on the Hypothesis of Indifference Verdict on the Greater‐Good Defense Suggested Reading.

The author encountered evocations of suffering and death in all the studies and research he devoted, over 40 or so years, to the intellectual, social and religious life of western Muslim Judaism, and indeed the whole of traditional Jewish thought and its varied modes of expression: rabbinical law, Hebrew poetry, the literature of homily and preaching, mystical writings and the kabbala, dialect and popular literatures in Judeo-Arabic and Judeo-Berber. Some passages are taken from the Zohar (‘The town the (...) angel of death cannot enter’, for instance). The author also refers to the Talmud and magic therapeutics, the power of sacred names, Jewish and Muslim miracle workers, hunting down and casting out demons, etc. Agony, refusal to die, joyous commemoration of death, the cemetery and the cult of the dead, Judeo-Muslim pilgrimages, the wealth of the customs, beliefs and rites of the past lead the author to reflect on the question of death in the present-day world. (shrink)

Asbestos-related illnesses contribute to the deaths of more than 100,000 people worldwide (ILO 2006) and the plight of sufferers of these illnesses has become a global ethical issue. A leading, Australian building products corporation, James Hardie, created a complex corporate structure that included the establishment of a “Victims Compensation Fund”, and moved its corporate headquarters to the Netherlands to reduce its liabilities. Hardie claimed that this move was tax minimization (Haigh 2006). In this study case, a number of ethical issues (...) provides the opportunity to discuss many business-society questions. These include the duties of the company towards a wide range of stakeholders affected in some way by Hardie’s earlier production of asbestos-related products and its subsequent responses to the question of compensation. (shrink)

Abstract:The specialty of psychiatry has a long-standing, virtually monolithic view that a desire to die, even a desire for a hastened death among the terminally ill, is a manifestation of mental illness. Recently, psychiatry has made significant inroads into hospice and palliative care, and in doing so brings with it the conviction that dying patients who seek to end their suffering by asserting control over the time and manner of their inevitable death should be provided with psychotherapeutic (...) measures rather than having their expressed wishes respected as though their desire for an earlier death were the rational choice of someone with decisional capacity. This article reviews and critiques this approach from the perspective of recent clinical data indicating that patients who secure and utilize a lethal prescription are generally exercising an autonomous choice unencumbered by clinical depression or other forms of incapacitating mental illness. (shrink)

There is a massive amount of severe suffering and death in the world, and much of this suffering and death is out of our control. The amount and severity of suffering and death in the world can be used to make an argument for (or elicit a reaction against) the existence of God: if God—an all-powerful, all-knowing, and all-good being—exists, God would not allow such massive amounts of suffering and death. I'll propose (...) a line of response that begins by exploring what would be involved in taking a new perspective on the suffering and death in the world. I then argue that there is no good reason not to take that new perspective. If this is correct, the argument from (or reaction to) suffering and death to the conclusion that God doesn't exist has lost much of its force; an argument that seems forceful from one perspective is weak from a different perspective that is just as reasonable, or more reasonable, to take. (shrink)

IntroductionPalliative care is an emotionally and spiritually high-demanding setting of care. The literature reports on the main issues in order to implement self-care, but there are no models for the organization of the training course. We described the structure of training on self-care and its effects for a Hospital Palliative Care Unit.MethodWe used action-research training experience based mostly on qualitative data. Thematic analysis of data on open-ended questions, researcher’s field notes, oral and written feedback from the trainer and the participants (...) on training outcomes and satisfaction questionnaires were used.ResultsFour major themes emerged: “Professional role and personal feelings”; “Inside and outside the team”; “Do I listen to my emotions in the care relationship?”; “Death: theirs vs. mine.” According to participants’ point of view and researchers’ observations, the training course resulted in ameliorative adjustments of the program; improved skills in self-awareness of own’s emotions and sharing of perceived emotional burden; practicing “compassionate presence” with patients; shared language to address previously uncharted aspects of coping; allowing for continuity of the skills learned; translation of the language learned into daily clinical practices through specific facilitation; a structured staff’s support system for emotional experiences.DiscussionSelf-care is an important enabler for the care of others. The core of our intervention was to encourage a meta-perspective in which the trainees developed greater perspicacity pertaining to their professional role in the working alliance and also recognizing the contribution of their personal emotions to impasse experienced with patients. (shrink)

Kay Toombs is an influential ethicist and disability scholar. In a new edition of her book How Then Should We Die? Two Opposing Responses to the Challenges of Suffering and Death, she critiques soc...

To consider that the nature of forgiveness consists in its healing effects on the forgiver overlooks the distinction between the nature of forgiveness and the question about its desirable effects. What I suggest is that the curing effect of forgiveness is an indirectly intended consequence of forgiveness. To forgive mywrongdoer only because this is the way to gain inner peace or to “heal my soul” shows a somewhat utilitarian view on forgiveness. By forgiving the wrongdoer, thevictim extends an attitude of (...) authentic goodwill toward the offender as a person. However, the one who forgives does not extend this attitude toward the action theoffender performed. We can strongly oppose wrong behavior without opposing wrongdoers as persons. (shrink)

To consider that the nature of forgiveness consists in its healing effects on the forgiver overlooks the distinction between the nature of forgiveness and the question about its desirable effects. What I suggest is that the curing effect of forgiveness is an indirectly intended consequence of forgiveness. To forgive mywrongdoer only because this is the way to gain inner peace or to “heal my soul” shows a somewhat utilitarian view on forgiveness. By forgiving the wrongdoer, thevictim extends an attitude of (...) authentic goodwill toward the offender as a person. However, the one who forgives does not extend this attitude toward the action theoffender performed. We can strongly oppose wrong behavior without opposing wrongdoers as persons. (shrink)

Attempts to resolve the problem of evil often appeal to a greater good, according to which God’s permission of moral and natural evil is justified because (and just in case) the evil that is permitted is necessary for the realization of some greater good. In the extensive litany of greater good theodicies and defenses, the appeal to the greater good of an afterlife of infinite reward or pleasure has played a minor role in Christian thought but a more important role (...) in Islamic thought. In a recent article, Seyyed Jaaber Mousavirad invites us to reconsider a greater good theodicy of compensation. He contends that not only are all evils justified in that God compensates the sufferer in an afterlife, but because evils experienced produce some good, God has reason for bringing about or allowing evils in the first place (Mousavirad 211). In what follows I argue that this modified compensation theodicy is flawed in its premises, faces serious problems about its concept of justice, treats people as means only and not as intrinsically valuable, and ultimately fails to show that an afterlife compensation, along with some good produced here and now by evil, justify God bringing about or allowing evil. (shrink)

This paper presents my personal convictions, as an Evangelical, regarding the absolute impropriety of doctor-assisted suicide for Christians. They have been “bought with a price” and are owned by Another. Hence, they must always strive to glorify God in their bodies, both in life and in death. Although they crave the well-being of temporal health, when they are ill seek healing or relief, and may well recoil even from the thought of suffering and dying, they should realize that (...) their values and priorities must be rooted in biblical truths and that their well-being is eternal and not temporal, spiritual and not material. As Christians, their attitudes and responses to suffering and dying must be molded by the reality that their Creator and Sovereign will cause all things to work together for their good and that their Lord has called them into a fellowship of His suffering in which they are sustained by dependence upon Him. Hence, for Christians to take their lives in order to escape from the trials and testings ordained by Him would be a failure of love and a breach of trust. (shrink)

Imagine you find yourself in heaven after death, only to discover that the soul of your dearest love is suffering in hell. Would your bliss be marred by the suffering of your loved one? The “argument from love” challenges the traditional Christian conception of heaven and hell as places of perfect bliss and terrible suffering, respectively, on the grounds that no lover in heaven could be very happy if she were aware that her beloved was (...) class='Hi'>suffering in hell. Love requires concern for the well-being of one’s beloved, thus apparently rendering heavenly bliss impossible for those who love an unreformed sinner. Here I defend a traditional conception of heaven and hell against the perplexing mismatch between the blessed souls’ love for the damned and apparent indifference to their plight. (shrink)

According to the worm theory, persons are (maximal) aggregates of person-stages existing at different times. Personites, on the other hand, are non-maximal aggregates of stages that are nonetheless very much like persons. Their existence appears to make instances of prudential self-sacrifice morally problematic: the personites that exist at the time of the sacrifice but not at the time of the reward seem to be unfairly exploited. Instances of punishment appear to give rise to a similar problem. We argue that these (...) impressions arise from a mistaken assumption about which beings are the primary bearers of properties such as suffering, receiving compensation (in the future) and having (previously) committed a crime. According to the worm theory, stages, rather than persons or personites, possess these properties. Persons and personites have these properties only in a derivative sense. As we show, once this clarification and related ones are made, the apparent moral problems raised by the existence of personites dissolve. (shrink)

In his carefully documented article, “From reciprocity to autonomy in physician-assisted death: an ethical analysis of the Dutch Supreme Court ruling in the Albert Heringa case,” Berand Florijn (20...

It is often accepted that we may legitimately speak about voluntary euthanasia only in cases of persons who are suffering because they are incurably injured or have an incurable disease. This article argues that when we consider the moral acceptability of voluntary euthanasia, we have no good reason to concentrate only on persons who are ill or injured and suffering.

Empirical evidence indicates that bereaved spouses are surprisingly muted in their responses to their loss, and that after a few months many of the bereaved return to their emotional baseline. Psychologists think this is good news: resilience is adaptive, and we should welcome evidence that there is less suffering in the world. I explore various reasons we might have for regretting our resilience, both because of what resilience tells us about our own significance vis-à-vis loved ones, and because resilience (...) may render us incapable of comprehending how things really stand, valuewise. I also compare our actual dispositions to extreme alternatives (“sub-resilience” and “super-resilience”), and consider whether we might endorse (plain) resilience as a kind of mean. (shrink)

"Get a behind-the-scenes glimpse of what it takes to change the world in this comprehensive biography that tells the complete life story of internationally renowned peacemaker Nelson Mandela. Civil rights activist. World leader. Writer. Throughout his life, Nelson Mandela took on many roles, all in the pursuit of peace. Born in 1918 in South Africa, he grew up in a culture of government-enforced racism and became involved in the anti-apartheid movement at a young age. Deeply committed to nonviolent activism, Mandela (...) directed a peaceful campaign against the racist policies of his South African government, and spent twenty-seven years in prison as a result. In the years following his emergence as a free man, he continued his efforts to dismantle the country's apartheid system and was awarded the Nobel Peace Prize alongside South African President F.W. de Klerk. In 1994 he was inaugurated as South Africa's first black president and served until his retirement from active politics in 1999 at the age of eighty-one. He continued to promote global peace until his death in 2013, and his legacy lives on. From Nelson Mandela's childhood to his monumental impact on race relations and nonviolent activism, this comprehensive biography shares the truth about the man behind the iconic smile: his struggles, his triumphs, and the sacrifices along the way"--. (shrink)

Abstract: I argue that Orientalism continues to construct Arabs as subjects that cannot suffer violence, particularly the violence of torture. Beginning with Edward Said’s observation that Orientalists constructed ‘Arabs’ in the nineteenth -century as inorganic, metallic, and mineralized beings, I trace these themes through various sites in and around Guantanamo Bay. One finds the tropes of Orientalism in the Bybee memo as well as in the diary of Mohamedou Ould Slahi. Through these three distinct but related moments, one finds that (...) Orientalism continues to produce Arabs as inorganic entities beyond death and thereby immune to violence and specifically the violence of torture. Insofar as imperialism has co-opted the language of non-violence by constructing its enemies as inviolable, one must recognize the Orientalized Arab as a receptor of limitless ‘non - violent’ hostilities. (shrink)

A psychologist with a client who is terminally ill and wishes to discuss end-of-life options, specifically the option of hastening death, is faced with an ethical dilemma as to how to proceed with treatment. Specifically, he or she is bound by the American Psychological Association's (2002) potentially conflicting Principles A and E, which advise a psychologist to ?do no harm? as well as ?respect ? self-determination.? In addition, Standard 4 (Privacy and Confidentiality) mandates that a client's personal information is (...) to remain private, unless that client could be in danger of harming himself or herself or others. This article discusses such a nuanced case and provides considerations as well as guidelines for psychologists to effectively navigate through this sensitive and important dilemma. (shrink)

While unnecessarily killing or injuring an insect is arguably wrong, euthanasia of an accidentally injured insect raises anew issues of whether insects can experience pain. The question takes renewed significance due to increasing insect farming for food and feed and concerns over farmed insect welfare. For euthanasia of a damaged insect to be justifiable, the damage must be sensed as a noxious stimulus (nociception) that the insect consciously experiences as pain. This pain must then lead to suffering or frustrated (...) desire, with the possibility of the animal preferring death to continued existence. A failure at any of these points would deem euthanasia moot. The neurological, behavioral, and evolutionary evidence so far suggests the concept of euthanasia does not apply to insects. (shrink)

An estimated 1.2 to 2.3 million Hindus live in the United States. End-of-life care choices for a subset of these patients may be driven by religious beliefs. In this article, we present Hindu beliefs that could strongly influence a devout person’s decisions about medical care, including end-of-life care. We provide four case examples (one sacred epic, one historical example, and two cases from current practice) that illustrate Hindu notions surrounding pain and suffering at the end of life. Chief among (...) those is the principle of karma, through which one reaps the benefits and penalties for past deeds. Deference to one’s spouse or family is another important Hindu value, especially among Hindu women, which can impact the decision-making process and challenge the Western emphasis on autonomy. In addition, the Hindu embrace of astrology can lead to a desire to control the exact time of death. Confounding any generalizations, a Hindu patient may reject or accept treatments based on the individual patient’s or family’s interpretation of any given tradition. Through an awareness of some of the fundamental practices in Hinduism and the role of individual interpretation within the tradition, clinicians will be better able to support their Hindu patients and families at the end of life. (shrink)

When talking about decisionmaking for children with a life-threatening condition, the death of children with brain tumors deserves special attention. The last days of the lives of these children can be particularly harsh for bystanders, and raise questions about the suffering of these children themselves. In the Netherlands, these children are part of the group for whom a wide range of end-of-life decisions are discussed, and questions raised. What does the end-of-life for these children look like, and what (...) motivates physicians and parents to make decisions that may affect the life and death of these children? This article highlights the story of the parents of the sisters Roos and Noor. When both their daughters were diagnosed with a hereditary brain tumor, they had to make similar decisions twice. Their story sheds light on the suffering of children in the terminal phase, and how this suffering may motivate parents and physicians to make decisions that influence the end of life of these children’s lives.We argue that complete knowledge about suffering in the terminal phase of children with brain tumors is impossible. However, by collecting experiences like those of Roos and Noor, we can move toward an experienced-based understanding and better guide parents and physicians through these hardest of decisions. (shrink)

Experiments in Love and Death is about the depth and complexity of the ethical issues that arise in illness and medicine. In his concept of 'microethics' Paul Komesaroff provides an alternative to the abstract debates about principles and consequences that have long dominated ethical thought. He shows how ethical decisions are everywhere: in small decisions, in facial expressions, in almost inconspicuous acts of recognition and trust. Through powerful descriptions of case studies and clear and concise explanations of contemporary philosophical (...) theory the book brings discussions about ethics in medicine back to where they belong-to the level of the everyday experience where people actually live, suffer and hope. A fresh and evocative look at the changing world of ethics as it applies to health and illness, this is an important book for all those touched by illness or suffering. About the author Paul Komesaroff is a physician and philosopher at Monash University in Melbourne, Australia. His books include Objectivity, Science and Society, Troubled Bodies, Sexuality and Medicine (ed. with Philipa Rothfield and John Wiltshire) and Pathways to Reconciliation (ed. with Philipa Rothfield and Cleo Fleming). (shrink)

ABSTRACT:Guidelines and regulations for medical research recognize that the experiences of humans and animals both matter morally. They thus set a presumption against harming research subjects, whether humans or animals, and mandate that the harms subjects experience should be the minimal necessary for achieving the scientific aims of the study. Beyond this, guidelines and regulations place upper limits on the extent to which human, but not animal, subjects may be harmed. They also mandate that human, but not animal, subjects should (...) be compensated for the harms they experience. In this article, I argue that this common approach to regulating medical research is mistaken. In particular, there are upper limits on the extent to which animals may ethically be harmed in order to collect data to benefit others, and there are moral reasons to compensate them for the harms they experience. I conclude that guidelines and regulations for research with animals should be revised accordingly. (shrink)

OSCAR HORTA | : This paper examines the extent of the opposition between environmentalists and those concerned with wild-animal suffering and considers whether there are any points they may agree on. The paper starts by presenting the reasons to conclude that suffering and premature death prevail over positive well-being in nature. It then explains several ways to intervene in order to aid animals and prevent the harms they suffer, and claims that we should support them. In particular, (...) the paper argues in favour of carrying out more research to learn the best ways to intervene without causing more harm to other animals and to intervene first in areas significantly transformed by human action. It then examines what positions environmentalist views can have towards intervention in nature for the sake of animals. It claims that, while ecocentric and naturocentric views will strongly oppose intervention in certain circumstances, they should not do so in other cases in which the values they promote are not at stake or might be outweighed. The paper then argues that, contrary to what it might seem at first, biocentric views should strongly support intervention. It then discusses whether there may be certain practical issues about which those concerned with wild animal suffering and environmentalists may support the same approach, such as opposition to the greening of desert ecosystems. Finally, it claims that raising awareness about wild animal suffering seems to be the most urgent task now for those concerned about it. | : Le présent article examine l’étendue de l’opposition entre les environnementalistes et ceux qui se préoccupent de la souffrance des animaux sauvages, afin de déterminer s’il existe des points sur lesquels ils peuvent être en accord. L’article débute en présentant les raisons permettant de conclure que la souffrance et la mort prématurée l’emportent sur le bien-être positif dans la nature. Ensuite, il explique plusieurs façons d’intervenir afin d’aider les animaux et de prévenir les maux dont ils souffrent et plaide pour la mise en oeuvre de celles-ci. Plus précisément, l’article préconise un plus grand nombre de recherches afin de déterminer les meilleures façons d’intervenir sans causer davantage de maux à d’autres animaux ainsi que pour prioriser des interventions en des endroits que l’action humaine a significativement transformés. L’article examine par la suite les positions que les conceptions environnementalistes peuvent adopter quant aux interventions dans la nature pour le bien des animaux. L’article propose que, bien que des visions écocentriques et naturocentriques s’opposent vivement à l’intervention dans certaines circonstances, elles ne devraient cependant pas s’y opposer dans les cas où les valeurs qu’elles promeuvent n’entrent pas en jeu ou peuvent avoir moins de poids que d’autres facteurs. L’article soutient ensuite que, contrairement à ce que l’on pourrait penser à première vue, les théories biocentristes devraient fortement appuyer l’intervention. Il pose la question à savoir si certains problèmes pratiques peuvent faire l’objet d’une approche commune parmi les environnementalistes et ceux qui se soucient de la souffrance des animaux sauvages, par exemple s’opposer à l’écologisation des déserts. Enfin, l’article propose que la tâche la plus pressante pour ceux qui se préoccupent de la souffrance des animaux sauvages consiste à accroître la sensibilisation à ce problème. (shrink)

The focus falls within the boundaries of what happens to persons and to a person's sense of identity when confronted by pain, suffering, and death. ...

The gamer’s dilemma, initially proposed by Luck (Ethics and Information Technology 11(1):31–36, 2009) posits a moral comparison between in-game acts of murder and in-game acts of paedophilia within single-player videogames. Despite each activity lacking the obvious harms of their real-world equivalents, common intuitions suggest an important difference between them. Some responses to the dilemma suggest that intuitive responses to the two cases are based on important differences between the acts themselves or their social meaning. Others challenge the fundamental assumptions of (...) the dilemma. In this paper, we identify and explore key imaginative and emotional differences in how certain types of in-game violence are experienced by players, consider how these differences factor into the moral lives of players, and use these insights to resolve the dilemma. The view we develop is that the key moral emotion in offensive video gameplay is self-repugnance. This is not repugnance of the act one directs a game character to perform in the game, nor repugnance of the character one plays. It is repugnance of oneself in playing the game. If self-repugnance is a fitting emotional response to playing a videogame, then this is prima facie grounds for thinking it is wrong to play the videogame. Our approach to the gamer’s dilemma is to distinguish the fittingness conditions of self-repugnance from the fittingness conditions of other moral emotions as they pertain to playing videogames. We argue that because of the virtual character of the actions performed in video games, self-repugnance is a fitting response to particular kinds of offensive gameplay. On the other hand, in-game murder is not invariably a fitting ground for self-repugnance. We argue that this difference is grounded in imaginative responses to the harm of death and the harms of profound suffering. Our task is to explain and justify this difference in fittingness conditions and use this to resolve the gamer’s dilemma. (shrink)

The ethical problems surrounding voluntary assisted suicide remain formidable, and are unlikely to be resolved in pluralist societies. An examination of historical attitudes to suicide suggests that modernity has inherited a formidable complex of religious and moral attitudes to suicide, whether assisted or not. Advocates usually invoke the ending of intolerable suffering as one justification for euthanasia of this kind. This does not provide an adequate justification by itself, because there are (at least theoretically) methods which would relieve (...) class='Hi'>suffering without causing the physical death of the suffering person. Carried to extremes, these methods would finish the life worth living, but leave a being which was technically alive. Such acts, however, would provide no moral escape, since they would create beings without meaning. Arguments seeking to justify ending the lives of others need some grounding in concepts of the meaning of a life. The euthanasia discourse therefore needs to take at least some account of the meaning we construct for our lives and the lives of others. (shrink)

Modern biomedical technologies managed to revolutionise the End-of-Life Care (EoLC) in many aspects. The dying process can now be "engineered" by managing the accompanying physical symptoms or by "prolonging/hastening" death itself. Such interventions questioned and problematised long-established understandings of key moral concepts, such as good life, quality of life, pain, suffering, good death, appropriate death, dying well, etc. This volume examines how multifaceted EoLC moral questions can be addressed from interdisciplinary perspectives within the Islamic tradition. Contributors (...) Amir Abbas Alizamani, Beate Anam, Hamed Arezaei, Asma Asadi, Pieter Coppens, Hans Daiber, Khalid Elzamzamy, Mohammed Ghaly, Hadil Lababidi, Shahaboddin Mahdavi, Aasim Padela, Rafaqat Rashid and Ayman Shabana. (shrink)

Animals, like humans, suffer and die from natural causes. This is particularly true of animals living in the wild, given their high exposure to, and low capacity to cope with, harmful natural processes. Most wild animals likely have short lives, full of suffering, usually ending in terrible deaths. This book argues that on the assumption that we have reasons to assist others in need, we should intervene in nature to prevent or reduce the harms wild animals suffer, provided that (...) it is feasible and that the expected result is positive overall. It is of the utmost importance that academics from different disciplines as well as animal advocates begin to confront this issue. The more people are concerned with wild animal suffering, the more probable it is that safe and effective solutions to the plight of wild animals will be implemented in the future. (shrink)

The assumption was verified that for patients suffering from cancer levels of anxiety and self-esteem differ compared to other patients before surgery. 120 patients of urology were assigned to subgroups according to diagnosis and the duration of hospitalization. Patients suffering from cancer declared higher anxiety than other patients. Longer hospitalization was connected to higher anxiety. A threat-congruent difference in explicit self-esteem was revealed only between two groups: 1. cancer and long hospitalization and 2. non-cancer and short hospitalization. For (...) implicit self-esteem the phenomenon of implicit compensation of self-esteem was predicted and confirmed: among cancer-sufferers the Name Letter Effect was greater than among other patients. Also, in the cancerpatients group, the result of Rudman et al. was replicated: increasing anxiety was connected with increasing implicit self-esteem. (shrink)

A signal challenge of twenty-first century psychiatry is the effective treatment of existential/spiritual suffering in palliative care. This chapter will concentrate on research to assess the therapeutic potential of psilocybin to assuage that suffering. If a “psychedelic experience” can facilitate an acceptance of impending death, and reduce the existential suffering of those who endure it, it could prove to be a valuable intervention where one is sorely needed. The therapeutic use of psilocybin with dying patients (hereinafter (...) patients) raises numerous questions about research trial design, the model of psychiatry that might accommodate it, and the kind of experience it induces. Are these the sorts of experience that psychiatric treatment should effect on troubled patients? Is spiritual care within the ambit of psychiatry? There are epistemological questions as to the veridicality of the psychedelic experience. How much credence should we give it? I will argue in cautious support of ongoing research to evaluate the therapeutic use of psilocybin in palliative care. This argument can be extended to research on its therapeutic use in psychotherapy. The chapter will focus on four questions: (1) what is the ethical justification for this research on patients? (2) What types of research trial design are best used to assess the purported benefits of a psychedelic drug experience? (3) What is the epistemic warrant of the “mystical” and “noetic” facets of this experience? (4) What models of (a) psychiatry and (b) drug action could accommodate the therapeutic use of psilocybin in palliative care? (shrink)

Christians, health care, and basic moral reasoning -- When life ends -- Chronic illness, suffering, and Christian responses -- Organ donation and heroic medicine -- Scarce resources and Christian compassion -- Abortion -- Assisted reproduction and embryo selection -- Embryo research and cloning -- What happened to the neighbors? global health care -- The global challenge of HIV/AIDS -- Concluding thoughts.

Euthanasia, today, is one of the most debated issues in bioethics. Euthanasia, at the time of Thomas Aquinas, was an unheard-of term. Nevertheless, while there is no direct statement with respect to “euthanasia” per se in the writings of Aquinas, Aquinas’s moral theory and certain theological commitments he held could be applied to the euthanasia question and thus bring Aquinas into contemporary bioethical debate. In this paper, I present the relevant aspects of Aquinas’s account of natural law and his theological (...) views on suffering, examining what conclusions each entails with respect to directly intended euthanasia. I then proceed to discuss cases that involve either the administration of palliative medication that hastens death, terminal sedation, or the non-utilization of life-sustaining treatment. This involves a detailed investigation into Aquinas’s account of human intentional action and the question of whether Aquinas holds some form of the Principle of Double-Effect. I end with a final statement of Aquinas’s position on these various types of cases as a synthesis of the conclusions drawn from the different areas of his thought discussed in this paper. My aim is to provide a set of guidelines, based upon Aquinas’s thought, for those who may be faced with decisions regarding the proper form of palliative treatment to be provided to those suffering from a painful terminal illness. Decision-makers, in such cases, may include a terminally ill patient, a patient’s immediate family, health care providers, and lawmakers concerned with establishing the legality of certain forms of treatment. Establishing a clear set of moral guidelines, specifically addressed to this type of decision, can assist the relevant decision-makers in forming their consciences such that they may take the appropriate course of action in confronting the suffering of a terminally ill patient. (shrink)

Recent times have witnessed a groundswell in the number of British television programmes that deal with the ‘real life’ experiences of people in various health care settings. Such programmes tend to focus upon the two interrelated strands of the experience of those who deliver professional care and those who are at the receiving end of it. The usual rationale given for such programmes is that they offer insights about the delivery of health care that are not readily accessible to members (...) of the public. This article will look beneath the rationale and reasons offered by programme makers for the existence of such documentaries. It will explore insidious and questionable elements that go beyond revealing the ‘lived experience’ of professional carers and those for whom they care. Emerging from this is the challenging notion that such programmes deliver the opportunity to experience the vulnerability, suffering and even death of others through a voyeuristic gaze. (shrink)

While extensive scholarship has been dedicated to the emotional experiences of transplant patients, little is known about the emotional experiences of transplant co‐ordinators. Semi‐structured face‐to‐face interviews conducted with ten transplant co‐ordinators who have worked for more than 20 years in this job. The transplant co‐ordinators spoke of negative feelings and moral distress with regard to futile care of deceased donor family members as well as of living donors. Transplant co‐ordinators experience intense negative feelings, emotional pain, and moral distress on a (...) daily basis. Transplant co‐ordinators play a pivotal role in the process of obtaining consent for live or dead donation of organ; however, their well‐being and job satisfaction are impaired by contradictions between their moral values and the tasks they are instructed to perform. The study exposes the silent emotional suffering of transplant co‐ordinators; main findings show that the transplant co‐ordinators are torn between contradictory expectations and a gap between values and praxis. It is recommended to offer them training and support for the sake of their retention. (shrink)

In the US, research payments are technically taxable income. This article argues that tax liability is a form of possible economic and legal risk of paid research participation. Findings are presented from empirical research on Phase I healthy volunteer trials. The article concludes by discussing the implications of these findings for the informed consent process, as well as for broader ethical issues in whether and how payments for research participation should be regulated.

Pictures of sides of beef, hanging from overhead rails in refrigerated warehouses and meat-processing plants, often leave a feeling of unease. These pictures provoke the notion that human beings have no right to inflict suffering and death on other sentient beings for the sole purpose of providing food. However, the ethical analysis conducted in this study shows that meat production, if animal welfare and deaths per calorie created are considered, is less of a pressing problem compared to the (...) production of milk. While meat can be provided with minimal suffering to animals, the consumption of milk is always associated with considerable suffering during the dairy cow’s life-span and the lives of their offspring. Moreover, more bovine deaths per unit of calorific value created are associated with milk production compared to meat production. The vegan movement, which is currently growing, wishes to minimise farm animal suffering as much as possible. However, if a vegan diet is not possible, consumers should make an informed decision about the products they consume. Replacement of the calories obtained from meat with those from milk and dairy products is not rational if animal welfare is considered. (shrink)