In this paper we articulate how time and temporalities are involved in the making of living things. For these purposes, we draw on an instructive episode concerning Norfolk Horn sheep. We attend to historical debates over the nature of the breed, whether it is extinct or not, and whether presently living exemplars are faithful copies of those that came before. We argue that there are features to these debates that are important to understanding contemporary configurations of life, time, and the (...) organism, especially as these are articulated within the field of synthetic biology. In particular, we highlight how organisms are configured within different material and semiotic assemblages that are always structured temporally. While we identify three distinct structures, namely the historical, phyletic, and molecular registers, we do not regard the list as exhaustive. We also highlight how these structures are related to the care and value invested in the organisms at issue. Finally, because we are interested ultimately in ways of producing time, our subject matter requires us to think about historiographical practice reflexively. This draws us into dialogue with other scholars interested in time, not just historians, but also philosophers and sociologists, and into conversations with them about time as always multiple and never an inert background. (shrink)

In early 2020, a number of countries developed and published intensive care triage guidelines for the pandemic. Several of those guidelines, especially in the UK, encouraged the explicit assessment...

Imagine that we are considering whether our healthcare system (or insurer) should fund treatment or procedure X. One factor that may be cited is that of so-called ‘medical necessity’. The claim would be that treatment X should be eligible for funding if it is medically necessary, but ineligible if this does not apply. Similarly, (and relevant to the debates in this special issue), if considering whether a particular treatment should be ethically and/or legally permitted, we may wish to distinguish between (...) cases where the treatment is medically necessary, and those were it is not. But what do we mean by this concept? Here I will propose and briefly defend one plausible and practical definition. (shrink)

BackgroundECMO is a particularly scarce resource during the COVID-19 pandemic. Its allocation involves ethical considerations that may be different to usual times. There is limited pre-pandemic literature on the ethical factors that ECMO physicians consider during ECMO allocation. During the pandemic, there has been relatively little professional guidance specifically relating to ethics and ECMO allocation; although there has been active ethical debate about allocation of other critical care resources. We report the results of a small international exploratory survey of ECMO (...) clinicians’ views on different patient factors in ECMO decision-making prior to and during the COVID-19 pandemic. We then outline current ethical decision procedures and recommendations for rationing life-sustaining treatment during the COVID-19 pandemic, and examine the extent to which current guidelines for ECMO allocation (and reported practice) adhere to these ethical guidelines and recommendations.MethodsAn online survey was performed with responses recorded between mid May and mid August 2020. Participants (n = 48) were sourced from the ECMOCard study group—an international group of experts (n = 120) taking part in a prospective international study of ECMO and intensive care for patients during the COVID-19 pandemic. The survey compared the extent to which certain ethical factors involved in ECMO resource allocation were considered prior to and during the pandemic.ResultsWhen initiating ECMO during the pandemic, compared to usual times, participants reported giving more ethical weight to the benefit of ECMO to other patients not yet admitted as opposed to those already receiving ECMO, (p < 0.001). If a full unit were referred a good candidate for ECMO, participants were more likely during the pandemic to consider discontinuing ECMO from a current patient with low chance of survival (53% during pandemic vs. 33% prior p = 0.002). If the clinical team recommends that ECMO should cease, but family do not agree, the majority of participants indicated that they would continue treatment, both in usual circumstances (67%) and during the pandemic (56%).ConclusionsWe found differences during the COVID-19 pandemic in prioritisation of several ethical factors in the context of ECMO allocation. The ethical principles prioritised by survey participants were largely consistent with ECMO allocation guidelines, current ethical decision procedures and recommendations for allocation of life-sustaining treatment during the COVID-19 pandemic. (shrink)

Decisions about providing life-sustaining treatments for extremely premature infants born after preterm labor are complex, contested, and fraught. They are medically uncertain—the outcome of embark...

Comment on "The ethical 'elephant' in the death penalty 'room'". Arguments in defense of the death penalty typically fall into one of two groups. Consequentialist arguments point out beneficial aspects of capital punishment, normally focusing on deterrence, while non-consequentialist arguments seek to justify execution independently of its effects, for example, by appealing to the concept of retribution. Michael Keane's target article "The ethical 'elephant' in the death penalty 'room'" should, we believe, be read as an interesting new consequentialist defense of (...) physician involvement in capital punishment. (shrink)

The debate about positive and negative claims of conscience is, in large part, about ethical consistency. In this commentary I argue that there can be differences between conscientious provision of treatment and conscientious nonprovision of treatment that are ethically relevant. However, in many cases, including those described in this commentary, there is not sufficient ethical reason to treat them differently. This means that asymmetrical conscientious objection policies are potentially unjustified.

In this commentary I assess the possible harms to a fetus with trisomy 18 of continued life. I argue that, although there is good reason to avoid subjecting infants to major surgery and prolonged intensive care where there is little chance of benefit, doctors should support and engage honestly with parents who decide to continue their pregnancies. We should ensure that infants with trisomy 18 have access to high quality palliative care.

This book provides a theoretical and practical exploration of the constitutional bar against cruel and unusual punishments, excessive bail, and excessive fines. It explores the history of this prohibition, the current legal doctrine, and future applications of the Eighth Amendment. With contributions from the leading academics and experts on the Eighth Amendment and the wide range of punishments and criminal justice actors it touches, this volume addresses constitutional theory, legal history, federalism, constitutional values, the applicable legal doctrine, punishment theory, prison (...) conditions, bail, fines, the death penalty, juvenile life without parole, execution methods, prosecutorial misconduct, race discrimination, and law & science. (shrink)

Can metaphysics yield the consolations of philosophy? One possibility, defended by Derek Parfit, is that reflection on the nature of identity and time could diminish both fear of death and grief. In this paper, I assess the prospect of such consolation, focussing especially on attempts to console a grieving third party. A shift to a reductionist view of personal identity might mean that death is less threatening. However, there is some evidence to suggest that such a shift does not necessarily (...) translate into less death anxiety. Moreover, applied to grief at loss of another, such a perspective may be misdirected. A temporally neutral perspective offers a theoretically powerful way of reducing the sense of loss at being separated in time from a loved one. However, it is unclear whether it is psychologically possible to achieve. Even if it were possible, it may not diminish the pain of separation.I identify a serious challenge to philosophical consolation for grief. The greater the consolation that is offered, the greater the risk of losing important attachments and the less it may be psychologically accessible. (shrink)

The paper explores the question of the relationship between science and religion today in light of its modern origin in the Galileo affair. After first presenting Ian Barbour’s four standard models for the possible relationships between science and religion, it then draws on the work of Richard Blackwell and Ernan McMullin to consider the Augustinian principles at work in Galileo’s understanding of science and religion. In light of this the paper proposes a fifth, hybrid model, “dialogical convergence,” as a more (...) adequate model of the relationship in-between science and religion because it is epistemically just in its coherence with the last fifty years of philosophy of science by which it affords more than the mere tolerance of an independence view which leaves no space for the possibility of a theological understanding of nature. (shrink)

I am grateful to the commentators for their deep engagement with the issues raised in my paper. They raise a number of important challenges and questions about the use of frailty i...

The paper explores the question of the relationship between science and religion today in light of its modern origin in the Galileo affair. After first presenting Ian Barbour’s four standard models for the possible relationships between science and religion, it then draws on the work of Richard Blackwell and Ernan McMullin to consider the Augustinian principles at work in Galileo’s understanding of science and religion. In light of this the paper proposes a fifth, hybrid model, “dialogical convergence,” as a more (...) adequate model of the relationship in-between science and religion because it is epistemically just in its coherence with the last fifty years of philosophy of science by which it affords more than the mere tolerance of an independence view which leaves no space for the possibility of a theological understanding of nature. (shrink)

Conventional wisdom suggests that the Platonist philosophers of Late Antiquity, from Plotinus (third century) to the sixth-century schools in Athens and Alexandria, neglected the political dimension of their Platonic heritage in their concentration on an otherworldly life. Dominic O'Meara presents a revelatory reappraisal of these thinkers, arguing that their otherworldliness involved rather than excluded political ideas, and he reconstructs for the first time a coherent political philosophy of Late Platonism.

The Pythagorean idea that numbers are the key to understanding reality inspired philosophers in late Antiquity (4th and 5th centuries A.D.) to develop theories in physics and metaphysics based on mathematical models. This book draws on some newly discovered evidence, including fragments of Iamblichus's On Pythagoreanism, to examine these early theories and trace their influence on later Neoplatonists (particularly Proclus and Syrianus) and on medieval and early modern philosophy.

Knowledge of the structure of the cosmos, Plato suggests, is important in organizing a human community which aims at happiness. This book investigates this theme in Plato's later works, the Timaeus, Statesman, and Laws. Dominic J. O'Meara proposes fresh readings of these texts, starting from the religious festivals and technical and artistic skills in the context of which Plato elaborates his cosmological and political theories, for example the Greek architect's use of models as applied by Plato in describing the (...) making of the world. O'Meara gives an account of the model of which Plato's world is an image; of the mathematics used in producing the world; and of the relation between the cosmic model and the political science and legislation involved in designing a model state in the Laws. Non-specialist scholars and students will be able to access and profit from the book. (shrink)