The right to refuse medical intervention is well established, but it remains unclear how best to respect and exercise this right in life support. Contemporary ethical guidelines for critical care give ambiguous advice, largely because they focus on the moral equivalence of withdrawing and withholding care without confronting the very real differences regarding who is aware and informed of intervention options and how patient values are communicated and enacted. In withholding care, doctors typically withhold information about interventions judged too futile (...) to offer. They thus retain greater decision-making burden and face weaker obligations to secure consent from patients or proxies. In withdrawing care, there is a clearer imperative for the doctor to include patients in decisions, share information and secure consent, even when continued life support is deemed futile. How decisions to withhold and withdraw life support differ ethically in their implications for positive versus negative interpretations of patient autonomy, imperatives for consent, definitions of futility and the subjective evaluation of benefits and burdens of life support in critical care settings are explored. Professional reflection is required to respond to trends favouring a more positive interpretation of patient autonomy in the context of life support decisions in critical care. Both the bioethics and critical care communities should investigate the possibilities and limits of growing pressure for doctors to disclose their reasoning or seek patient consent when decisions to withhold life support are made. (shrink)

Well and Good presents a combination of "classic" and little-known cases in health care ethics. These cases, accompanied by information about the major ethical theories, give students a chance to grapple with the ethical challenges faced by health care practitioners, policy makers, and recipients. The authors' narrative style and leading questions provoke student interest and engagement, while allowing instructors the freedom to draw from the theoretical perspectives they consider most useful. This fourth edition includes an expanded discussion of feminist ethics, (...) and new cases addressing pandemic ethics, humanitarian aid, the social determinants of health, research and aboriginal communities, and a number of other emerging issues. (shrink)

Much debate concerning ‘precedent autonomy’ – that is, the authority of former, competent selves to govern the welfare of later, non-competent selves – has assumed a radical discontinuity between selves, and has overlooked the ‘bridging’ role of intimate proxy decision-makers. I consider a recent proposal by Lynn et al. (1999) that presents a provocative alternative, foregrounding an imagined dialogue between the formerly competent patient and her/his trusted others. I consider what standards must be met for such dialogues to have moral (...) force, appealing to narrative and feminist ethics. I then critique the dualistic construction of selves implicit in much of the advance directive literature, noting the continuities of dependence, character, and body, as well as the social dimension of the construction of selves. (shrink)

Readings in Health Care Ethics provides a wide-ranging selection of important and engaging contributions to the field of health care ethics. The second edition adds a chapter on health care in Canada, and the introduction has been expanded to include discussion of a new direction in feminist naturalized ethics. The book presupposes no prior knowledge, only an interest in the bioethical issues that are shaping our world.

In “Where Is the Sin in Synecdoche?” (2005) Adrienne Asch and David Wasserman criticize the choice to use prenatal testing (PNT) to determine disability. Notwithstanding the multiple meanings, motives, and circumstances behind people’s reproductive choices, Asch and Wasserman argue that individual choices to reject impaired potential offspring should be the subject of moral scrutiny, since they are likely to be the result of synecdoche—“the uncritical reliance on a stigma-driven inference from a single feature to a whole future life” (181). Such (...) synecdochal choices, they argue, assume that in virtue of impairment, the future child in question would be “incapable of [the] intimacy and community” involved in family.. (shrink)

The aim of this study is to explore how nurses perceive patient participations of patients over 75 years old undergoing hemodialysis treatment in dialysis units, and of their next of kin. Ten nurses told stories about what happened in the dialysis units. These stories were analyzed with critical discourse analysis. Three discursive practices are found: (1) the nurses’ power and control; (2) sharing power with the patient; and (3) transferring power to the next of kin. The first and the predominant (...) discursive practice can be explained with an ideology of paternalism, in which the nurses used biomedical explanations and the ethical principle of benefice to justify their actions. The second can be explained with an ideology of participation, in which the nurses used ethical narratives as a way to let the patients participate in the treatment. The third seemed to involve autonomous decision-making and the ethical principle of autonomy for the next of kin in the difficult end-of-life decisions. (shrink)

In my 1993 IJPS paper it was suggested that postmodernist verdicts on ‘the death of philosophy’ relied on a rejection of any ‘substantive’ or ‘metaphysical’ notion of truth. The present paper relates these verdicts to Wittgenstein’s alleged ‘philosophical quietism’. In both cases, for example, there is a rejection of ‘depth’. Various characterisations of Wittgenstein’s position are questioned, including the idea that his quietism consists in showing the impossibility of sceptical challenges to our ‘hinge’ propositions and beliefs. It is then argued, (...) however, that recognition of the groundlessness of beliefs (and practices), far from curing ‘vertigo’ or ‘Angst’, is apt to inspire it. In a final section, I propose that the ‘metaphysical horror’ at the impossibility of articulating grounds for our beliefs can be allayed only by the thought that these answer to a reality that cannot be articulated and must therefore remain a mystery. One role for philosophy might be to cultivate a sense of this mystery and trace its implications for how we should live. (shrink)

В статье философия характеризуется на основе дискурсной парадигмы анализа: как текст, интеллектуальная деятельность и коммуникация. Характеризуются два равнозначных аспекта философского дискурса - когнитивный и коммуникативный. Обсуждается феномен философских контроверз, специфика философского спора, выразительные (знаковые) средства философского дискурса, роль мировоззренческого дискурса в современной общественно-политической ситуации в стране.

Because factory-farmed meat production inflicts gratuitous suffering upon animals and wreaks havoc on the environment, there are morally compelling reasons to become vegetarian. Yet industrial plant agriculture causes the death of many field animals, and this leads some to question whether consumers ought to get some of their protein from certain kinds of non factory-farmed meat. Donald Bruckner, for instance, boldly argues that the harm principle implies an obligation to collect and consume roadkill and that strict vegetarianism is thus immoral. (...) But this argument works only if the following claims are true: all humans have access to roadkill, roadkill would go to waste if those who happen upon it don’t themselves consume it, it’s impossible to harvest vegetables without killing animals, the animals who are killed in plant production are all-things-considered harmed by crop farming, and the best arguments for vegetarianism all endorse the harm principle. As I will argue in this paper, each claim is deeply problematic. Consequently, in most cases, humans ought to strictly eat plants and save the roadkill for cats. (shrink)

An adequate theory of rights ought to forbid the harming of animals to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible with recognizing the (...) inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

In recent discussions, it has been argued that a theory of animal rights is at odds with a liberal abortion policy. In response, Francione (1995) argues that the principles used in the animal rights discourse do not have implications for the abortion debate. I challenge Francione’s conclusion by illustrating that his own framework of animal rights, supplemented by a relational account of moral obligation, can address the moral issue of abortion. I first demonstrate that Francione’s animal rights position, which grounds (...) moral consideration in sentience, is committed to the claim that a sentient fetus has a right to life. I then illustrate that a fully developed account of animal rights that recognizes the special obligations humans have to assist animals when we cause them to be dependent and vulnerable through our voluntary actions or omissions is committed to the following: a woman also has a special obligation to assist a sentient fetus when she causes it to be dependent and vulnerable through her voluntary actions or omissions. From these considerations, it will become evident that a fully developed and consistent animal rights ethic does in fact have implications for the abortion discussion. (shrink)

In The Case for Animal Rights, Tom Regan argues that although all subjects-of-a-life have equal inherent value, there are often differences in the value of lives. According to Regan, lives that have the highest value are lives which have more possible sources of satisfaction. Regan claims that the highest source of satisfaction, which is available to only rational beings, is the satisfaction associated with thinking impartially about moral choices. Since rational beings can bring impartial reasons to bear on decision making, (...) Regan maintains that they have an additional possible source of satisfaction that nonrational beings do not have and, consequently, the lives of rational beings turn out to have greater value.. (shrink)

This grounded study investigated the negotiation of authorship by faculty members, graduate student mentors, and their undergraduate protégés in undergraduate research experiences at a private research university in the northeastern United States. Semi-structured interviews using complementary scripts were conducted separately with 42 participants over a 3 year period to probe their knowledge and understanding of responsible authorship and publication practices and learn how faculty and students entered into authorship decision-making intended to lead to the publication of peer-reviewed technical papers. Herein (...) the theoretical model for the negotiation of authorship developed through the analysis of these interviews is reported. The model identifies critical causal and intervening conditions responsible for the coping strategies faculty and students employ, which, in our study, appear to often produce unfortunate consequences for all involved. The undergraduate student researchers and their graduate student mentors interviewed in this study exhibited a limited understanding of authorship and the requirements for authorship in their research groups. The power differential between faculty and students, the students’ limited epistemic development, the busy-ness of the faculty, and the faculty’s failure to prioritize authorship have been identified as key factors inhibiting both undergraduate and graduate students from developing a deeper understanding of responsible authorship and publication practices. Implications for graduate education and undergraduate research are discussed, and strategies for helping all students to develop a deeper understanding of authorship are identified. (shrink)

Recent discussions in the just war literature suggest that soldiers have a duty to assume certain risks in order to protect the lives of all innocent civilians. I challenge this principle of risk by arguing that it is justified neither as a principle that guides the conduct of combat soldiers, nor as a principle that guides commanders in the US military. I demonstrate that the principle of risk fails on the first account because it requires soldiers both to violate their (...) strict duty of obedience and loyalty and to exceed their special obligations to protect their fellow comrades, the state, the state's constituents and other protected civilians. I then illustrate that the principle of risk fails on the second account since it conflicts with the commander's primary obligation to protect and promote the welfare and lives of his or her soldiers. I conclude by arguing that we cannot reasonably expect soldiers and commanders to adhere to the principle of risk until there is a radical, institutional-level transformation of militaristic goals, values, strategies, policies, warrior codes and expectations of service members in the US Armed Forces. (shrink)

Smysl zhizni -- Statʹi raznykh let : Staryĭ i novyĭ nat︠s︡ionalʹnyĭ messianizm. Umozrenie v kraskakh. Dva mira v drevnerusskoĭ ikonopisi. "Inoe t︠s︡arstvo" i ego iskateli v russkoĭ narodnoĭ skazke.

The rise of modern natural sciences was based on the belief that knowledge about nature would increase steadily and that sooner or later it would prove useful for people and society. How these expectations shaped the self-image and the development of the natural sciences is the subject of this book. It turns out that expectations have repeatedly changed: from the universal ideal of utility of the 17th and 18th centuries to the promise of technical progress that is decisive today. The (...) unshakable belief in the usefulness of the natural sciences has always been accompanied by the insight that progress in knowledge can only be guaranteed if research is not based solely on short-term needs. In her story of the modern understanding of science, Désirée Schauz draws a bow from early modern natural research to the natural sciences of the 20th century. With its long-term perspective and its conceptual historical instruments, this book not only makes an important contribution to the modern history of science, but also provides a historically sound basis for current debates on science and innovation policy."-- publisher's website. (shrink)

In the Caribbean as in many other areas costly biomedical resources and personnel are limited, and more and more people are turning to alternative medicine and folk practitioners for health care. To meet the goal of providing health care for all, research on nonbiomedical therapies is needed, along with legal recognition of folk practitioners to establish standards of practice.

We present a method to characterize the preferences of a decision maker in decisions with multiple attributes. The approach modifies the outcomes of a multivariate lottery with a multivariate transformation and observes the change in the decision maker’s certain equivalent. If the certain equivalent follows this multivariate transformation, we refer to this situation as multiattribute transformation invariance, and we derive the functional form of the utility function. We then show that any additive or multiplicative utility function that is formed of (...) continuous and strictly monotonic utility functions of the individual attributes must satisfy transformation invariance with a multivariate transformation. This result provides a new interpretation for multiattribute utility functions with mutual utility independence as well as a necessary and sufficient condition that must be satisfied when assuming these widely used functional forms. We work through several examples to illustrate the approach. (shrink)

In the probability literature, a martingale is often referred to as a “fair game.” A martingale investment is a stochastic sequence of wealth levels, whose expected value at any future stage is equal to the investor’s current wealth. In decision theory, a risk neutral investor would therefore be indifferent between holding on to a martingale investment, and receiving its payoff at any future stage, or giving it up and maintaining his current wealth. But a risk-averse decision maker would not be (...) indifferent between a martingale investment and his current wealth level, since he values uncertain deals less than their mean. A risk seeking decision maker, on the other hand, would readily accept a martingale investment in exchange for his current wealth, and would repeat this investment any number of times. These ideas lead us to introduce the notion of a “risk-adjusted martingale”; a stochastic sequence of wealth levels that a rational decision maker with any attitude toward risk would value constantly with time, and would be indifferent between receiving its pay-off at any future stage, or giving it up and maintaining his current wealth level. We show how to construct such risk-adjusted investments for any decision maker with a continuous monotonic utility function. The fundamental result we derive is that a pay-off structure of an investment (i) is a risk-adjusted martingale and (ii) can be represented by a lattice if and only if the pay-off functions are invariant transformations of the given utility function. (shrink)

Examines how the educations of America's first four presidents, and in particular their scholarly devotion to ancient Greek and Roman classics, informed the beliefs and ideals that shaped the nation's constitution and government.

The Spinoza party -- The Tractatus Theologico-Politicus: a democratic manifesto -- The Tractatus Politicus: a science of the state -- The Ethics: a political anthropology -- Politics and communication.

This new translation presents the _Analects_ in a revolutionary new format that, for the first time in any language, distinguishes the original words of the Master from the later sayings of his disciples and their followers, enabling readers to experience China's most influential philosophical work in its true historical, social, and political context.

The moral doctrine of Hobbes, in many ways the most interesting of our major British philosophers, is, I think, commonly seen in a false perspective which has seriously obscured its real affinities. This is, no doubt, largely due to the fact that most modern readers begin and end their study of Hobbes's ethics with the Leviathan , a rhetorical and, in many ways, a popular Streitschrift published in the very culmination of what looked at the time to be a permanent (...) revolution, and do not pay such attention to the more calmly argued statements of the same doctrine contained in the Elements of Law , circulated before the outbreak of the Civil War, or the De Cive. (shrink)

First published in 1994. Routledge is an imprint of Taylor & Francis, an informa company.

"I suspect that this will become the book on Schopenhauer's metaphysics for many years to come, and will be required reading for any serious student of Schopenhauer's thought."--David E. Cartwright, University of Wisconsin, Whitewater.

The recent drastic development of agriculture, together with the growing societal interest in agricultural practices and their consequences, pose a challenge to agricultural science. There is a need for rethinking the general methodology of agricultural research. This paper takes some steps towards developing a systemic research methodology that can meet this challenge – a general self-reflexive methodology that forms a basis for doing holistic or (with a better term) wholeness-oriented research and provides appropriate criteria of scientific quality.From a philosophy of (...) research perspective,science is seen as an interactive learning process with both a cognitive and a social communicative aspect. This means, first of all,that science plays a role in the world that it studies. A science that influences its own subject area, such as agricultural science, is named a systemic science. From this perspective, there is a need to reconsider the role of values in science. Science is not objective in the sense of being value-free.Values play, and ought to play, an important role in science – not only in form of constitutive values such as the norms of good science, but also in the form of contextual values that enter into the very process of science. This goes against the traditional criterion of objectivity. Therefore, reflexive objectivity is suggested as a new criterion for doing good science, along with the criterion of relevance. Reflexive objectivity implies that the communication of science must include the cognitive context, which comprises the societal,intentional, and observational context. Ina ccordance with this, the learning process of systemic research is shown as a self-reflexive cycle that incorporates both an involved actor stance and a detached observer stance. The observer stance forms the basis for scientific communication.To this point, a unitary view of science as a learning process is employed. A second important perspective for a systemic research methodology is the relation between the actual,different, and often quite separate kinds of science. Cross-disciplinary research is hampered by the idea that reductive science is more objective, and hence more scientific, than the less reductive sciences of complex subject areas – and by the opposite idea that reductive science is necessarily reductionistic. Taking reflexive objectivity as a demarcator of good science, an inclusive framework of science can be established. The framework does not take the established division between natural, social, and human science as a primary distinction of science.The major distinction is made between the empirical and normative aspects of science,corresponding to two key cognitive interests.Two general methodological dimensions, the degree of reduction of the research world and the degree of involvement in the research world, are shown to span this framework. The framework can form a basis for transdisciplinary work by way of showing the relation between more and less reductive kinds of science and between more detached and more involved kinds of science and exposing the abilities and limitations attendant on these methodological differences. (shrink)

Philosophers constantly discuss Responsibility. Yet in every discussion of which I am aware, a rather obvious point is ignored. The obvious point is that responsibility is ascribed to collectives, as well as to individual persons. Blaming attitudes are held towards collectives as well as towards individuals. Responsibility is often ascribed to nations, towns, clubs, groups, teams, and married couples. ‘Germany was responsible for the Second World War’; ‘The club as a whole is to blame for being relegated’. Such statements are (...) not rare. (shrink)

We describe in some detail how to build an infinite computing machine within a continuous Newtonian universe. The relevance of our construction to the Church-Turing thesis and the Platonist-Intuitionist debate about the nature of mathematics is also discussed.

Is God's foreknowledge compatible with human freedom? One of the most attractive attempts to reconcile the two is the Ockhamistic view, which subscribes not only to human freedom and divine omniscience, but retains our most fundamental intuitions concerning God and time: that the past is immutable, that God exists and acts in time, and that there is no backward causation. In order to achieve all that, Ockhamists distinguish ‘hard facts’ about the past which cannot possibly be altered from ‘soft facts’ (...) about the past which are alterable, and argue that God's prior beliefs about human actions are soft facts about the past. (shrink)

Ethics teaching in engineering can be problematic because of student perceptions of its subjective, ambiguous and philosophical content. The use of discipline-specific case studies has helped to address such perceptions, as has practical decision making and problem solving approaches based on some ethical frameworks. However, a need exists for a wider range of creative methods in ethics education to help complement the variety of activities and learning experiences within the engineering curriculum. In this work, a novel approach is presented in (...) which first-year undergraduate students are responsible for proposing ethics education activities of relevance to their peers and discipline area. The students are prepared for the task through a short introduction on engineering ethics, whereby generic frameworks for moral and professional conduct are discussed, and discipline and student-relevance contexts provided. The approach has been used in four departments of engineering at Imperial College London, and has led to the generation of many creative ideas for wider student engagement in ethics awareness, reflection and understanding. The paper presents information on the premise of the introductory sessions for supporting the design task, and an evaluation of the student experience of the course and task work. Examples of proposals are given to demonstrate the value of such an approach to teachers, and ultimately to the learning experiences of the students themselves. (shrink)

We analysed research ethics committee (REC) letters. We found that RECs frequently identify process errors in applications from researchers that are not deemed “favourable” at first review. Errors include procedural violations (identified in 74% of all applications), missing information (68%), slip-ups (44%) and discrepancies (25%). Important questions arise about why the level of error identified by RECs is so high, and about how errors of different types should be handled.