Family involvement in healthcare decision-making for competent patients occurs to varying degrees in many communities around the world. There are different attitudes about who should make treatment decisions, how and why. Legal and professional ethics codes in most jurisdictions reflect and support the idea that competent patients should be enabled to make their own treatment decisions, even if others, including their healthcare professionals, disagree with them. This way of thinking contrasts with some cultural norms that put more emphasis on the (...) family as a decision-making entity, in some circumstances to the exclusion of a competent patient. Possible tensions may arise between various combinations of patient, family members and healthcare professionals, and healthcare professionals must tread a careful path in navigating family involvement in the decision-making process. These tensions may be about differences of opinion about which treatment option is best and/or on who should have a say or influence in the decision-making process. While some relevant cultural, legal and policy considerations vary from community to community, there are ethical issues that healthcare professionals need to grapple with in balancing the laws and professional codes on decision-making and the ethical principle of respecting patients and their autonomy. This paper will highlight and propose that a partial resolution to these issues may lie in relational understandings of autonomy, which in principle justify interventions by healthcare professionals and family that support patients in decision-making. (shrink)

During a pandemic, where there is widespread human infection, various and varying measures are taken that are targeted at public health objectives. During the early stages of a pandemic, these objectives may focus on containing the disease and minimizing its spread, but they may switch to mitigation as the emergent infectious disease takes hold in a population. There has been considerable debate and elucidation of the ethical principles and framework for the various responses including the need to fast track research (...) and vaccine development. However, the measures imposed during a pandemic would have unintended and untoward effect on ongoing clinical research. For example, precautionary measures, such as social distancing, may hamper ongoing clinical research, because recruitment and participation of patients and healthy volunteers is a potential source of virus spread. In this paper, we argue that a framework is needed to ensure the continuity of such research. Such a framework that considers the pertinent issues would need the ‘buy in’ of the key stakeholders (policy makers, funding agencies, institutional authorities, researchers and subjects) to ensure that the issues that are ethically relevant to pandemic planning would not be neglected or overlooked. (shrink)

In a recent article in Health Care Analysis (Vol. 8, No. 1),Campbell misrepresents our specific arguments about commercialsurrogate motherhood (C.S.M.) and our general philosophical andpolitical views by saying or suggesting that we are `Millsian'liberals and consequentialists. He gives too the false impressionthat we do not oppose, in principle, slavery and child purchase.Here our position on C.S.M. is re-expressed and elaborated uponin order to eliminate possible confusion. Our general ethical andphilosophical framework is also outlined and shown to be otherthan (...) class='Hi'>Campbell says that it is. In particular, a moral philosophythat it is based on neither consequentialism nor Kantianism ispresented. C.S.M., it is argued, is not child purchase. It is like it insome respects and unlike it in others. It is unlike it in therespects which, relative to the present discussion, matter. (shrink)

Professor H. J. Rose's article in C.Q. xxxiii. 69 f. has advanced the study of this perplexing passage in two important respects. He has observed that, in order to determine the ‘eye’ as metaphorical, ỏΦθαλμός requires a dependent genitive, and he has therefore restored μεαλν πολων to this relation by punctuating as above instead of after πολίων And he is surely equally right in maintaining that this plural genitive must have a plural reference; it must mean ‘of great cities’ and (...) not ‘of Cyrene’. For although there is a figure called pluralis maiestatis, such obscurity in the use of it seems too affected, such ambiguity too perverse; a poem honouring the prince of Cyrene will refer to this famous city in unmistakable terms. (shrink)

Professor H. J. Rose's article in C.Q. xxxiii. 69 f. has advanced the study of this perplexing passage in two important respects. He has observed that, in order to determine the ‘eye’ as metaphorical, ỏΦθαλμός requires a dependent genitive, and he has therefore restored μεαλν πολων to this relation by punctuating as above instead of after πολίων And he is surely equally right in maintaining that this plural genitive must have a plural reference; it must mean ‘of great cities’ and (...) not ‘of Cyrene’. For although there is a figure called pluralis maiestatis, such obscurity in the use of it seems too affected, such ambiguity too perverse; a poem honouring the prince of Cyrene will refer to this famous city in unmistakable terms. (shrink)

Definitions are traditionally seen as abbreviations, as tools for notational convenience that do not increase inferential power. From a Philosophy of Mathematical Practice point of view, however, there is much more to definitions. For example, definitions can play a role in problem solving, definitions can contribute to understanding, sometimes equivalent definitions are appreciated differently, and so on. This chapter reviews the literature on definitions and (to a certain extent) concepts in mathematical practice. It is structured according to four themes through (...) which definitions (and concepts) in mathematical practice have been studied. These themes concern (1) the nature of definitions, (2) whether and how concepts evolve, (3) definitions and concepts from a communal perspective, and (4) different values relating to definitions and concepts. (shrink)

In the philosophy of mathematical practice, the aim is to understand the various aspects of this practice. Even though definitions are a central element of mathematical practice, the study of this aspect of mathematical practice is still in its infancy. In particular, there is little empirical evidence to substantiate claims about definitions in practice. In this article, we address this gap by reporting on an empirical investigation on how mathematicians create definitions and which roles and properties they attribute to them. (...) On the basis of interviews with thirteen research mathematicians, we provide a broad range of relevant aspects of definitions. In particular, we address various roles of definitions and show that definitions are not just a product of mathematical factors, but also of social and contingent factors. Furthermore, we provide concrete examples of how mathematicians interact and think about definition. This broad empirical basis with a variety of examples provides an optimal starting point for future investigations into definitions in mathematical practice. (shrink)

The Hiero is an account in Socratic conversational form of a meeting between Simonides the poet and Hiero the tyrant of Syracuse; it was written by Xenophon of Athens in the fourth century b.c., but is set in the fifth, when the historical Simonides and Hiero lived and met. The subject they are portrayed discussing is the relative happiness of the tyrant and private individual. Plato also makes this a topic of discussion in his Republic. However, whereas Plato writes a (...) regular Socratic dialogue, Xenophon does not, for though he represents his characters using Socratic conversation, Socrates himself does not appear; the characteros of the Hiero are Simonides and Hiero, poet and tyrant. This is the problem of the Hiero. It requires explanation. The action of the Hiero is initiated by Simonides and begins in the following way: Simonides the poet once came to the court of Hiero the tyrant. When they were both at leisure, Simonides said, ‘Would you be willing to tell me, Hiero, something you are likely to know better than I?’ And Hiero said, ‘What is it that I should know better than you, who are such a wise man?’ He replied, ‘I know that you were once a private individual and are now a tyrant. Since you have experienced both conditions, you are likely to know better than I how tyrannical life differs from private life in respect of men's pleasures and griefs’ . The identification of Simonides as a wise man who nevertheless seeks wisdom from others establishes his Socratic nature from the start. (shrink)

Case-based, multidisciplinary seminars provided a vehicle for clinicians, philosophers and students to debate current problems in medical ethics in a manner which ensured maximum learning and interest for all participants. Prior training in philosophical medical ethics was an essential prerequisite, giving students the knowledge and skills to take part in the discussions at an appropriate level of sophistication.

As one might expect of an author of the complexity of John of Salisbury, there is little scholarly agreement regarding the proper interpretation of the major features of his social and political thought. The twelfth-century church-man has always been a controversial figure. Since the late Middle Ages, the ideas contained in his main contribution to political theory, the Policraticus , have been widely analyzed and interpreted. In more recent years, controversy has raged about the nature and significance of many of (...) his main doctrines , his source materials, and his attitudes towards contemporary events and people. (shrink)

Since James defined emotion as consciousness of bodily reactions and Cannon and others detailed the nature of these reactions, there has been an increasing tendency among behaviorists to equate emotions with visceral reactions and to neglect some of the genetic and adaptive aspects of emotion which had been discussed by Darwin.