In this book, C. G. Prado addresses the difficult question of when and whether it is rational to end one’s life in order to escape devastating terminal illness. He specifically considers this question in light of the impact of multiculturalism on perceptions and judgments about what is right and wrong, permissible and impermissible. Prado introduces the idea of a “coincidental culture” to clarify the variety of values and commitments that influence decision. He also introduces the idea of a “proxy premise” (...) to deal with reasoning issues that are raised by intractably held beliefs. Primarily intended for medical ethicists, this book will be of interest to anyone concerned about the ability of modern medicine to keep people alive, thereby forcing people to choose between living and dying. In addition, Prado calls upon medical ethicists and practitioners to appreciate the value of a theoretical basis for their work. (shrink)
This study examined health professionals’ (HPs) experience, beliefs and attitudes towards brain death (BD) and two types of donation after circulatory death (DCD)—controlled and uncontrolled DCD. Five hundred and eighty-seven HPs likely to be involved in the process of organ procurement were interviewed in 14 hospitals with transplant programs in France, Spain and the US. Three potential donation scenarios—BD, uncontrolled DCD and controlled DCD—were presented to study subjects during individual face-to-face interviews. Our study has two main findings: (1) (...) In the context of organ procurement, HPs believe that BD is a more reliable standard for determining death than circulatory death, and (2) While the vast majority of HPs consider it morally acceptable to retrieve organs from brain-dead donors, retrieving organs from DCD patients is much more controversial. We offer the following possible explanations. DCD introduces new conditions that deviate from standard medical practice, allow procurement of organs when donors’ loss of circulatory function could be reversed, and raises questions about “death” as a unified concept. Our results suggest that, for many HPs, these concerns seem related in part to the fact that a rigorous brain examination is neither clinically performed nor legally required in DCD. Their discomfort could also come from a belief that irreversible loss of circulatory function has not been adequately demonstrated. If DCD protocols are to achieve their full potential for increasing organ supply, the sources of HPs’ discomfort must be further identified and addressed. (shrink)
American healthcare -- Bioterror and bioart -- State of emergency -- Licensed to torture -- Hunger strikes -- War -- Cancer -- Drug dealing -- Toxic tinkering -- Abortion -- Culture of death -- Patient safety -- Global health -- Statue of security -- Pandemic fear -- Bioidentifiers -- Genetic genocide.
Foreword -- Prologue -- Attorney Eileen Fitzpatrick -- Dr. Jeanne Fitzpatrick -- section 1. Death and dying in America -- 1. The need for change : the cautionary tale of Phyllis Shattuck -- Dr. Fitzpatrick tells Phyllis Shattuck's story -- Reflections -- How this book will help -- Lessons to learn -- New name, old concept -- 2. Your right to die -- Your right to die is born : the case of Karen Ann Quinlan -- The Supreme Court (...) weights in : the case of Nancy Cruzan -- Advance directive forms : an imperfect solution -- The more things change, the more they stay the same : the case of Terri Schiavo -- Moving forward : comfort care only and the Compassion Protocol -- A personal choice -- section 2. Who can use the Compassion Protocol -- 3. The competent elderly -- Dr. Fitzpatrick tells Willa Simpson's story -- Learning from Willa -- The Compassion Protocol increases choice and control at the end of lie -- The Compassion Protocol and the competent elderly -- 4. The terminally ill -- Dr. Fitzpatrick tells Melissa Blackburn's story -- Terminal illness and the Compassion Protocol -- Current practices -- Compassion Protocol practices -- 5. Alzheimer's dementia and the Compassion Protocol -- Dr. Fitzpatrick tells Carl Novack's story -- Alzheimer's dementia and the Compassion Protocol -- Is this really legal? -- Updating time-honored advice -- section 3. How the Compassion Protocol works -- 6. Step one : know your options -- Option one : don't go to the hospital again -- Option two : refuse antibiotics -- Option three : discontinue your usual medications -- Option four : refuse hydration and nutrition -- Health care options summary -- Choosing when your options take effect -- Step one summary -- 7. Step two : make your decisions -- Introduction to step two -- The Compassion Protocol worksheet -- Your list of pros and cons -- A story of our own worst fears -- Step two and the Alzheimer's patient -- Selecting a health care decision maker -- Review -- 8. Step three : communicate your decisions -- The importance of full and adequate communication : the story of Ray Sullivan -- What constitutes effective communication? -- Tell your health care decision maker -- Tell your doctor and other health care providers -- Tell your family -- Tell your friends -- Dr. Fitzpatrick talks about her end-of-life choices -- Attorney Fitzpatrick talks about her end-of-life choices -- Step three summary -- 9. Step four : do the paperwork -- Introduction to the Contract for Compassionate Care -- Legal basis of the Compassion Protocol -- The long and short of legal forms -- And never forget the "people" part -- 10. Step five : plan the kind of death you want -- Changing society one death at a time -- 11. Hospice and the Compassion Protocol -- The importance of fighting for life and of letting go : Dr. Fitzpatrick tells the story of one patient's experience with hospice -- The team approach -- Paying for hospice -- Hospice and the Compassion Protocol -- 12. Everyone's worst fear : the nursing home -- Dr. Fitzpatrick relates the story of Sean O'Connor : a regrettably common nursing home experience -- Understanding you nursing home option -- Nursing homes : a growth business -- The home health care alternative -- When the system works : Dr. Fitzpatrick tells the story of Sally Forest -- Reflections -- 13. Looking ahead -- Appendix A. Contract for Compassionate Care -- Appendix B. Tools for the Compassion Protocol -- Glossary. (shrink)
Some proponents of the pro-life movement argue against morning after pills, IUDs, and contraceptive pills on grounds of a concern for causing embryonic death. What has gone unnoticed, however, is that the pro-life line of argumentation can be extended to the rhythm method of contraception as well. Given certain plausible empirical assumptions, the rhythm method may well be responsible for a much higher number of embryonic deaths than some other contraceptive techniques.
Men have been talking of death from time immemorial - sometimes sublimely in prose and poetry, in painting and sculpture and in music - till silence seemed to fall in the recent past. Now men are again talking about death - interminably but colloquially. They talk on television, on the radio, in books and in pamphlets. Dr Kenneth Boyd therefore finds it entirely timely to offer this historical sketch of attitudes to death. The earlier part of his (...) paper covers fairly familiar ground but his final and longest section on the work of a social historian, Philippe Ariès, may be new to many. Ariès is reinterpreting the long history of attitudes to death in a form which may well interest those who today are concerned with helping modern man to accept his own death - death which still, for most people, is the death of another, not of oneself. (shrink)
Since the collapse of Japan's bubble economy in the early 1990' s, the Japanese economy has only recovered slightly. This has direct implications for employment. Both the seniority wage system and the lifetime employment system, which were popular during the period of economic growth in Japan, unavoidably changed to an outcome-wage system. Now there is greater mobility in employment, increased use of nonregular employees, and diversed working patterns. The problem of karoshi – a potentially fatal syndrome resulting from long work (...) hours – has been known since the early 1980s. This problem has become more serious in recent years. The purpose of this article is to provide an overview of the economic and employment conditions in Japan, as well as to examine the working lifestyle of Japanese men and its connection to "karoshi." It is argued that (1) the long work hours are not the preference of individuals, but rather the result of the adaptation to the work environment, and; (2) solving this problem requires re-conceptualization of workers' human rights on the part of both companies and the society as a whole. (shrink)
Fundamental principles : the nature of the dispute -- Types of euthanasia -- Psychiatric assisted suicide -- Neonates -- Incompetent adults -- Human life is sacred -- The slippery slope -- Medical views -- Four methods of easing death and their effect on doctors -- Looking further ahead.
This research examines business and psychology students’ attitude toward unethical behavior (measured at Time 1) and their propensity to engage in unethical behavior (measured at Time 1 and at Time 2, 4 weeks later) using a 15-item Unethical Behavior measure with five Factors: Abuse Resources, Not Whistle Blowing, Theft, Corruption, and Deception. Results suggested that male students had stronger unethical attitudes and had higher propensity to engage in unethical behavior than female students. Attitude at Time 1 predicted Propensity (...) at Time 1 accurately for all five factors (concurrent validity): If students consider it to be unethical, then, they are less likely to engage in that unethical behavior. Attitude at Time 1 predicted only Factor Abuse Resources for Propensity at Time 2. Propensity at Time 1 was significantly related to Propensity at Time 2. Attitude at Time 1, Propensity at Time 1, and Propensity at Time 2 had achieved configural and metric measurement invariance across major (business vs. psychology). Thus, researchers may have confidence in using these measures in future research. (shrink)
Two recent events have caused renewed anxiety concerning the ethics of donor transplantation. The first is the report of the British Transplantation Society and the second is the Bill introduced by Mr Tam Dalyell MP (see page 61 of this issue) in which he seeks to establish by law that unless an individual in his life time has expressly contracted out his organs may after death be used for transplantation. Dr Mahoney in this paper therefore examines from the point (...) of view of ethics some of the personal and social aspects of both proposals. (shrink)
The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a (...) do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (shrink)
The division between the natural and the artificial is itself artificial. But we continue to yearn for a 'homecoming' to our natural state – which means, to the identity with our environment which was the condition of the hunter-gatherer. Totemism is the thought-process whereby the prey can be simultaneously consecrated as a species, and pursued to the death as an individual. This thought-process has an evident ecological function. The morality of hunting resides in the maintenance of this dual (...) class='Hi'>attitude. An anthropological explanation is offered of the perceived rituals of hunting, and of 'guiltless killing'. (shrink)
This essay explores how strategies integral to inquiry in the humanities provide insights into developing an interdisciplinary approach to studies of death and dying that will be relevant to medical practice as well as to humanistic study. The author asks how we can produce new modes of knowledge in an area where “knowing” is highly problematized and argues that while a putative field of death and dying studies must include a range of disciplinary approaches it must also account (...) for lived, subjective experience and the ways that we, as individuals and as a culture, create meaning. (shrink)
In the ninth fragment of his posthumous work Living Up to Death , Paul Ricoeur reflects on Jacques Derrida’s final interview given to the French newspaper Le Monde just months prior to his death. Although he confesses to a genuine distanciation from Derrida regarding salient aspects of their individual memento mori , he does so within the context of significant concessions of agreement. I argue in this article that their differing positions de facto agree at a critical structural (...) level with reference to the possibility of positing something akin to a textual immortality. Both contend that traces of the author remain in the corpus of a work, a remainder that allows for a form of resurrection through reading. By analogizing their perspectives with Rudolf Bultmann’s kerygmatic resurrection of Christ in the proclaimed word, I conclude that Ricoeur and Derrida contend that one truly learns to live up to death ‘ finally ’, that is, enfin — ‘at last’, ‘after all’, or one might say, ‘ in a word ’. (shrink)
Biology has been advancing with explosive pace over the last few years and in so doing has raised a host of ethical issues. This book, aimed at the general reader, reviews the major advances of recent years in biology and medicine and explores their ethical implications. From birth to death the reader is taken on a tour of human biology - covering genetics, reproduction, development, transplantation, aging, dying and also the use of animals in research and the impact of (...) human populations on this planet. In each chapter there is a sketch of a field's most recent scientific advances, combined with discussions of the ethical and moral principles and implications for social frameworks and public policy raised by those advances. Anybody interested or concerned about the ethical dilemmas caused by advances in science and medicine should read this book. (shrink)
Right from the start of the Spanish Civil War, thousands of prisoners were executed by shooting. Today, many of them remain anonymous, but others, thanks to their writing, have passed into history. In the final hours before their execution, these men and women had the chance to write a few farewell letters to their nearest and dearest. These letters, known by historians as ?chapel letters,? passed either through official channels exercising prior censorship or else were sent clandestinely. In their farewell (...) letters, the condemned to death informed their families of their tragic fate and dedicated their last words to them. Genuine family relics, material and spiritual testaments, instruments of denunciation and propaganda, these chapel letters are regarded as the most sincere documents of any historical period. Since prisoners expressed in them their most intimate feelings and thoughts, they constitute the most exceptional testimony of all epistolary forms practised behind bars. By using an interdisciplinary approach this essay seeks to define the material and functional characteristics of this genre and to contextualise it in the framework of ordinary writings and scribal culture. (shrink)
This longitudinal study was in the main concerned with the relationship between developmental maturity (in the physiological sense) and attitude to school science, among a group of secondry school children. The sample consisted of 269 boys and girls in a midland secondary school. They were administered a non?verbal intelligence test, a Piagetian conceptual development test, and an attitude to school science scale, in the first and second years. In the fifth year they were again administered the attitude (...) to school science scale. On the basis of the onset of menstruation, the girls were divided into early, normal and late developers. The results showed that between the second and fifth years, attitudes to school science became more negative??this applied to both boys and girls, but it was more marked in the case of the girls. It was also found that in the first and second years of the study, early maturing girls showed significantly more negative attitudes to school science, but that by the fifth year, early and late maturing girls were showing equally negative attitudes to this subject. Although the normal developers shared in the general decline in attitudes between the second and fifth years, their reactions to school science were less unfavourable throughout. The implications of these findings are discussed at length within the framework of current reserch and theory in this area. (shrink)
In previous work we have defended the deprivation account of death’s badness against worries stemming from the Lucretian point that prenatal and posthumous nonexistence are deprivations of the same sort. In a recent article in this journal, Fred Feldman has offered an insightful critique of our Parfitian strategy for defending the deprivation account of death’s badness. Here we adjust, clarify, and defend our strategy for reply to Lucretian worries on behalf of the deprivation account.
I compare and assess two significant and opposing approaches to the self with respect to what they have to say about death: the anti-narrativist, as articulated by Galen Strawson, and the narrativist, as pieced together from a variety of accounts. Neither party fares particularly well on the matter of death. Both are unable to point towards a view of death that is clearly consistent with their views on the self. In the narrativist’s case this inconsistency is perhaps (...) not as explicit but is in the end more entrenched. (shrink)
The purpose of this paper is to establish a proper context for reading Jacques Derrida's The Gift of Death, which, I contend, can only be understood fully against the backdrop of "Violence and Metaphysics." The later work cannot be fully understood unless the reader appreciates the fact that Derrida returns to "a certain Abraham" not only in the name of Kierkegaard but also in the name of Levinas himself. The hypothesis of the reading that follows therefore would be that (...) Derrida writes The Gift of Death not as an attempt to re-present Kierkegaard's Abraham either rightly or wrongly but as an effort to do with Kierkegaard's Abraham what is possible with his thought in a broadly Levinasian/Derridean framework. That the reading he provides of the Abraham story would not be recognizable to Kierkegaard is not the principal point of Derrida's effort; his aim is to demonstrate that Levinas should not have been so hasty to dismiss Kierkegaard but could have recovered his interpretation of Abraham for purposes that Derrida and Levinas both share. (shrink)
D. Alan Shewmon has advanced a well-documented challenge to the widely accepted total brain death criterion for death of the human being. We show that Shewmon's argument against this criterion is unsound, though he does refute the standard argument for that criterion. We advance a distinct argument for the total brain death criterion and answer likely objections. Since human beings are rational animals – sentient organisms of a specific type – the loss of the radical capacity for (...) sentience (the capacity to sense or to develop the capacity to sense) involves a substantial change, the passing away of the human organism. In human beings total brain death involves the complete loss of the radical capacity for sentience, and so in human beings total brain death is death. (shrink)
This article announces the discovery of a Sinhalese version of the traditional meditation ( borān yogāvacara kammaṭṭhāna ) text in which the Consciousness or Mind, personified as a Princess living in a five-branched tree (the body), must understand the nature of death and seek the four gems that are the four noble truths. To do this she must overcome the cravings of the five senses, represented as five birds in the tree. Only in this way will she permanently avoid (...) the attentions of Death, Māra, and his three female servants, Birth, Sickness and Old Age. In this version of the text, when the Princess manages not to succumb to these three, Māra comes and snatches her from her tree and rapes her. The Buddha then appears to her to explain the path to liberation. The text provides a commentary, padārtha , which explains the details of the symbolism of the fruit in terms of rebirth and being born, the tree in terms of the body, etc. The text also offers interpretations of signs of impending death and prognostications regarding the next rebirth. Previously the existence of Khmer and Lānnā versions of this text have been recorded by Francois Bizot and Francois Lagirarde, the former publishing the text as Le Figuier a cinq branches (Le figuier à cinq branches, 1976). The Sinhalese version was redacted for one of the wives of King Kīrti Śrī Rājasiṅha of Kandy by the monk Varañāṇa Mahāthera of Ayutthayā. This confirms earlier speculation that this form of borān/dhammakāya meditation was brought to Sri Lanka with the introduction of the Siyam Nikāya in the mid-eighteenth century. It also shows that in Sri Lanka, as in Ayutthayā, this form of meditation—which in the modern period was to be rejected as ‘unorthodox’—was promoted at the highest levels of court and Saṅgha. (shrink)
A number of common and generally noncontroversial practices in the care of patients at the end of life lead to their deaths. For example, physicians honor a patient's refusal of medical intervention even when doing so leads to the patient's death. Similarly, with a patient's or surrogate's consent, physicians administer sedatives in order to relieve pain and distress at the end of life, even when it is known that doing so will cause the patient's death. In contemporary U.S. (...) public policy, these practices are accepted as ethical and legal while physician-assisted suicide (PAS) isrejected in current U.S. law and public policy. Some think, however, that if one accepts practices that are known to lead to a patient's death, then one cannot reasonably reject a patient's request for a lethal dose of medication so that she may kill herself (PAS). (shrink)
Background: Thrombolytic drugs to treat an acute ischaemic stroke reduce the risk of death or major disability. The treatment is, however, also associated with an increased risk of potentially fatal intracranial bleeding. This confronts the patient with the dilemma of whether or not to take a risk of a serious side effect in order to increase the likelihood of a favourable outcome. Objective: To explore acute stroke patients’ perception of risk and willingness to accept risks associated with thrombolytic drug (...) treatment. Design: Eleven patients who had been informed about thrombolytic drug treatment and had been through the process of deciding whether or not to participate in a thrombolytic drug trial went through repeated qualitative, semistructured interviews. Results: Many patients showed a limited perception of the risks connected with thrombolytic drug treatment. Some perceived the risk as not relevant to them and were reluctant to accept that treatment could cause harm. Others seemed to be aware that treatment would mean exposure to risk. The patients’ willingness to take a risk also varied substantially. Several statements revealed ambiguity and confusion about being involved in a decision about treatment. The patients’ reasoning about risk was put into the context of their health-related experiences and life histories. Several patients wanted the doctor to be responsible for the decisions. Conclusion: Acute stroke patients’ difficulties in perceiving and processing information about risk may reduce their ability to be involved in clinical decisions where risks are involved. (shrink)
Do professional ethicists behave any morally better than other professors do? Do they show any greater consistency between their normative attitudes and their behavior? In response to a survey question, a large majority of professors (83 percent of ethicists, 83 percent of nonethicist philosophers, and 85 percent of nonphilosophers) expressed the view that “not consistently responding to student e-mails” is morally bad. A similarly large majority of professors claimed to respond to at least 95 percent of student e-mails. These professors, (...) and others, were sent three e-mails designed to look like queries from students. Ethicists’ e-mail response rates were not significantly different from the other two groups’. Expressed normative view correlated with self-estimated rate of e-mail responsiveness, especially among the ethicists. Empirically measured e-mail responsiveness, however, was at best weakly correlated with self-estimated e-mail responsiveness; and professors’ expressed normative attitude was not significantly correlated with empirically measured e-mail responsiveness for any of the three groups. (shrink)
In October 2003 the Supreme Court of the United States allowed Arkansas officials to force Charles Laverne Singleton, a schizophrenic prisoner convicted of murder, to take drugs that would render him sane enough to be executed. On January 6 2004 he was killed by lethal injection, raising many ethical questions. By reference to the Singleton case, this article will analyse in both moral and legal terms the controversial justifications of the enforced medical treatment of death-row inmates. Starting with a (...) description of the Singleton case, I will highlight the prima facie reasons for which this case is problematic and merits attention. Next, I will consider the justification of punishment in Western society and, in that context, the evolution of the notion of insanity in the assessment of criminal responsibility during the past two centuries, both in the US and the UK. In doing so, I will take into account the moral justification used to enforce treatment, looking at the conflict between the prisoner’s right to treatment and his right to refuse medication where not justified by outcomes that can be reasonably expected to be positive for the individual. Finally, in contrast with some retributivist arguments in favour of enforced treatment to enable execution, I will propose a possible alternative, necessary if we are to consistently uphold the notion of autonomy. (shrink)
D. Alan Shewmon has advanced a well-documented challenge to the widely accepted total brain death criterion for death of the human being. We show that Shewmon's argument against this criterion is unsound, though he does refute the standard argument for that criterion. We advance a distinct argument for the total brain death criterion and answer likely objections. Since human beings are rational animals - sentient organisms of a specific type - the loss of the radical capacity for (...) sentience (the capacity to sense or to develop the capacity to sense) involves a substantial change, the passing away of the human organism. In human beings total brain death involves the complete loss of the radical capacity for sentience, and so in human beings total brain death is death. (shrink)
Pragmatismo é um movimento filosófico que inclui aqueles que afirmam que uma proposição é verdadeira se funciona de forma satisfatória, que o significado de uma proposição pode ser encontrado nas conseqüências práticas de aceitá-la, e que as idéias pouco práticas devem ser rejeitadas. O Pragmatismo começou no final do século XIX, com Charles Sanders Peirce (Como tornar nossas idéias mais claras, Fixação da Crença) e foi desenvolvido na obra de William James (Peirce e James eram membros do Clube Metafísico). O (...) pragmatismo tem uma idéia principal: a verdade é mutável. Este artigo é uma discussão teórico-conceitual sobre o direito de crer, a partir da filosofia pragmatista de William James. O artigo inicia com uma breve discussão sobre a religião, em seguida, discute a posição de Nietzsche e, por fim, discute-se a perspectiva da filosofia americana pragmatista criada por Charles Peirce e William James. Palavras-chave : Religião; Pragmatismo; Filosofia; Morte de DeusPragmatism is a philosophical movement that includes those who claim that a proposition is true if it works satisfactorily, and that the meaning of a proposition is to be found in the practical consequences of accepting it, and that unpractical ideas are to be rejected. The Pragmatism began in the late nineteenth century with Charles Sanders Peirce (How to Make Our Ideas Clear; The Fixation of Belief) and it was developed further in the works of William James (Peirce and James were members of The Metaphysical Club). The Pragmatism has a major idea: truth is mutable. This article is a theoretical-conceptual discussion about the right to believe, from the perspective of pragmatist philosophy of William James. The article begins with a brief discussion about religion, and then discusses the position of Nietzsche and, finally, the perspective of American philosophy created by the pragmatist Charles Peirce and William James is discussed. Keywords: Religion; Pragmatism; Philosophy; Death of God. (shrink)
The utilitarian construct of two alternative criteria of human death increases the supply of transplantable organs at the end of life. Neither the neurological criterion (heart-beating donation) nor the circulatory criterion (non-heart-beating donation) is grounded in scientific evidence but based on philosophical reasoning. A utilitarian death definition can have unintended consequences for dying Muslim patients: (1) the expedited process of determining death for retrieval of transplantable organs can lead to diagnostic errors, (2) the equivalence of brain (...) class='Hi'>death with human death may be incorrect, and (3) end-of-life religious values and traditional rituals may be sacrificed. Therefore, it is imperative to reevaluate the two different types and criteria of death introduced by the Resolution (Fatwa) of the Council of Islamic Jurisprudence on Resuscitation Apparatus in 1986. Although we recognize that this Fatwa was based on best scientific evidence available at that time, more recent evidence shows that it rests on outdated knowledge and understanding of the phenomenon of human death. We recommend redefining death in Islam to reaffirm the singularity of this biological phenomenon as revealed in the Quran 14 centuries ago. (shrink)
Edmund Husserl’s critique of using the natural scientific method to investigate meaningful human experience remains relevant to recent debates in psychology. Discursive Psychology (DP) claims to draw upon phenomenological insights to critique quantitative psychology for studying theoretical concepts rather than the actual practices of the lived social world. In this paper, I will argue that DP overlooks the important distinction that can be made between the theoretical attitude and the natural scientific attitude in Husserlian Phenomenology and hence, once (...) again, loses sight of the meaningfully constituted life-world. In doing so, I will demonstrate the continued relevance of Husserl’s critique of natural science to the discipline of psychology. (shrink)
OBJECTIVES: The subject of patient self-determination in health care has gained broad interest because of the increasing number of incompetent patients. In an attempt to solve the problems related to doctors' decision making in such circumstances, advance directives have been developed. The purpose of this study was to examine relationships between public attitudes towards patient autonomy and advance directives. SUBJECTS AND MAIN OUTCOME MEASURES: A stratified random sample of 600 adults in northern Sweden was surveyed by a questionnaire with a (...) response rate of 78.2%. The subjects were asked about their wish for control of their health care, their concerns about health care, their treatment preferences in a life-threatening situation (both reversible and irreversible), and their attitudes towards the application of advance directives. RESULTS: Numerous relationships between various aspects of self-determination in health care (desire for control, fears of over-treatment, and choice of treatment level) in general and advance directives, in particular, were found. Those who wanted to have a say in their health care (about 94%) also mainly supported the use of an advance directive. CONCLUSIONS: The fact that almost 30% of the respondents were undecided concerning their personal use of advance directives points to a lack of knowledge and to the necessity of education of the public on these issues. (shrink)
This article assesses the significance of a “politics of life”, also termed biopolitics, for any theological analysis of death. By charting the manner in which modern theological approaches to death are closely related to political attempts to secure life (especially in the work of Hobbes), the piece hopes to offer a theological history of the present from which a theology of death might be re-envisioned.
In a recent article published in this journal, Andrew Chignell proposes some candidates for greater or ‘balancing out’ goods that could explain why God allows some infants to be tortured to death. I argue that each of Chignell's proposals is either incoherent, metaphysically dubious, and/or morally objectionable. Thus, his proposals do not explain what might justify God in allowing infants to be tortured, and the existence of infant suffering remains a serious problem for traditional theism.
As the single most important experience in the lives of all people, the process and event of death must be handled carefully by the medical community. Twentieth-century advances in life-sustaining technology impose new areas of concern on those who are responsible for dying persons. Physicians and surrogates alike must be ready and willing to decide not to intervene in the dying process, indeed to hasten it, when they see the autonomy and dignity of patients threatened. In addition, the very (...) ways we talk about death and dying need to come under scrutiny, and it is likely that our technical advances should be parallelled by equally arduous advances in the semantic and rhetorical approaches we take to death. (shrink)
continent. 1.4 (2011): 310—311. Writing Death . Jeremy Fernando, foreword by Avital Ronell. Den Haag: Uitgeverij. 2011 ISBN: 978-90-817091-0-1 Rite and ceremony as well as legend bound the living and the dead in a common partnership. They were esthetic but they were more than esthetic. The rites of mourning expressed more than grief; the war and harvest dance were more than a gathering of energy for tasks to be performed; magic was more than a way of commanding forces of (...) nature to do the bidding of man; feasts were more than a satisfaction of hunger. Each of these communal modes of activity united the practical, the social, and the educative in an integrated whole having esthetic form.(1) Jeremy Fernando’s Writing Death is a sensitive attempt at exploring the depths and heights to which the processes of mourning can take us. Death, as an absence, renders all gestures (for what is mourning but a gesture with many faces) surrounding it at once as a possibility and an impossibility. Fernando poses questions that often elude the mourner and the mourned—the same, and different—by raising the specter of subject and object; by compelling the examination of what it actually means to mourn; and most crucially, by considering the very status of possibility itself that the act of mourning foregrounds. Mourning, he reminds us, is premised upon memory (remembrance, recollection), the shadow of forgetting upon which is perpetually cast—the inextricability between memory and forgetting haunts the living more than it does the dead. And if grief has anything to do with it, mourning can quite easily be mistaken for an attempt to remember in order to forget; an attempt, in other words, to deny death, deny the one thing that confirms mortality. As if living has anything to do with it. What, then, of writing death? It becomes an unceasing process of locating—and addressing—possibility itself: the passing as possibility; loss as possibility; impossibility as, and of, naming this possibility. In confronting the passing on, it is possible, nay inevitable, to move on, move away from the site of loss, of grief. All the while, we forget, Fernando reminds us, that mourning has little to do with the dead, and a whole lot to do with the living, the mourning self. Here, he echoes Dewey’s consolidation of rituals and ceremonies, of the dead and of the living, all as parts of a larger unity, of a social, public gesture meant to sate a private need: In trying to “get over it,” are we trying to get over ourselves? Or more than that: are we trying to get over the fact that we can never quite get over ourselves? (Fernando, 77) As if guilt has anything to do with it. And “it” continues to be the point that he is driving at, driving towards. “It” is the possibility and impossibility, death and life, memory and forgetting, lost and cherished. “It” is what eludes mourning, eludes attempts to overcome grief. Nonetheless, move on, he must. And Fernando does this in fewer moves than a 12-step program—hardly therapeutic, but intellectually satisfying. Writing Death attends to some of the pertinent aspects of the act of mourning—both as gesture and as meditation: eulogy, distress (call), tears, and the question of how (beyond ritual, beyond sentimentality) to mourn. And what’s love got to do with it? Everything and nothing. Mourning, after all, is an articulation of love, but it is also one that forces the mourner to be selective, as with myth-making, in the recollection: Remembering only ever occurs in exception to memory—quite possibly in betrayal of a memory. In this way, each remembrance is a naming of that memory, a naming of something as memory, bringing with it an act of violence. (40) Mourning is thus not only an act of fictionalizing, it is also an act of reading, to continually be compelled to respond to another, all the while keeping vigil against a reconceptualization of the dead, without, therefore, misreading the dead. This can only be done, Fernando argues, by all the while “maintaining the otherness of the other. After all, one must try not to forget that one cannot be too close—space is needed—to touch.” (82) There is also tacit acknowledgement that doing so foregrounds the fact that the selectivity of memory becomes exclusive, and concretizes into a singularity, thus negating the multi-dimensionality of a life lived – and thus killing the already dead. Writing Death is framed by two eulogies—or the approximations of eulogies; approximation because both foreground and call into question the eulogy as a genre. The first is Avital Ronell’s foreword to the book, remembering Philippe Lacoue-Labarthe; the second is Fernando’s own response to the passing of a mentor, Jean Baudrillard. Both are not merely attempts to philosophize their way out of the act of mourning. Both are in fact deeply moving pieces that remind us of the emotional possibilities that may reside within any intellectual undertaking, that the latter need not be cold and devoid of feelings. And whereas Writing Death does not attempt to make any philosophical claim for humanism, the underlying wistfulness of both pieces does suggest that there is a proper place for deep-seated human response to death. We can (and the book does) intellectualize and problematize the acts of mourning and grieving, but these do not diminish the fact that we mourn and grieve. And, framing Writing Death as the two eulogies do, Jeremy Fernando perhaps finally, and inadvertently, names “It”—it is, above everything else, Human. August, 2011 Singapore NOTES (1) Dewey, John. Art as Experience . New York: Perigee, 1934. (shrink)
The main theme of the article is the tension between the obligation to preserve life, and the value of timely death. This tension is resolved by distinguishing between precipitating death, which is prohibited, and merely removing an impediment to it, which is permitted. In contemporary Jewish law, a distinction is made between therapy, which may be discontinued, and life-support, which must be maintained until the establishment of death. Another theme is that of “soft” patient autonomy, and its (...) role in dealing with the dying in both traditional Jewish law and Israel’s Terminal Patient Law, 2005. Preventing suffering in relation to a dying person, and praying for his or her death are also discussed in the article. (shrink)
The results of the Progress in International Reading Literacy Study (PIRLS 2001) were published in 2003. In addition to data about the reading achievements of 10?year?olds in 35 countries, PIRLS 2001 also collected questionnaire information from children, their teachers, headteachers and parents. The results showed not just how well students can perform in various reading tasks, but also the relationship between reading abilities and other characteristics, including the characteristics of their homes and schools, the students' attitudes to reading, reading enjoyment, (...) self?confidence, engagement and perceptions of their reading abilities. Surprisingly enough, children in England were reported as having poor attitudes to reading, compared to children in many other countries, despite high achievement on the reading tests. This paper raises some concerns about the interpretation of results from the study, suggesting a more complex picture than that presented in the summary index published in 2003. Our secondary analysis of the attitude and achievement data from PIRLS shows that pupils with low ability levels have misunderstood the questions which tested their attitudes towards reading. The authors point out that caution is needed when making cross?country comparisons to avoid naïve approaches to interpretation. (shrink)
Alan Shewmons article, The brain and somatic integration: Insights into the standard biological rationale for equating brain death with death (2001), strikes at the heart of the standard justification for whole brain death criteria. The standard justification, which I call the standard paradigm, holds that the permanent loss of the functions of the entire brain marks the end of the integrative unity of the body. In my response to Shewmons article, I first offer a brief summary of (...) the standard paradigm and cite recent work by advocates of whole brain criteria who tenaciously cling to the standard paradigm despite increasing evidence showing that it has significant weaknesses. Second, I address Shewmons case against the standard paradigm, arguing that he is successful in showing that whole brain dead patients have integrated organic unity. Finally, I discuss some minor problems with Shewmons article, along with suggestions for further elaboration. (shrink)
The relation between two systems of attitude ascription that capture all the empirically significant aspects of an agents thought and speech may be analogous to that between two systems of magnitude ascription that are equivalent relative to a transformation of scale. If so, just as an objects weighing eight pounds doesnt relate that object to the number eight (for a different but equally good scale would use a different number), similarly an agents believing that P need not relate her (...) to P (for a different but equally adequate interpretive scheme could use a different proposition). In either case the only reality picked out by any system of ascription is what is common to all equivalent rivals. By emphasizing some contrasts between decision theory and belief-desire psychology, it is argued that if attitude ascription is appropriately analogous to measurement then not only is being related to a proposition an artifact of the system of representation chosen, so are belief and desire. (shrink)
In this paper I address three problems posed by modern medical technology regarding comatose dying patients. The first is that physicians sometimes hide behind the tests for whole-brain death rather than make the necessary human decision. The second is that the tests themselves betray a metaphysical judgment about death that may be ontologically faulty. The third is that discretion used by physicians and patients and/or family in deciding to cease treatment when the whole-brain death criteria may not (...) be met are sometimes open to challenge. In each of these problems I find that the operative concept of death relates to life itself. This point is expanded by examining the uses of the word death in our language and culture. From these I formulate an initial ontology of death. In it, death is described through a relationship with life, rather than as an absence of life, of consciousness, awareness, or sensation. This ontology then leads to a proposal for an ethics of discretion about the discontinuation of treatment for comatose patients. (shrink)