The work of the French Lithuanian Jewish philosopher, Emmanuel Levinas, describes a perceptive rethinking of the possibility of concrete acts of goodness in the world, a rethinking never more necessary than now, in the wake of the cruel realities of the twentieth century—ten million dead in the First World War, forty million dead in the Second World War, Hiroshima, Nagasaki, the Soviet gulags, the grand slaughter of Mao’s “Great Leap Forward,” the pointless and gory Vietnam War, the Cambodian self-genocide (...) and many an attempted extermination from the face of the earth of entire nations of indigenous peoples. The list of horrors goes on and on—daily holocausts that do not distinguish between the civilian and the soldier, the guilty and the innocent, those deserving of life and those less deserving. (shrink)

Contributors; Preface; Introduction; Part I. Instruments in Experiments: 1. Scientific instruments: models of brass and aids to discovery; 2. Glass works: Newton’s prisms and the uses of experiment; 3. A viol of water or a wedge of glass; Part II. Experiment and Argument: 4. Galileo’s experimental discourse; 5. Fresnel, Poisson and the white spot: the role of successful predictions in the acceptance of scientific theories; 6. The rhetoric of experiment; Part III. Representing and Realising: 7. ’Magnetic curves’ and the magnetic (...) field: experimentation and representation in the history of a theory; 8. Artificial clouds, real particles; 9. Living in the material world; 10. Justification and experimentation; Part IV. The Constituency of Experiment: 11. Extraordinary experiment: electricity and the creation of life in Victorian England; 12. Why did Britain join CERN?; Part V. Hallmarks of Experiment: 13. From Kwajalein to Armageddon? Testing and the social construction of missile accuracy; 14. The epistemology of experiment; Select bibliography; Name index; Subject index. (shrink)

This innovative volume is an extended intellectual conversation about the ways personal lives are being undone and remade today. Examining the ethnography of the modern subject, this preeminent group of scholars probes the continuity and diversity of modes of personhood across a range of Western and non-Western societies. Contributors consider what happens to individual subjectivity when stable or imagined environments such as nations and communities are transformed or displaced by free trade economics, terrorism, and war; how new information and medical (...) technologies reshape the relation one has to oneself; and which forms of subjectivity and life possibilities are produced against a world in pieces. The transdisciplinary conversation includes anthropologists, historians of science, psychologists, a literary critic, a philosopher, physicians, and an economist. The authors touch on how we think and write about contingency, human agency, and ethics today. (shrink)

Presumably, great men, including John Dewey, have great flaws. For decades, Dewey scholars assumed that the Hegelian cast of his early philosophy proved, prima facie, that it was merely derivative and hopelessly metaphysical in the worst possible sense of that term, as though nothing original or practically applicable to real life could possibly come from studying Hegel. I believe it is fair to say that, among Dewey scholars, the term “Hegelian” became an ossified pejorative that required little, if any, (...) explanation. “Hegelian,” and related terms such as “idealism” and “the dialectic,” were exempt from further inquiry. In recent years a growing number of scholars have taken closer looks at Dewey’s early writings.. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Don Quijote and the Law of LiteratureCarl Good (bio)The part is one of these beings, the whole minus this part the other. But the whole minus a part is not the whole and as long as this relationship persists, there is no whole, only two unequal parts.—Rousseau, Social Contract, cited by Paul de Man in Allegories of ReadingBut it is not just that, because it is also a performative.... (...) There is first a performative, the act of positing..., which then moves to a system of tropes; a kind of anamorphosis of tropes takes place, in which all the tropological systems are engendered, as a result of this original act of positing.... It is circulation which is out of hand,... the sheer circulation or play of the signifier, and which is, as you know, the root of error, madness, stupidity and all other evil.—Paul de Man, “The Concept of Irony”Amid a confusion of narrative inversions, misleading appearances, and unresolvable disputes, at least two things are consistent in Don Quijote de la Mancha: first, the knight’s singular fidelity to what I will refer to as a law of literature, which persists like a phantasm of continuity throughout the larger narrative; and, second, the many interruptions of this narrative by the stories, or episodes, recounted by the characters who cross don Quijote’s path (including the knight himself), in the form of speeches, testimonies, plays, jokes, poems, and so on. In at least one strict sense, these other stories have nothing to do with that path other than their interruptions of it and by it. Such a claim has its own strategic value and does not entirely contradict the reasonings of a long history of critics of the Quijote who have tended to argue from a variety of different standpoints for some kind of ideological cohesion that would bind the smaller episodes to the larger story that they interpolate. But at a certain ground zero of interpretation—albeit a paradoxical ground that prohibits a scholarly shelter to be built on it—no argument would be sufficient to establish such a coherence among the work’s separate narrative parts, since such an argument would live in the brief, oneiric intensity of the critic’s testimony and that testimony’s potential effects rather than in the composition of the work itself somewhere beyond its apprehension by reading. Nonetheless, out of the dismembered ensemble of the Quijote what does perhaps effect its own strange kind of life is the very play of ironic interruptions and frictions between the dismembered parts, the profusion of which seems to impose itself as the work’s own aggressive insistence on itself as something which makes sense possible by constantly provoking and unsettling sense. That is where we could begin to speak of don Quijote himself, not only as the phantasmatic agent of this unsettling but also as the mad promise of justice that could be said to motivate it.The play of interruptions in don Quijote’s own story begins to outline the shifting contours and living contradictions of this novel as a “text” in the sense in which Derrida [End Page 44] and others have used the term: that which “names or relates in its way... [a] conflict without encounter between law and singularity” [“Before the Law” 187]. Although the story of this “encounter” has been often recounted, it bears another citation here, at least because it seems to be forgotten more often than it is told. Even when it is told, the story is often muted in homage to the name of Derrida by writers who tacitly assume that Derrida’s is the only possible version of this “conflict without encounter.” That version would be better described as merely one particular ethical shaping or forcing—a powerful one—of a story that has been told, and remains untold, in uncountable ways. Nonetheless, such a democratic assessment of Derrida does not quite justify a dismissal of his version as merely one among others, since, for one thing, it would be unable to account for the astonishing hold that different versions of Derridean “deconstruction” continue to have on the imagination of North American... (shrink)

In theory, at least, we might achieve a certain sort of invulnerability right at the end of life. Suppose that under favorable circumstances we can live a certain number of years, say 125, but no longer, and also that we can make life as a whole better and better over time. Under these assumptions we might hope to disarm death by spending 125 years making life as good as it can be. If we were lucky enough to (...) accomplish that, afterwards we would be immune to mortal harm. Especially for those who are closer to the beginning of life than to the end, however, this strategy leaves much to be desired. It is like devouring an entire banquet so as to eliminate the danger of someone stealing it from us. Like a feast, a good life is safely ours after it is over, but then safety comes too late to be of any use to us. To be of practical value, we need protection from mortal harm much earlier in life. (shrink)

The Metaphysical Club, a gathering of intellectuals in the 1870s associated with Harvard, is widely recognized as the crucible where pragmatism, America's distinctively original philosophy, was refined and proclaimed. Louis Menand's bestseller about the group was a dramatic publishing success. However, only three actual members - Oliver Wendell Holmes Jr., Charles S. Peirce, and William James - appear in this book, alongside other thinkers such as John Dewey who were never in the Club. The Real Metaphysical Club tells the full (...) story of how this influential group shifted the course of philosophy in America. In addition to pioneering pragmatism, the group explored radical empiricism and idealism, and formulated personalism and process philosophy, equally important developments. This volume contains thirty-seven important writings dating from 1870 to 1885 by the real members of the Metaphysical Club. The first section centers on pragmatism and science; the second part collects writings of the lawyers; and the third part covers idealist and personalist philosophers. Many of these writings have never been reprinted before, and nothing like this impressive collection has ever been attempted. A general introduction provides a narrative history, and the editors' three introductions to the volume's sections vividly bring to life the intense meetings, sustained debates, and pioneering thought from the Metaphysical Club. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:"To make a difference...":Narrative Desire in Global MedicineByron J. Good and Mary-Jo DelVecchio GoodIf, as Arthur Frank (2002) writes, "moral life, for better and worse, takes place in storytelling," this collection of narratives written by physicians working in field settings in global medicine gives us a glimpse of some aspects of moral experience, practice, and dilemmas in settings of poverty and low health care resources. These essays are (...) written from the midst of practice, in diverse settings in Africa, South Asia, Latin America, the Caribbean, and the United States. The majority of the writers are practitioners of contemporary 'global medicine'—physicians from North America or Europe who spend part of their lives flying into settings of poverty or special need to practice medicine and work with on-going collaborative clinical and public health systems—while a smaller number are working in the societies in which they were born. Although a few work for classic humanitarian organizations or have developed their own local NGO's, the great majority are engaged in the 'hybrid life' described by Robert Riviello and noted by Renée Fox, moving between academic medical centers and distant health care systems that are supported by local governments, major international organizations and funding agencies, and international NGO's like Partners in Health. These diverse forms of practice have become a common model for contemporary clinicians engaged in what has emerged as a new discipline of global health or global medicine, and these narratives give us a glimpse of some of the enduring, as well as newly emerging, forms of moral practice and ethical dilemmas characteristic of today's global medicine.Many of these stories are filled with the tension and pathos that makes clinical narratives powerful to read. Physicians are forced to make unfathomable decisions about whether to resuscitate and keep a baby alive, using all means available, or to let the infant die, whether to carry out a procedure that will save an infant in birth but would put the mother at risk, about how to deal with a cancer found in a very advanced state. However, virtually all of the stories transcend these classical stories of the decisions physicians are forced to make by being placed in settings of great scarcity of resources, which stand in particular contrast to the academic medical settings in North America or Europe where many of these global medicine specialists have trained and many continue to practice. The unspeakable inequality of resources emerges throughout these narratives as a kind of master theme, as the underlying moral, as opposed to plot, which gives meaning and sense to the stories. For those who practice medicine in such settings, global inequalities and scarcity of medical resources are deeply felt. They produce the rage that Jeffrey Deal describes. ("I learned to despise American churches during that time, a time when my world encompassed a dying newborn in Sudan, as well as the air conditioned padded seats [End Page 121] of our affluent suburban church.") They produce the distinctive experiences of helplessness and pain felt by clinicians who cannot separate how they would be able to treat such a patient at home from how they have to practice in these settings. For those clinicians working in their own societies, scarcity of resources often produces deep anger at the corrupt governments that fail to support basic human services for the great majority of their population. ("We were temporary actors performing in the cynical play of scarcity on permanent display in Port-au-Prince," writes Haitian physician Paul Pierre about his experience prior to joining Partners in Health.)But for those who regularly travel back and forth across the divide between rich and poor, whether across national boundaries or within their own society, the challenge to live a moral life is unendingly complicated. While becoming a part of a struggle for global justice with colleagues and advocates from both sides of the divide, few of the narrators can avoid personal feelings of ambivalence and guilt at being able to easily move from one side of that divide to the other back home. Many fantasize about giving up their lives in the north to devote themselves... (shrink)

For many years, researchers and practitioners have sought out meaningful indicators of sales performance. Yet, as the concept of performance has broadened, the understanding of what makes up a successful seller, has become far more complicated. The complexity of buyer–seller relationships has changed therefore as the definition of sales performance has expanded, cultivating a growing interest in ethical/unethical actions since they could potentially have impacts on sales performance. Given this environment, the purpose of this study is to explore the impact (...) of moral judgment on sales performance and sellers engaging in a customer-oriented selling approach. Specifically, by utilizing a sample of 345 business-to-business salespeople, this study examines the relationships between moral judgment, customer-oriented selling, and outcome and behavior based performance. Results, managerial implications, and opportunities for future research are provided. (shrink)

Paediatric research in low-income countries is essential to tackle high childhood mortality. As with all research, consent is an essential part of ethical practice for paediatric studies. Ethics guidelines recommend that parents or another proxy provide legal consent for children to participate, but that children should be involved in the decision through providing assent. However, there remain uncertainties about how to judge when children are ready to give assent and about appropriate assent processes. Malawi does not yet have detailed guidelines (...) on assent. Understanding perspectives among children and their parents can assist in developing contextually-appropriate assent guidance. Qualitative research was conducted with children and parents in three settings in Southern Malawi, to take account of any variations between socioeconomic and cultural contexts. In each setting, interviews were conducted with parents and their children who had participated in paediatric research to understand their experiences of assent and views on appropriate assent practice. Focus groups were also conducted with children and parents, to understand broader social perspectives. We found widespread support for involving children in decisions on research participation. Participants identified a range of factors that affect children’s capacity to give assent, including intellectual capacity, emotional development, life experience and cultural norms. Age was often mentioned as a consideration, but deemed an unreliable sole indicator of capacity to assent. In relation to appropriate assent processes, participants emphasised considerations such as supporting effective understanding and minimizing harms. Views on how to achieve these aims varied; for example, there were different ideas about the appropriate order in which to approach children and parents, and about whose decision to respect in the event of disagreement. Parents and children agreed about the value of involving children in decisions on research, and about the need to promote children’s decision-making capacity while respecting parents’ interests in children’s welfare. Developing practical guidance that meets these principles is challenging, particularly given the need for flexible approaches that suit different study types, children’s capacities and family environments. Further discussion within the Malawi research and ethics community will help develop contextually-appropriate guidelines. (shrink)

The so-called Disability Paradox arises from the apparent tension between the popular view that disability leads to low well-being and the relatively high life-satisfaction reports of disabled people. Our aim in this essay is to make some progress toward dissolving this alleged paradox by exploring the relationship between disability and various “goods of life”—that is, components of a life that typically make a person’s life go better for her. We focus on four widely recognized goods of (...) life (happiness, rewarding relationships, knowledge, achievement) and four common types of disability (sensory, mobility, intellectual, and social) and systematically examine the extent to which the four disability types are in principle compatible with obtaining the four goods of life. Our findings suggest that that there is a high degree of compatibility. This undermines the widespread view that disabilities, by their very nature, substantially limit a person’s ability to access the goods of life, and it provides some guidance on how to dissolve the Disability Paradox. (shrink)

This article attempts to explain the value that we assign to the presence of friends at the time when life is ending. It first shows that Aristotle’s treatment of friendship does not provide a clear account of such value. It then uses J. L. Austin’s notion of performativity to supplement one recent theory of friendship – given by Dean Cocking and Jeanette Kennett – in such a way that that theory can then account for friendship’s special value at our (...) time of death. (shrink)

This volume addresses the role value judgments play in science. It is my contention that a particular research programme in modern physical cosmology rests crucially on a value judgment. Before making my case, let me introduce the following abbreviations for the following propositions.

Life is to be enjoyed -- We are here to serve God -- We are here to seek wisdom and self-actualization -- The meaning of life is a mystery -- Life is meaningless -- We are here to help others -- Life is a struggle -- We are here to contribute to society -- We must create meaning for ourselves -- Life is absurd.

As epigraph to his engrossing book of “clinical stories,” Creatures of a Day, dealing with the great varieties of the fear of death and the forms its overcoming takes, Irving Yalom, a psychiatrist with deep philosophical sympathies, stitches together the following sentences taken from various places in the Meditations of Marcus Aurelius: “All of us are creatures of a day; the rememberer and the remembered alike. All is ephemeral—both memory and the object of memory. The time is at hand when (...) you will have forgotten everything; and the time is at hand when all will have forgotten you. Always reflect that soon you will be no one, and nowhere”.1 These sentences were composed by Marcus... (shrink)

The Meditations of Marcus Aurelius are treasured today--as they have been over the centuries--as an inexhaustible source of wisdom. And as one of the three most important expressions of Stoicism, this is an essential text for everyone interested in ancient religion and philosophy. Yet the clarity and ease of the work's style are deceptive. Pierre Hadot, eminent historian of ancient thought, uncovers new levels of meaning and expands our understanding of its underlying philosophy. Written by the Roman emperor for his (...) own private guidance and self-admonition, the Meditations set forth principles for living a good and just life. Hadot probes Marcus Aurelius's guidelines and convictions and discerns the hitherto unperceived conceptual system that grounds them. Abundantly quoting the Meditations to illustrate his analysis, the author allows Marcus Aurelius to speak directly to the reader. And Hadot unfolds for us the philosophical context of the Meditations, commenting on the philosophers Marcus Aurelius read and giving special attention to the teachings of Epictetus, whose disciple he was. The soul, the guiding principle within us, is in Marcus Aurelius's Stoic philosophy an inviolable stronghold of freedom, the "inner citadel." This spirited and engaging study of his thought offers a fresh picture of the fascinating philosopher-emperor, a fuller understanding of the tradition and doctrines of Stoicism, and rich insight on the culture of the Roman empire in the second century. Pierre Hadot has been working on Marcus Aurelius for more than twenty years; in this book he distills his analysis and conclusions with extraordinary lucidity for the general reader. (shrink)

The attempt to define life has gained new momentum in the wake of novel fields such as synthetic biology, astrobiology, and artificial life. In a series of articles, Cleland, Chyba, and Machery claim that definitions of life seek to provide necessary and sufficient conditions for applying the concept of life—something that such definitions cannot, and should not do. We argue that this criticism is largely unwarranted. Cleland, Chyba, and Machery approach definitions of life as classifying (...) devices, thereby neglecting their other epistemic roles. We identify within the discussions of the nature and origin of life three other types of definitions: theoretical, transdisciplinary, and diagnostic definitions. The primary aim of these definitions is not to distinguish life from nonlife, although they can also be used for classificatory purposes. We focus on the definitions of life within the budding field of astrobiology, paying particular attention to transdisciplinary definitions, and diagnostic definitions in the search for biosignatures from other planets. (shrink)

In response to a global population with increasingly complex issues at the end of life, a movement in the U.S. has emerged incorporating doulas into end-of-life care. These end-of-life (EOL) doulas are not just focused on the quality of life, but also the quality of death. Like birth doulas, who provide support for pregnant patients and their families, EOL doulas help alleviate physical and mental discomfort in those who are dying. In this paper, we explore the (...) role of EOL doulas in improving the care of unrepresented patients, who lack decision-making capacity and have no surrogates or documents to guide their healthcare decisions. We argue that EOL doulas may help this traditionally underserved population experience a “good death” by answering several ethical and procedural challenges. As quasi-independent, non-medical members of the healthcare team, they provide a balancing, advocating voice on behalf of the patient, and may also help reduce inappropriate treatment, delays in care, and the overburdening of the public guardianship system. As such, attention should be given to formally defining their place within the healthcare infrastructure. Ultimately, we contend that EOL doulas are key to ensuring optimal, ethical care for unrepresented patient populations. (shrink)

Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient’s life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics.

This book is an account of the philosophical movement named Lebensphilosophie, which flourished at the end of the 19th and the beginning of the 20th century. There many philosophers who participated in the movement, but this book concentrates on the three most important: Friedrich Nietzsche, Wilhelm Dilthey and Georg Simmel. The movement was called Lebensphilosophie—literally, philosophy of life—because its main interest was not life as a biological phenomenon but life as it is lived by human beings. They (...) regarded human life and experience as the fundamental reality, the basis of all knowledge and value, and disputed the relevance of any supernatural realm transcending human experience. The purpose of life was therefore life itself. Lebensphilosophie was the first modern philosophical movement in the Western tradition. It was “modern” in the sense that it was entirely humanist and secular, deriving all values from a non-religious perspective. Nietzsche, Dilthey and Simmel were either atheists or agnostics; they denied the relevance of any transcendent reality or being for human life. They abjured the traditional Christian concern with salvation and immortality. They also disputed the existence of natural law, teleology or a providential order; human beings created their own values and they did not conform to any made by nature. In anticipation of later existentialism, the Lebensphilosophen maintained that human beings are the makers of their own fate. Contrary to pessimism, they affirmed the great value of life while still acknowledging its frequent tragedy. The Lebensphilosophen were champions of an individualist ethics, which maintained that the highest good for a human being was self-realization, the development of a persons’s unique individuality. Their ethics was neither utilitarian nor de-ontological: it was not utilitarian because it did not regard the highest good as pleasure; self-realization could be a very unpleasant experience; and it was not de-ontological because it grounded moral norms upon the facts of human development and experience. The Lebensphilosophen were major advocates of historicism. They believed that human experience is formed by history, and that its horizons and limits are historical. Just as it was impossible to transcend human experience, so it was impossible to transcend history. All values and norms were therefore historical. In attempting to describe historical experience, the Lebensphilosophen developed the discipline of hermeneutics. They refused to accept mechanical explanation as a paradigm of explanation. This book attempts to describe and analyze the fundamental aspects of Lebensphilosophie by looking in detail at the views of its three leading figures. It examines their ethics, their religious background, their responses to pessimism and relativism, and their contributions to hermeneutics and historicism. (shrink)

Most properties have comparatives, which are relations. For instance, the property of width has the comparative relation denoted by `_ is wider than _'. Let us say a property is reducible to its comparative if any statement that refers to the property has the same meaning as another statement that refers to the comparative instead. Width is not reducible to its comparative. To be sure, many statements that refer to width are reducible: for instance, `The Mississippi is wide' means the (...) same as `The Mississippi is wider than most rivers'. But some statements that refer to width are not reducible: for instance, `Electrons have zero width' is not. A property is not reducible to its comparative if it has absolute degrees, and specifically an absolute zero. A property's comparative relation places things in an order from those that have the property least to those that have it most. If there is an absolute zero point somewhere in this ordering, the property is not reducible to its comparative. For width, there is an absolute zero at one end of the ordering, so width is not reducible. The property of goodness is reducible to its comparative, betterness. In particular, there is no absolute zero of goodness. Things are ordered by betterness – some things are better than others – but nothing is absolutely good or absolutely bad. This is an exaggeration. In certain applications, goodness does have absolute degrees of a sort, and an absolute zero. For instance, it makes sense to say an event is good, and another event bad. These are absolute degrees of a sort, but they are themselves reducible to betterness. To say an event is good simply means the event is better than what would otherwise have happened. The goodness of lives has a different sort of absolute zero. Lives are ordered by betterness; some lives are better than others. We can make sense of the question `Where in this ordering is the division between lives that are good and those that are bad?' The division between good and bad lives is again reducible to betterness. To say a person's life is good means it is better that the person should continue living, rather than that she should die. Or it may mean it is better that her life should be lived rather than that it should never have been lived at all. As it is often put: a good life is a life worth living. Derek Parfit appears to attach a different sense to the idea of a good life. He appears to mean a life that contains a preponderance of good things (such as pleasure) over bad things (such as pain). If a life contains no good things and no bad things, it has zero goodness in this sense. In this sense, absolute goodness and the absolute zero of goodness are not reducible to betterness. However, this is a naturalistic sense of goodness, and it is subject to the open-question objection. If a life contains no good things and no bad things, it is an open question whether it has zero goodness. It might, for instance, be a bad thing that this life should be lived. In discussing the evil of death, some philosophers seem to have been searching for an absolute goodness that is not reducible to betterness. Thomas Nagel speaks of an asymmetry between what is good about life and what is bad about death. But if a person's life is good, that only means it would be better that she should continue living than that she should die. And if a person's death would be bad, that only means it would be worse that she should die than that she should continue living. So there can be no asymmetry. (shrink)

Discussions of value play a central role in contemporary philosophy. This book considers the role of values in truth seeking, in morality, in aesthetics and also in the spiritual life. The distinguished contributors include Simon Blackburn, Jonathan Dancy, Paul Horwich, John Leslie, Timothy Sprigge, and David Wiggins.

I defend the theory that one's life is meaningful to the extent that one promotes the good. Call this the good cause account (GCA) of the meaning of life. It holds that the good effects that count towards the meaning of one's life need not be intentional. Nor must one be aware of the effects. Nor does it matter whether the same good would have resulted if one had not existed. What matters is that one is causally (...) responsible for the good. I argue that the best theory of the meaning of life should clearly distinguish between subjective fulfillment and objective meaningfulness. The GCA respects the distinction. And it is superior to its leading rivals in the recent literature, most notably those of Erik Wielenberg and Susan Wolf. (shrink)

Its critics to the contrary, the “gift of life” metaphor is not to be blamed for the indebtedness and guilt that organ recipients often experience. It is certainly misused, however, both by post‐transplant caregivers, who exploit it to manipulate recipients' behavior, and by the organ procurement system, which has failed to understand that the decision to give the gift of life must be approached communally.

BackgroundCompetent end-of-life care is an essential component of total health care provision, but evidence suggests that it is often deficient. This study aimed to evaluate the knowledge and attitudes about key end-of-life issues and principles of good death among doctors in clinical settings.MethodsA cross-sectional study was conducted among allopathic medical doctors working in in-ward clinical settings of tertiary care hospitals in Sri Lanka using a self-administered questionnaire with open- and close-ended questions as well as hypothetical clinical scenarios. Univariate (...) and logistic regression analysis were used to identify the independent factors associated with knowledge and attitudes.ResultsOf the responders who had not been a caregiver for a terminally ill relative (n = 390), 57.9% were men with a mean age of 36.5 years (SD = 8.2). Compared to undergraduate (65.6%; n = 256), only 27.4% (n = 107) had received end-of-life care training at postgraduate level. Only 65.9% of doctors favoured disclosing terminal prognosis to patients; 27.7% of doctors were aware of advance directives; 14.6% were aware of the correct time of death when certifying brain death; 70.3% felt more comfortable in withholding than withdrawing life-sustaining treatment; 61.3% were aware of do-not-attempt cardiopulmonary resuscitation (DNACPR) decisions while 26.7% felt reluctant to administer it; 15.1% thought that all life-sustaining therapy should be withdrawn with a DNACPR decision; and only17.9% were able to name the four principles of medical ethics while 57.9% could not name a single. Participants scored a mean of 9.2 (SD = 3.9) of a maximum 14 points when tested on principles of a ‘good death’. Doctors who had pursued postgraduate studies were more likely to be aware of breaking bad news (adjusted-Odds-Ratio:1.99; 95%CI = 1.19–3.32), advance directives (adjusted-OR: 4.15; 95%CI = 2.49–6.94), aware of certifying the correct time of death (adjusted-OR:2.37; 95%CI = 1.33–4.2) and less reluctant to make DNACPR decisions (adjusted-OR:1.74; 95%CI = 1.13–2.68). Doctors who had worked in ICU were more comfortable withholding than withdrawing treatment (adjusted-OR:1.99; 95%CI = 1.2–3.31).ConclusionsKnowledge and attitudes about end-of-life care, good death and principles of medical ethics among doctors in Sri Lanka were suboptimal. Structured training of end-of-life care needs to be integrated within curricula and in-service training. (shrink)

Quality of life is part of many different discourses and has been used in a variety of meanings ranging from purely descriptive (as in some medical contexts) to distinctly evaluative meanings (as in some social science and political contexts). The paper argues that there are good normative reasons to make the concept as descriptive as possible at least in its medical applications and, furthermore, to reconstruct it in a thoroughgoing subjectivist way, making the reflexive self-evaluation of the subject him- (...) or herself the ultimate standard. Attention is drawn to the fact that only few of the measures of quality of life applied in present-day medicine correspond to these requirements. (shrink)

This collection of original essays, from both established scholars and newcomers, takes up a debate that has recently flared up in philosophy, sociology, and disability studies on whether disability is intrinsically a harm that lowers a person's quality of life. While this is a new question in disability scholarship, it is also touches on one of the oldest philosophical questions: What is the good human life? Historically, philosophers have not been interested in the topic of disability, and when (...) they are it is usually only in relation to questions such as euthanasia, abortion, or the moral status of disabled people. Consequently, implicitly or explicitly, disability has been either ignored by moral and political philosophers or simply equated with a bad human life, a life not worth living. This collection takes up the challenge that disability poses to basic questions of political philosophy and bioethics, among others, by focusing on fundamental issues as well as practical implications of the relationship between disability and the good human life. (shrink)

Noted scholar and humanist argues that we can find answers to important human questions without recourse to faith in a supernatural deity. What gives purpose to our existence? What happens to our mind and body when we die? What invests our lives with meaning and propels us to go on from day to day? These are some of the questions that have occupied humankind for centuries. Do solutions to these problems of life and death depend, as many believe, on (...) the existence and intervention of a supernatural creator god? In this contribution to the Prometheus Lecture Series, noted scholar and humanist Kurt Baier, one of the leading ethical theorists of the 20th century, contends that rational humanism is the best alternative to theism. In Problems of Life & Death: A Humanist Perspective, he offers a lively discussion of humanism and supernaturalism; problems of practical wisdom featuring death and the good; and traditional moral problems. Part one traces contemporary rational humanism to its roots in ancient Greece; its revival in the Christian renaissance; its development during the scientific revolution, the 18th century Enlightenment, the Darwinian theory of evolution, and its contemporary developments. Part two answers broad questions of practical wisdom from the rationalist point of view. The third part offers a rationalist conception of morality to replace "the will of God" as the impetus for human action. Baier then applies this moral stance to a number of contemporary moral problems including how to lead a rewarding life, homosexual behavior, birth control, and suicide. With fresh ideas, a carefully argued thesis, and convincing conclusions, Baier shows how the rational humanist can come to grips with some of the deepest problems of human existence, without assumptions based on religious faith. (shrink)

This article argues that a person’s well-being at a time and the goodness of her life are two distinct values. It is commonly accepted as platitudinous that well-being is what makes a life good for the person who lives it. Even philosophers who distinguish between well-being at a time and the goodness of a life still typically assume that increasing a person’s well-being at some particular moment, all else equal, necessarily improves her life on (...) the whole. I develop a precise statement of this standard assumption, and then show that it is subject to counterexamples. The possibility of such counterexamples depends only on premises similar to those sometimes invoked to argue that a person’s well-being over a long period is not simply the aggregate well-being of the shorter periods that compose the long period. The refutation of the standard assumption linking well-being and life-goodness entails that these are distinct and sometimes divergent values. As an alternative to the standard assumption, it is proposed that well-being is best understood as an ingredient in a good life. (shrink)

Monetary Intelligence theory asserts that individuals apply their money attitude to frame critical concerns in the context and strategically select certain options to achieve financial goals and ultimate happiness. This study explores the bright side of Monetary Intelligence and behavioral economics, frames money attitude in the context of pay and life satisfaction, and controls money at the macro-level and micro-level. We theorize: Managers with low love of money motive but high stewardship behavior will have high subjective well-being: pay satisfaction (...) and quality of life. Data collected from 6586 managers in 32 cultures across six continents support our theory. Interestingly, GDP per capita is related to life satisfaction, but not to pay satisfaction. Individual income is related to both life and pay satisfaction. Neither GDP nor income is related to Happiness. Our theoretical model across three GDP groups offers new discoveries: In high GDP entities, “high income” not only reduces aspirations—“Rich, Motivator, and Power,” but also promotes stewardship behavior—“Budget, Give/Donate, and Contribute” and appreciation of “Achievement.” After controlling income, we demonstrate the bright side of Monetary Intelligence: Low love of money motive but high stewardship behavior define Monetary Intelligence. “Good apples enjoy good quality of life in good barrels.” This notion adds another explanation to managers’ low magnitude of dishonesty in entities with high Corruption Perceptions Index. In low GDP entities, high income is related to poor Budgeting skills and escalated Happiness. These managers experience equal satisfaction with pay and life. We add a new vocabulary to the conversation of monetary intelligence, income, GDP, happiness, subjective well-being, good and bad apples and barrels, corruption, and behavioral ethics. (shrink)

The author discusses B.G. Yudin's image technoscience as having two contours, the external one dealing with science, business and society, and the internal one represented by laboratories. Together these two contours present a multidimensional net of relations between science and technology in conducting experiments, development of instruments (e.g. visualization tools), etc. The author argues that, in such a system, coordinated activity of the internal and the external contours is provided by a synergy of regulatory principles of truth, good and usefulness. (...) He discusses a case of synthetic biology which, as he argues, demonstrates that the internal and external contours of technoscience undergo a process of technologization. Technologization is understood as a transition from research techniques to systematic use of technologies. Biotechnologies are claimed to have a double socio-biological helix network structure. Each network is formed as a kind of ad hoc "factory" and is aimed at solving specific research problems. (shrink)

How an acceptance of our limitations can lead to a more fulfilling life and a more harmonious society We live in a world oriented toward greatness, one in which we feel compelled to be among the wealthiest, most powerful, and most famous. This book explains why no one truly benefits from this competitive social order, and reveals how another way of life is possible—a good-enough life for all. Avram Alpert shows how our obsession with greatness results in (...) stress and anxiety, damage to our relationships, widespread political and economic inequality, and destruction of the natural world. He describes how to move beyond greatness to create a society in which everyone flourishes. By competing less with each other, each of us can find renewed meaning and purpose, have our material and emotional needs met, and begin to lead more leisurely lives. Alpert makes no false utopian promises, however. Life can never be more than good enough because there will always be accidents and tragedies beyond our control, which is why we must stop dividing the world into winners and losers and ensure that there is a fair share of decency and sufficiency to go around. Visionary and provocative, The Good-Enough Life demonstrates how we can work together to cultivate a good-enough life for all instead of tearing ourselves apart in a race to the top of the social pyramid. (shrink)

Gerontologists have proposed different concepts for ageing well such as ‘successful ageing’, ‘active ageing’, and ‘healthy ageing’. These conceptions are primarily focused on maintaining health and preventing disease. But they also raise the questions: what is a good life in old age and how can it be achieved? While medical in origin, these concepts and strategies for ageing well also contain ethical advice for individuals and societies on how to act regarding ageing and old age. This connection between gerontology (...) and ethics is overlooked by both schools of thought. We thus develop this research programme for a systematic geroethics in four steps. First, we analyze ‘successful ageing’ as put forward by Rowe and Kahn as a paradigmatic example of a gerontological conception of ageing well. Then, in a second step, we move from criticisms within gerontology to an ethical perspective; in particular, we want to clarify the problem of the claim of universal validity of conceptions of the good life. In a third constructive step, we explain how the ‘capabilities approach’ could be applied in this context as a normative foundation for the implicit normative assumptions of gerontological conceptions of ageing well, such as a particular choice of functionings, the ethical relevance of human agency, and the resulting claims of individuals towards society. Finally, using a concept developed by the German philosopher Ursula Wolf, we systematically develop the different aspects of the connection between ageing well and the theory of the good life in their full complexity and show their interconnectedness. (shrink)

The management of patients suffering from chronic disorders of consciousness inevitably raises important ethical questions about the end of life decisions. Some ethical positions claim respect of human life sacredness and the use of good medical practices require allowing DOC patients to live as long as possible, since no one can arbitrarily end either his/her or others’ life. On the other hand, some currents of thought claim respect of human life dignity, patients’ wishes, and the right (...) of free choice entail allowing the withdrawal of life sustaining therapy. This could happen when patients believe their own life to be not worth living, or if therapy is not very beneficial, excessively burdensome, or even futile. Indeed, the decision to withdraw therapies in a DOC patient should be guided by reliable information about DOC diagnosis and prognosis and on how the patient would wish to be treated in such a condition. Taking into account such issues, it would be possible to make the decision that more adequately fits a DOC patient’s best interest. This review aims to overview the range of ethical issues referring to end-of-life decisions in DOC patients, with regard to the thorny debate on the sacredness and dignity of human life. (shrink)

The aim of the present paper is to describe three different attempts, which have been made by philosophers, to define what quality of life is; and to spell out some of the difficulties that faces each definition. One, Perfectionism, focuses on the capacities that human beings possess: capacities for friendship, knowledge and creative activity, for instance. It says that the good life consists in the development and use of these capacities. Another account, the Preference Theory, urges that satisfying (...) one's preferences, or desires, is what improves one's quality of life. And a third account, Hedonism, sees life-quality as consisting in the enjoyment of pleasure and the avoidance of pain. The paper describes and evaluates objections to each of these views, thereby displaying their weaknesses and strengths. Since no view comes out as the right one there is a choice to be made. At the end of the paper it is being discussed how well each of the views cohere with different methodologies used in quality of life research. Also it is suggested that considerations about what the research is to be used for are relevant. (shrink)