This article examines the impact of traditional Chinese culture on organ donation from the perspective of Confucianism, Buddhism, and Taoism. In each of these cultural systems, it appears that there are some particular sayings or remarks that are often taken in modern Chinese society to be contrary to organ donation, especially cadaveric organ donation. However, this article argues that the central concerns of Buddhism, Confucianism, and Taoism are “great love,” “ren,” and “dao,” which can be reasonably interpreted to support organ (...) donation. The author understands that each cultural system, in order to play its cultural function, must have its central concerns as well as relevant ritual practices (li) that incarnate its religious and ethical commitments. That is, each plays a general cultural role, which influences organ donation in particular not merely through abstract or general ethical principles and teachings, but through a combination of ethical teachings and the forming of particular ritual practices. This article contends that the primary reason Chinese individuals fail to donate sufficient cadaveric organs for transplantation is not because particular remarks or sayings from each of these systems appear to conflict with donation. Neither is it that the central concerns of these systems cannot support cadaveric donation. Rather, it is that modern Chinese individuals have failed to develop and secure relevant ritual practices that support the central concerns of organ transplantation. The article concludes that in order to promote more donations, there is a need to form relevant ritual practices supporting organ donation in conformity with the central concerns of these cultural systems. (shrink)

Following a discussion of some historical roots of conscience, we offer a systematized version of reflective equilibrium. Aiming at a comprehensive methodology for bioethical deliberation, we develop an expanded variant of reflective equilibrium, which we call ‘triangular reflective equilibrium’ and which incorporates insights from hermeneutics, critical theory and narrative ethics.We focus on a few distinctions, mainly between methods of justification in ethics and the social practice of bioethical deliberation, between coherence in ethical reasoning, personal integrity and consensus formation, and between (...) political and moral deliberation.The ideal of deliberation is explicated as a sharing of conscience within a special commitment to sincerity and openness to persuasion. Personal growth in wisdom is an indirect by-product of the continuous practice of moral deliberation. This is explicated in the light of Sternberg's balance theory of wisdom and in the context of medicine as a profession embodying altruistic responsibilities of care in democratic and pluralistic societies. (shrink)

If a hereditary predisposition to colorectal cancer or breast cancer is diagnosed, most guidelines state that clinical geneticists should request index patients to inform their at-risk relatives about the existence of this condition in their family, thus enabling them to consider presymptomatic genetic testing. Those identified as mutation carriers can undertake strategies to reduce their risk of developing the disease or to facilitate early diagnosis. This procedure of informing relatives through the index patient has been criticised, as it results in (...) relatively few requests for genetic testing, conceivably because a certain number of relatives remain uninformed. This pilot study explored attitudes toward informing family members and relevant practices among clinical geneticists. In general, clinical geneticists consider it to be in the interests of family members to be informed and acknowledge that this goal is not accomplished by current procedures. The reasons given for maintaining present practices despite this include clinical ‘mores’, uncertainty about the legal right of doctors to inform family members themselves, and, importantly, a lack of resources. We discuss these reasons from an ethical point of view and conclude that they are partly uninformed and inconsistent. If informing relatives is considered to be in their best interests, clinical geneticists should consider informing relatives themselves. In the common situation in which index patients do not object to informing relatives, no legal obstacles prevent geneticists from doing so. An evaluation of these findings among professionals may lead to a more active approach in clinical practice. (shrink)

This article isolates ten prepositions, which constitute the undercurrent paradigm of contemporary discourse of health disease and medicine. Discussion of the interrelationship between those prepositions leads to a systematic refutation of this paradigm. An alternative set is being forwarded. The key notions of the existing paradigm are that health is the natural condition of humankind and that disease is a deviance from that nature. Natural things are harmonious and healthy while human made artifacts are coercive interference with natural balance. It (...) is suggested that the current paradigm is influenced by the world of finances and by instrumental reason. The alternative model suggests that human nature cannot be delineated. Humans fashion their own selves and nature by artificial means, medicine among them. The article discusses the implications of the paradigm adapted in various scholarly and popular debates such as the use of sex hormones for contraception, the care of the elderly, holistic medicine and distributive justice in health care. Medicine is not an isolated or a privileged realm. There is no unique entitlement to health care. It is always part of a broader agenda of social values and institutions. A open view of human societies, values and practices as they are situated within concrete material conditions is the platform required for an integrative and creative discourse of health care. (shrink)

This study presents an exploration of the belief changes of prospective teachers through social co-constructivist teaching. The future presumed in-class teaching orientations of the PTs were also estimated by metaphor analysis. A case study was conducted to monitor the belief changes of the PTs and estimate their probable in-class practices. The participants were six PTs involved in a certification in education programme. The data were gathered from the following different sources; interviews, written reflections and metaphor explanations. The data that were (...) analysed interpretatively and specific parts of the analysed data were subjected to quantification. The PTs held considerably conventional and idealistic teaching beliefs prior to the implementations. The PTs improved their reasoning and enlarged their conceptualisations regarding teaching and learning after the implementations. Five types of teaching belief typologies displaying inherently sophisticated nature of the beliefs were extracted. Some of the PTs appeared to have promise in terms of implementing more learner-centred teaching; however, others preserved their traditional teaching practical orientations. It was considered that changes in teaching beliefs may have motivational and attitudinal dimensions. Finally, capturing the metaphors of the PTs regarding teaching and learning appeared to provide more realistic insights into the estimated in-class practical orientations. (shrink)

In psychiatry, pharmacological drugs play an important experimental role in attempts to identify the neurobiological causes of mental disorders. Besides being developed in applied contexts as potential treatments for patients with mental disorders, pharmacological drugs play a crucial role in research contexts as experimental instruments that facilitate the formulation and revision of neurobiological theories of psychopathology. This paper examines the various epistemic functions that pharmacological drugs serve in the discovery, refinement, testing, and elaboration of neurobiological theories of mental disorders. I (...) articulate this thesis with reference to the history of antipsychotic drugs and the evolution of the dopamine hypothesis of schizophrenia in the second half of the twentieth century. I argue that interventions with psychiatric patients through the medium of antipsychotic drugs provide researchers with information and evidence about the neurobiological causes of schizophrenia. This analysis highlights the importance of pharmacological drugs as research tools in the generation of psychiatric knowledge and the dynamic relationship between practical and theoretical contexts in psychiatry. (shrink)

The ArgumentYehuda Halevi'sKuzariwas written in response to the challenge posed to Judaism by a highly spiritual, nondenominational philosophy. Science, especially that embodied in the Hellenistic heritage, was a major component of philosophy; thus, if for no other reason than to make Judaism a serious competitor, Halevi had to show that the Jewish tradition as well possessed a body of scientific knowledge. The superiority of the Jewish teachings was demonstrated chiefly by appeal to the criteria of tradition, consensus, and authority, which, (...) in Halevi's judgement, were in practice the criteria most influential in deciding scientific opinion. Despite the rather unique setting for the book, and the wide range of stances Halevi develops, theKuzariwas rather quickly and smoothly absorbed into the mainstream of Jewish religious thought. (shrink)

Purpose. The paper considered the explication of the concept of "Sinn des Lebens" within the framework of Western philosophy and psychology of the ХІХ-ХХІ centuries. On the basis of this, the role of this concept in contemporary theoretical discussions and psychological and psychotherapeutic practices is understood. Theoretical basis. The authors believe that understanding the concept of "Sinn des Lebens" is possible only based on the synthesis of modern analytical philosophy methods with the methodological guidelines of modern psychology, in particular logotherapy. (...) Originality. The authors have proved that the problem of "meaning of life" is not an "eternal problem" of philosophy, but arises only in the early nineteenth century as a reflection on European secularization and widespread individualistic values and becomes extremely relevant gaining different interpretations at the beginning of the twentieth century based on the crisis of the sensory values of modern man. Conclusions. The concept of "Sinn des Lebens" originated in the philosophy of the German Romantics and gained philosophical significance only in the works by Schopenhauer, Kierkegaard and Nietzsche. Russian philosophy and literature give priority to the meaning of life in ethical and anthropological studies, focusing on its religious intentions. Analytical philosophy and existentialism appear to be diametrically opposed to the life-purpose anthropological problems, but they attempt to solve this problem by understanding the absurdity of human existence and language from different angles of view. The most reasonable concept of meaning in psychology can be considered Frankl’s logotherapy, which, despite certain drawbacks, remains the most significant in modern Western psychology. Modern philosophical studies on the problems of the meaning of life, despite their prudent analyticity and systematic nature, have not found credible criteria and means of human life self-reflection yet and have further incentives to develop their methodological and philosophical considerations. However, the diversity of interpretations of the concept of "meaning of life" that exists in modern scientific literature needs further reflection. (shrink)

Elliott Sober can be understood as advancing two distinct arguments that similarly conclude that evolutionary theory does not say that Scriven’s infamous twins have the same fitness, despite the twins’ identical genotypes and phenotypes. The first argument relies on denying that evolutionary theory can say that the twins are in the same environment, and the second relies on asserting an epistemic access asymmetry between token fitness and trait fitness. Motivated by good reasons, I respond to both of these arguments by (...) showing that the theory of evolution by natural selection has adequate means for determining whether the twins are in the same environment via causal-probabilistic decomposition, and that equivalence in fitness can be asserted even from a partial theory of fitness, regardless of epistemology. Finally, I point out an absurd result regarding genetic drift as indiscriminate sampling that follows if Sober’s conclusion is true. (shrink)

In a beautiful recent essay, the philosopher Walter Sinnott-Armstrong explains the reasons for his departure from evangelical Christianity, the religious culture in which he was brought up. Sinnot-Armstrong contrasts the interpretive methods used by good philosophers and fundamentalist believers: Good philosophers face objections and uncertainties. They follow where arguments lead, even when their conclusions are surprising and disturbing. Intellectual honesty is also required of scholars who interpret philosophical texts. If I had distorted Kant’s view to make him reach a conclusion (...) that I preferred, then my philosophy professor would have failed me. The contrast with religious reasoning is stark. My Christian friends seemed happy to hide serious problems in the Bible and in their arguments. They preferred comfort to intellectual honesty. I couldn’t. To what extent can we, historians of philosophy, claim the virtue of intellectual honesty? Speaking frankly, I do not find the practice criticized by Sinnot-Armstrong’s philosophy professor rare or unusual at all. We very frequently distort the views of past philosophers in order to reach the conclusions we prefer. We just call it “Charitable Interpretation.” In this essay, I discuss and criticize the logic behind so-called charitable interpretations in the history of philosophy. This phenomenon is ubiquitous and is not at all restricted to a particular philosophical strand or ideology. Analytic philosophers and post-modernists, Marxists, liberals, secularists, and fundamentalists, we all engage in the very same domestication project. Even more disturbing than the sheer ideological pervasiveness of this phenomenon is the fact that, on many occasions, superb philosophers and historians take part in this fairly childish endeavor. In the first part of this essay, I discuss the general logic of charitable interpretations in the history of philosophy, mostly by addressing discussions in metaphysics and epistemology. In the second part, I focus on the somewhat less noticed use of charitable interpretations in the study of political philosophy, and point out the quintessential role ideology plays in these discussions. In both parts, I concentrate mostly on the interpretation of Spinoza’s thought. I do so not because I have special fondness for Spinoza (“guilty as charged,” I admit), but because Spinoza is such a beast (and may I add, an enchanting beast) and attracts a disproportionate share of the domestication efforts from historians and philosophers of all creeds and persuasions. In the third and final part of the paper, I will begin to outline an alternative methodology, which suggests that past philosophers can be most relevant to our current philosophical discussion, to the extent that they provide us with well-motivated challenges to our common-sense beliefs. Such challenges have the invaluable virtue of being able to undermine our most fundamental and secure beliefs, and force us to engage with the most fundamental questions. What more can we expect from good philosophy? (shrink)

Legal coercion seems morally problematic because it is susceptible to the Hegelian objection that it fails to respect individuals in a way that is ‘due to them as men’. But in what sense does legal coercion fail to do so? And what are the grounds for this requirement to respect? This paper is an attempt to answer these questions. It argues that legal coercion fails to respect individuals as reason-responsive agents; and individuals ought to be respected as such in virtue (...) of the fact that they are human beings. Thus it is in this sense that legal coercion fails to treat individuals with the kind of respect ‘due to them as men’. (shrink)

End-of-life organ donation is controversial in Islam. The controversy stems from: scientifically flawed medical criteria of death determination; invasive perimortem procedures for preserving transplantable organs; and incomplete disclosure of information to consenting donors and families. Data from a survey of Muslims residing in Western countries have shown that the interpretation of religious scriptures and advice of faith leaders were major barriers to willingness for organ donation. Transplant advocates have proposed corrective interventions: reinterpreting religious scriptures, reeducating faith leaders, and utilizing media (...) campaigns to overcome religious barriers in Muslim communities. This proposal disregards the intensifying scientific, legal, and ethical controversies in Western societies about the medical criteria of death determination in donors. It would also violate the dignity and inviolability of human life which are pertinent values incorporated in the Islamic moral code. Reinterpreting religious scriptures to serve the utilitarian objectives of a controversial end-of-life practice, perceived to be socially desirable, transgresses the Islamic moral code. It may also have deleterious practical consequences, as donors can suffer harm before death. The negative normative consequences of utilitarian secular moral reasoning reset the Islamic moral code upholding the sanctity and dignity of human life. (shrink)

In this paper, I first review previous interpretations of Wittgenstein's remarks on private language, revealing their inadequacies, and then present my own interpretation. Basing mainly on Wittgenstein's notes for lectures on private sensations, I establish the following points: ‘remembering the connection right’ means ‘reidentifying sensation-types’; the reason for ‘no criterion of correctness’ is that nothing, especially no inner mechanisms nor external devices, can be utilised by the private speaker to tell whether some sensations are of one type or different types; (...) and private names are not really names, private language is not really a language, therefore, private language is a grammatical illusion. My interpretation has the advantage of being able to reconcile Wittgenstein's conception of philosophy, which is to dissolve philosophical problems by rearranging grammatical facts, with his actual philosophical practice, at least in the case of private language. (shrink)

In this paper, I first review previous interpretations of Wittgenstein's remarks on private language, revealing their inadequacies, and then present my own interpretation. Basing mainly on Wittgenstein's notes for lectures on private sensations, I establish the following points: ‘remembering the connection right’ means ‘reidentifying sensation-types’; the reason for ‘no criterion of correctness’ is that nothing, especially no inner mechanisms nor external devices, can be utilised by the private speaker to tell whether some sensations are of one type or different types; (...) and private names are not really names, private language is not really a language, therefore, private language is a grammatical illusion. My interpretation has the advantage of being able to reconcile Wittgenstein's conception of philosophy, which is to dissolve philosophical problems by rearranging grammatical facts, with his actual philosophical practice, at least in the case of private language. (shrink)

While the Value-Free Ideal (VFI) had many precursors, it became a solidified bulwark of normative claims about scientific reasoning and practice in the mid-twentieth century. Since then, it has played a central role in the philosophy of science, first as a basic presupposition of how science should work, then as a target for critique, and now as a target for replacement. In this paper, we will argue that a narrow focus on the VFI is misguided, because the VFI coalesced in (...) the midst of other important shifts in the relationship between science and society. In particular, the mid-twentieth century saw the acceptance of the “social contract for science,” a tacit agreement between scientists and government officials, and more broadly between science and society. It was built around three core concepts: a distinction between basic and applied science, a conception of scientific freedom that limited social responsibility for scientists, and a justification for public funding of basic science in the form of the linear model. Within the conceptual framework of the social contract for science, it is clearer both (1) why the VFI was adopted, (2) why it is difficult to replace the VFI within the old social contract, and (3) how we need to revise the social contract for science in order to replace the VFI. (shrink)

Jewish philosophy has seen better days. It has been quite a while since the discipline of Jewish philosophy enjoyed the respect of the wider philosophical community, and an obvious question is what are the reasons for this state of things? Providing a detailed and thorough answer to this question is beyond the scope of the current chapter. Still, I would like to contribute here a few ideas that might shed some light on the current predicament and its causes. Such an (...) attempt is timely because the current moment in the development of Anglo-American philosophy is impregnated with a promise – which I hope is sincere – to turn the study of philosophy and the history of philosophy into an inclusive and genuinely universal field of inquiry, shared equally by all human beings, rather than an imposition of the prevalent beliefs of white Christian European males. A study of philosophy that is genuinely ecumenical could profit enormously from the encounter and dialogue with the philosophical thinking of minority cultures, since it is precisely this encounter with the philosophical thought of minority cultures that could expose the potentially numerous blind spots of the majority. If anything can heal Western philosophy from the prejudice that what one takes to be natural must be equally judged so by all rational human beings, it is only the encounter with non-Christian, or non-Western, philosophical thinking that could refute its illusory pretense of universality. Obviously, the real issue at stake is the sincerity of the attempt to understand foreign cultures and their philosophical thinking in their own terms. An identity politics that is merely interested in extending fig leaves would be far worse than the old, conservative state of things, insofar as the new and “inclusive” appearance would only provide the majority culture with a sense of self-satisfaction that would allow it to stick to its old and obstinate prejudicial practices. My aims in the current chapter are pretty modest and concrete. In the first two parts of the chapter, I will attempt to shed light on two blind spots related to perceptions of Jewish philosophy, from without and from within, respectively. These two parts will thus inquire into the nature of Jewish philosophy as minority philosophy. In the third and final part, I will turn to the rudimentary requirements of Jewish philosophy qua philosophy. In this part, I will suggest some fundamental desiderata which might – I hope – help the field flourish and achieve the recognition it deserves. Here too, my claims would be quite plain, as most of the desired characteristics I would argue for are pretty trivial, yet unfortunately still mostly lacking. (shrink)

Spinoza’s recognition of the unpredictable fortunes of individuals, explicable through the interplay between their intrinsic natures and their susceptibility to external causes, informs his account of political success and – what for him is the same thing – political virtue. Thus, a state may thrive because it has a good constitution (an internal feature), or because it was fortunate not to be surrounded by powerful enemies. Normally, however, it is the combination of both luck and internal qualities that determines the (...) fate of things. What is true about the fate of states holds equally of the fate of other types of individual, both human and non-human. In a sense, even the fate of a theory is determined by the interplay between its intrinsic virtues, and mere historical luck. A quarter century ago, shortly after I began my graduate studies in philosophy at Yale, I started thinking about writing a dissertation on Spinoza’s philosophy. A good and caring friend in my graduate cohort advised me against the idea, which he believed was tantamount to “professional suicide” given the oddity of Spinoza’s thought. Indeed, the environment of analytic philosophy in the mid- and even late-1990s was not particularly auspicious for the academic study of Spinoza. Spinoza was – rightly – considered as having little commitment to commonsense, and commitment to commonsense – the most stubborn of prejudices – was (and still is) considered by many a minimal requirement for entry into the club of “decent” philosophers. Yet, things have changed over the past twenty-five years. So much so, that recently a (non-Spinozist) early modernist colleague of mine complained to me about the futility of changing the description of an event he planned from a ‘Spinoza workshop’ into an ‘early modern philosophy workshop,’ since “one way or another, most of the submitted abstracts are going to deal with Spinoza.” Indeed, in many ways, the interest and intensity of the study of Spinoza’s philosophy in the Anglo-American world has eclipsed that of almost all other early modern philosophers, and we seem to be facing a circumstance in which Spinoza is gradually competing with, if not replacing, Kant as the compass of modern philosophy. One can list many reasons for these dramatic developments: from Spinoza’s radical naturalism, to his dismissal of the fairytales of anthropomorphic and anthropocentric religion – while Kant on these issues could at best be said to kick the ghosts from the front door while inviting them back as ‘ideas’ or ‘postulates of practical reason’ through the back door –- to his unequivocal rejection of the illusions of humanism. Still, we lack a full explanation of the recent Spinozist upheaval in North American philosophy. (shrink)

Many patients believe that cardiopulmonary resuscitation is more likely to be successful than it really is in clinical practice. Even when working with accurate information, some nevertheless remain resolute in demanding maximal treatment. They maintain that even if survival after cardiac arrest with CPR is extremely low, the fact remains that it is still greater than the probability of survival after cardiac arrest without CPR. Without realising it, this line of reasoning is strikingly similar to Pascal’s Wager, a Renaissance-era argument (...) for accepting the proposition for God’s existence. But while the original argument is quite logical—if not universally compelling—the modern variant makes several erroneous assumptions. The authors here present a case of a patient who unwittingly appeals to Pascal’s Wager to explain his request for maximal treatment, in order to highlight the crucial divergences from the original Wager. In understanding the faulty assumptions inherent in the application of Pascal’s Wager to code status decisions—and identifying the underlying motivations which the Wager serves to confirm—providers can better ensure that the true values and preferences of patients are upheld. (shrink)

Abortion is the deliberate termination of a pregnancy. In current practice, this involves the death of the foetus. Consequently, the debate on whether those experiencing an unwanted pregnancy have the right to abortion is usually dichotomized as a matter of pro-choice versus pro-life. Pro-choice advocates maintain that abortion is acceptable under various circumstances. The idea that we ought to respect pregnant people’s rights to choose what to do with their bodies – respect for bodily autonomy – is cited as a (...) major reason for granting them abortion rights. Pro-life advocates, on the other hand, claim that abortion is not acceptable under most circumstances. They argue, typically, that the foetus has a right to life. Recent events, such as Poland’s High Court decision in October 2020 to ban most abortions, and the huge protests and outcries this generated around the world, indicate that the abortion debate is far from resolved. (shrink)

Objectives: To investigate the current situation of completing the informed consent for do-not-resuscitate (DNR) orders among the competent patients with terminal illness and the ethical dilemmas related to it. Participants: This study enrolled 152 competent patients with terminal cancer, who were involved in the initial consultations for hospice care. Analysis: Comparisons of means, analyses of variance, Student’s t test, χ2 test and multiple logistic regression models. Results: After the consultations, 117 (77.0%) of the 152 patients provided informed consent for hospice (...) care and DNR orders. These included 21 patients (17.9%) who signed the consent by themselves, and 96 (82.1%) whose consent sheet was signed only by family members. The reasons why patients were not involved in the discussions toward the consent (n = 82) included poor physical or psychological condition (44.9%), concerns of the consultant hospice team (37.2%), and the family’s refusal (28.2%). On a multivariate analysis, patients’ awareness of their poor prognosis (odds ratio = 4.07, 95% confidence interval = 2.05 to 8.07) and their understanding of hospice care (2.27, 1.33 to 3.89) were two independent factors (p<0.01) that influenced their participation in the discussions or their personal signature in the informed consent. Conclusion: The family-oriented culture in Asian countries may violate the principles of the Patient Self-Determination Act and the requirements of the Hospice Care Law in Taiwan, which inevitably poses an ethical dilemma. Earlier truth-telling and continuing education of the public by hospice care workers will be helpful in solving such ethical dilemmas. (shrink)

Background: Although maternal serum screening for Down’s syndrome has become routinely available in most obstetric clinics in many countries, few studies have addressed the reasons why women agree to undergo the MSS test.Objectives: The aims of this study were to describe the circumstances in which MSS was offered to pregnant women and their reasons for undertaking it.Methods: Participant observation and in depth interviews were used in this study; specifically, the experiences of women who had a positive result for MSS and (...) who then followed this up with amniocentesis were examined. The interviewees were twenty six mothers aged between 22 and 35 years. The interviews were audio taped and transcribed for analysis. The results were analysed by the constant comparative method.Results: This study identified the reasons on which pregnant women appeared to base their decisions when undergoing MSS. The reasons were first, the recognition that the procedure was a prenatal routine procedure; second, the need to avoid the risk of giving birth to a baby with Down’s syndrome, and third, a trust in modern technology and in the professional authorities.Conclusions: This study offers insights into the informed choice made by women with a positive MSS result. The reasons for undergoing MSS might help health professionals and policy makers to reflect on their practice and this may, in turn, improve the quality of prenatal care during MSS. (shrink)

All contemporary frameworks of mental capacity stipulate that we must begin from the presumption that an adult has capacity. This presumption is crucial, as it manifests respect for autonomy and guards against prejudice and paternalism on the part of the evaluator.Given its ubiquity, we might presume that we all understand the presumption’s meaning and application in the same way. Evidence demonstrates that this is not the case and that this has led to harm in vulnerable persons. There is thus strong (...) reason to question our presumptions about the presumption of capacity.We distinguish between two main ways of understanding and applying the presumption of capacity, and advocate for the one that we argue mitigates risk of harm. Our proposed interpretation offers many advantages in that it is consonant with actual practice of capacity evaluations, precludes confused and abusive avoidance of needed evaluations, and preserves the respect for autonomy motivating the presumption in the first place. (shrink)

Background Most jurisdictions that allow euthanasia and assisted suicide (AS) regulate it through the medical profession. However, the extent and nature of how medicine should be involved are debated. Swiss AS practice is unusual in that it is managed by lay AS organizations that rely on a law that permits AS when done for nonselfish reasons. Physicians are not mentioned in the law but are usually called upon to prescribe the lethal medications and perform capacity evaluations.Methods We analyzed in-depth interviews (...) of 23 Swiss AS experts including ethicists, lawyers, medical practitioners, and senior officials of AS organizations for their views on AS.Results Although there was agreement on some issues (e.g., need for better end-of-life care), the interviewees’ preferred model for AS, and the nature of preferred medical involvement, varied, which we categorized into five types: preference for AS practice as it occurred prior to lay AS organizations; preference for the current lay model; preference for a modified lay model to increase autonomy protections while limiting medical AS normalization; preference for various types of more medicalized models of AS; and, ambivalence about any specific model of medical involvement. The rationales given for each type of model reflected varying opinions on how medicine’s role would likely impact AS practice and demonstrated the experts’ attitudes toward those impacts.Conclusion The dynamics within the Swiss AS regime, as reflected in the varying views of Swiss AS experts, shed light on the dilemmas inherent to medical scope and involvement in AS, which may have implications for debates in other jurisdictions. (shrink)

To demarcate the limits of experimental knowledge, we probe the limits of what might be called an experiment. By appeal to examples of scientific practice from astrophysics and analogue gravity, we demonstrate that the reliability of knowledge regarding certain phenomena gained from an experiment is not circumscribed by the manipulability or accessibility of the target phenomena. Rather, the limits of experimental knowledge are set by the extent to which strategies for what we call ‘inductive triangulation’ are available: that is, the (...) validation of the mode of inductive reasoning involved in the source-target inference via appeal to one or more distinct and independent modes of inductive reasoning. When such strategies are able to partially mitigate reasonable doubt, we can take a theory regarding the phenomena to be well supported by experiment. When such strategies are able to fully mitigate reasonable doubt, we can take a theory regarding the phenomena to be established by experiment. There are good reasons to expect the next generation of analogue experiments to provide genuine knowledge of unmanipulable and inaccessible phenomena such that the relevant theories can be understood as well supported. This article is part of a discussion meeting issue ‘The next generation of analogue gravity experiments’. (shrink)

In three parts, this volume in the AP-LS series explores the phenomena of captivity and risk management, guided and informed by the theory, method, and policy of psychological jurisprudence. The authors present a controversial thesis that demonstrates how the forces of captivity and risk management are sustained by several interdependent "conditions of control." These conditions impose barriers to justice and set limits on citizenship for one and all. Situated at the nexus of political/social theory, mental health law and jurisprudential ethics, (...) the book examines and critiques constructs such as offenders and victims; self and society; therapeutic and restorative; health; harm; and community. So, too, are three "total confinement" case law data sets on which this analysis is based. The volume stands alone in its efforts to systematically "diagnose" the moral reasoning lodged within prevailing judicial opinions that sustain captivity and risk management practices impacting: (1) the rights of juveniles found competent to stand criminal trial, the mentally ill placed in long-term disciplinary isolation, and sex offenders subjected to civil detention and community re-entry monitoring; (2) the often unmet needs of victims; and (3) the demands of an ordered society. Carefully balancing sophisticated insights with concrete and cutting-edge applications, the book concludes with a series of provocative, yet practical, recommendations for future research and meaningful reform within institutional practice, programming, and policy. (shrink)

The article devoted to the phenomenon of ‘virtual‘ social media as a factor influencing the formation of the markers of the value palette and preferences of modern youth. The reasoning of this interest is due to the fact that it is the youth, who is a catalyst for the development of a society. The young people today are actively involved in the urban environment through the virtualization of everyday practices, through the incorporation in the colossal information stream and the virtual (...) urban communities. The aim of this study is to identify among the youth audience the role of social media in the formation of value-sense attitudes and preferences. The study methodology is based on research approach of Sheri Turkle. Through the empirical research, the authors define both the motives for the inclusion of young people in virtual communities and the direction of the content of these virtual groups. As a result, the authors come to the conclusion that the dominant force of social networking is self-assertion of a personality with an active representative example included in a variety of communities, living and acting according to the rules of these groups and receiving there social approval and support; it often leads to a break with the cultural tradition and to forming the personality of a new type. This reason determines the novelty and relevance of the research in modern conditions of development of the digital society. (shrink)

Russian translation of the Chpater 9 of Audi R. Practical Reasoning and Ethical Decision. – London, N. Y., 2006. Translated by Andrei Zavaliy with kind permission of the author.

To come to know what to do is to have a thought which itself consists of an awareness of its bringing about an action, or a rearrangement of one’s causal powers...The causal dimension of practical thinking is the coalescence of contemplation and the causation of that contemplation, and the contemplation of that causation.

In choosing between moral alternatives -- choosing between various forms of ethical action -- we typically make calculations of the following kind: A is better than B; B is better than C; therefore A is better than C. These inferences use the principle of transitivity and are fundamental to many forms of practical and theoretical theorizing, not just in moral and ethical theory but in economics. Indeed they are so common as to be almost invisible. What Larry Temkin's book (...) shows is that, shockingly, if we want to continue making plausible judgments, we cannot continue to make these assumptions. Temkin shows that we are committed to various moral ideals that are, surprisingly, fundamentally incompatible with the idea that "better than" can be transitive. His book develops many examples where value judgments that we accept and find attractive, are incompatible with transitivity. While this might seem to leave two options -- reject transitivity, or reject some of our normative commitments in order to keep it -- Temkin is neutral on which path to follow, only making the case that a choice is necessary, and that the cost either way will be high. Temkin's book is a very original and deeply unsettling work of skeptical philosophy that mounts an important new challenge to contemporary ethics. (shrink)

It is a popular view thatpractical deliberation excludes foreknowledge of one's choice. Wolfgang Spohn and Isaac Levi have argued that not even a purely probabilistic self-predictionis available to thedeliberator, if one takes subjective probabilities to be conceptually linked to betting rates. It makes no sense to have a betting rate for an option, for one's willingness to bet on the option depends on the net gain from the bet, in combination with the option's antecedent utility, rather than on the offered (...) odds. And even apart from this consideration, assigning probabilities to the options among which one is choosing is futile since such probabilities could be of no possible use in choice. The paper subjects these arguments to critical examination and suggests that, appearances notwithstanding, practical deliberation need not crowd outself-prediction. (shrink)

En este artículo se sostiene que existe una primacía de la práctica y la acción sobre el conocimiento intelectual y la contemplación. Si esta tesis fuese falsa, no resulta comprensible por qué la prudencia y el hombre prudente son la virtud suprema y el modelo de la vida buena en Aristóteles. La cuestión inicial es 1) ¿Cómo entender la racionalidad del deseo o qué significa deseo razonado?, y esto implica dos cuestiones adicionales: 2) ¿Qué es el silogismo práctico y qué (...) relación tiene con la recta razón? y 3) ¿cuál es la relación entre el razonamiento práctico, la prudencia y el hombre prudente? Estas cuestiones son analizadas para establecer algunas de las semejanzas y diferencias entre el silogismo práctico , los diversos tipos de inferencias prácticas y otros tipos de razonamientos, tratando de mostrar la relación que existe entre la formación del carácter o modo de ser, la recta razón y el silogismo práctico. (shrink)

El artículo pretende ofrecer algunas claves interpretativas de la Axiología y Práctica materiales de Husserl. El estudio de la primera parte se centra en la cuestión de la verdad y el cumplimiento de los actos no objetivantes. La segunda parte analiza los sentidos que en Husserl tiene la noción práctica de fin y pone en conexión la verdad práctica con el imperativo categórico en su versión husserliana de actuar según el mejor saber y la mejor conciencia, aplicado tanto a las (...) acciones particulares como a la voluntad común de perfeccionamiento que las preside. Se termina con unas conclusiones valorativas. The aim of this article is to offer some interpretative keys of Husserl´s material Axiology and Practice. The study of the former focuses on the fulfilment and truth in not objectivant acts. The latter analyzes the meanings that the notion of end acquires in Husserl and connects the practical truth with the categorial imperative in its Husserlian version, that says "act according to the best knowing and the best conscience", applied to both particular actions and the common will of perfecting that presides over them. The article ends with valuation. (shrink)

ABSTRACT Aristotle's account of rhetoric goes beyond its previous consideration as an art of persuasion to be regarded as a suitable logic for human affairs. In the realm of ethics and politics, he needs to appeal to a logic that can deal with contingency without discarding the concept of truth. I claim that the double rapport of rhetoric with dialectic and ethical-political issues links public discourse with the question of rationality and practical truth. I will start with a brief (...) overview of two passages of the Rhetoric that account for the liaison of rhetoric with dialectic. Secondly, I consider two contributions that rhetoric theory makes to the enhancement of the rationality of ethics. Lastly, I will reflect on the relationship of rhetorical discourse with practical truth. RESUMEN La reflexión aristotélica sobre la retórica va más allá de su consideración previa como un arte de persuasión para ser comprendida como una lógica adecuada a los asuntos humanos. En el ámbito de la ética y la política se necesita apelar a una técnica de razonamiento que pueda lidiar con la contingencia, sin descartar el concepto de verdad. En este artículo defiendo que la doble relación de la retórica con las cuestiones dialécticas y ético-políticas vincula el discurso público con la cuestión de la racionalidad y la verdad práctica. Comenzaré con una breve descripción de dos pasajes de la Retórica que explican el vínculo de la retórica con la dialéctica. En segundo lugar, consideraré dos contribuciones que hace la teoría de la retórica al realce de la racionalidad de la ética. Por último, reflexionaré sobre la relación del discurso retórico con la verdad práctica. (shrink)

Taking as a starting point Taylor's concept about man as a being of meanings, this article examines, in particular, the way that Taylor elaborates his conception of the practical use of reason, recovering some fundamental notions of the phenomenological tradition and hermeneutics, relating to language, such as, the idea of the background, and the incarnated situation of man. Considering that, ultimately, the background is a horizon of previous reference, from the ontological point of view, to the subjective domain of (...) reason in the human agent, the analysis of Taylor ends up favoring certain approaches of contemporary philosophy such as, Heidegger’s existential analytic that aims at leaving aside, paradoxically, the premise of the subject. If we consider this indication, a challenge that remains, then, to the future development of the ways of understanding moral philosophy and philosophical anthropology, is how to link the analysis of the moral problem, in a subject of senses, with the ontological theory of the background that is, however, a-subjective. Tomando como punto de partida el concepto que tiene Taylor acerca del ser humano como un ser de significados, este artículo estudia el modo como Taylor elabora su concepción del uso práctico de la razón, recuperando ciertas nociones fundamentales de la tradición fenomenológica y hermenéutica relativas al lenguaje, como lo son la idea del trasfondo y la situación encarnada del hombre. Puesto que, en definitiva, el trasfondo constituye un horizonte de referencia anterior, desde el punto de vista ontológico, al dominio subjetivo de la razón en el agente humano, el análisis de Taylor termina por favorecer ciertos enfoques de la filosofía contemporánea como, por ejemplo, la analítica existenciaria de Heidegger, que buscan prescindir, paradójicamente, de la premisa del sujeto. Si atendemos a esta indicación, un desafío que resta, pues, al desarrollo futuro de los modos de comprensión de la filosofía moral, y de la antropología filosófica, es el de cómo vincular el análisis del problema moral, de un sujeto de sentidos, con una teoría ontológica del trasfondo que es, en cambio, a-subjetiva. (shrink)

The political dimension of science has gained a particular interest in most recent decades for areas of knowledge like the Philosophy of science, as well as for political studies of science, history of science, among others. One reason for this development is that we are more conscious the results obtained by a scientist are a product of the interaction and interrelation of epistemic and none epistemic values. This dynamic is one of the factors which make progress in science possible and (...) reflects, at the same time, its integrity. Based on the contributions provided by Philip Kitcher, I shall characterize in this paper the two forms to treat scientific knowledge from a philosophical perspective. I shall argue, following Kitcher, that the scientific practice and social aspects of knowledge are not two different and disconnected things, but a unity of reasons which enable the progress of scientific knowledge. (shrink)

Resumen En este artículo se examina el Darwinismo Neural en su explicación de la evolución de la conciencia humana, contrastando su metodología con la utilizada por Richard Lewontin, Richard Levins y Steven Rose, quienes han hecho importantes aportaciones en el estudio de los sistemas vivos desde un punto de vista dialéctico. Concluimos que la explicación interaccionista de la evolución de la conciencia planteada en el DN, supera muchas de las deficiencias del determinismo biológico; sin embargo, al compartir algunos lineamientos con (...) el cartesianismo, mantiene un carácter a-histórico insuficiente para la explicación de la conciencia humana. Finalmente, proponemos la adopción de una teoría explicativa de la conciencia humana que considere las relaciones existentes en ella, no sólo como interacciones sino también como interpenetraciones ontogénicas y filogenéticas.This article examines Neural Darwinism proposed as an explanation of evolution of human consciousness. His methodology is contrasted with that used by Richard Lewontin, Richard Levins, and Steven Rose, who made important contributions to the study of living systems from a dialectical point of view. We conclude that the interactionist explanation of the evolution of conscience put forward in ND overcomes many of the deficiencies proper to biological determinism. However, as ND also shares many of the foundations of the Cartesian approach, it maintains a non-historical character, insufficient for the account of human consciousness. We suggest the adoption of an alternative theory, able to fully explain human conscience which must consider the whole of existing relations in it, and, instead of merely considering them as interactions, they have to be observed as dialectical interpenetrations. (shrink)

Contrary to the common view, this paper suggests that the Hippocratic oath does not directly refer to the controversial subjects of euthanasia and abortion. We interpret the oath in the context of establishing trust in medicine through departure from Pantagruelism. Pantagruelism is coined after Rabelais' classic novel Gargantua and Pantagruel. His satire about a wonder herb, Pantagruelion, is actually a sophisticated model of anti-medicine in which absence of independent moral values and of properly conducted research fashion a flagrant over-medicalization of (...) human problems. Ultimately this undermines the therapeutic core of medicine itself. We contend that PAS is a case of such over-medicalization and that its institution creates medicophobia. This article does not express an opinion about euthanasia in general. Rather, we claim that physicians should learn from the oath and from Rabelais that they should keep their practice to medical care and not to exploit their expertise and social privileges for the sake of ulterior motives, even when their patients desire those goals. (shrink)

The article examines the new discourse on medical professionalism and responsibility through the prism of conflicts among moral values, especially with regard to truth-telling. The discussion is anchored in the renaissance of English-language writing on medical ethics in the 18th century, which paralleled the rise of humanitarianism and the advent of the word “responsibility”. Following an analysis of the meanings of the value of responsibility in general and in medical practice in particular, it is argued that, similarly to the Aristotelian (...) notion of equity, responsibility of care is a second-order value, which corrects virtues, laws and norms in exceptional circumstances. Virtues and practices of the second order, such as responsibility and deliberation, bear especially on professional doctoring, which includes a commitment to give priority to the good of the patient over one’s own good. It is argued that, in situations of conflict, and particularly conflicts between personal moral identity and the good of patients, the fundamental professional commitment is to critical and rational deliberation and to the cultivation of psycho-moral flexibility. This leads indirectly to moral growth and strengthening of professional character. (shrink)