When attempting to answer the question, in the context of clinical healthcare, one might be tempted to leap to either of two rather obvious, but seemingly contradictory conclusions. On the one hand, we might have a general impression of religion not making much of a distinctive and clear difference, at least in the actions and outcomes of most cases of clinical interaction. Those of us in the bioethics world of discourse are likely to think only of the less common cases (...) of Christian Scientists, Jehovah's Witnesses, Orthodox Jews, or certain religious groups who seem to the majority of the population to hold especially sectarian, if not beliefs about medical matters. The so-called mainstream religious groups do not get much attention because they largely don't cause much trouble ; they have learned to bracket their religious commitments from at least any professional settings ; or they don't hold views entailing consequences any different from those of most nonbelieving, generally upright individuals. Furthermore, although religious believers may have some distinctive views, these views don't often noticeably manifest themselves in distinctive or significant ways. (shrink)

Debates over health care have focused for so long on economics that the proper goals for medicine seem to be taken for granted; yet problems in health care stem as much from a lack of agreement about the goals and priorities of medicine as from the way systems function. This book asks basic questions about the purposes and ends of medicine and shows that the answers have practical implications for future health care delivery, medical research, and the education of medical (...) students. The Hastings Center coordinated teams of physicians, nurses, public health experts, philosophers, theologians, politicians, health care administrators, social workers, and lawyers in fourteen countries to explore these issues. In this volume, they articulate four basic goals of medicine — prevention of disease, relief of suffering, care of the ill, and avoidance of premature death — and examine them in light of the cultural, political, and economic pressures under which medicine functions. In reporting these findings, the contributors touch on a wide range of diverse issues such as genetic technology, Chinese medicine, care of the elderly, and prevention and public health. The Goals of Medicine clearly demonstrates the importance of clarifying the purposes of medicine before attempting to change the economic and organizational systems. It warns that without such examination, any reform efforts may be fruitless. (shrink)

The biotechnology industry's intellectual property claims contribute to a subtle but not insignificant encroachment of commodification within health care. Drawing on the conceptual framework of Margaret Jane Radin, I argue that patent claims on human biological materials may commodify that with which our personhood and individuality is intertwined but that such commodification is broad and incomplete. Patents on nonhuman biological organisms contribute to a more materialistic understanding of them but do not significantly change our relationship to them. The systemic effects (...) of biotechnology's commodification within health care are various and may compromise the goal of good health. The morally problematic aspects of patent claims entail certain obligations to inhibit commodification from becoming more egregious, but on balance, those aspects are currently insufficient to justify denying the benefits the patent system promotes. (shrink)

Book reviewed in this article: Theological Voices in Medical Ethics. Edited by Allen Verhey and Stephen E. Lammers.

Book reviewed in this article: Theological Voices in Medical Ethics. Edited by Allen Verhey and Stephen E. Lammers.

As medical science continues its rapid advances, questions are raised that have more to do with theology than with technology: Where is God when I am hurt or suffering? What role does God play in my healing? "Pain Seeking Understanding" examines how believers and nonbelievers alike wrestle with questions of faith when confronted with pain and suffering that medicine alone cannot treat. Margaret Mohrmann and Mark Hanson call upon fellow experts in the fields of medicine, ethics, theology, and (...) pastoral care to help them weave the complex story of faith and science working together to ease suffering -- and to help broaden our understanding of God's role in suffering and healing. (shrink)

The UK government has recently committed to adopting a new policy—dubbed ‘Martha’s Rule’—which has been characterised as providing patients the right to rapidly access a second clinical opinion in urgent or contested cases. Support for the rule emerged following the death of Martha Mills in 2021, after doctors failed to admit her to intensive care despite concerns raised by her parents. We argue that framing this issue in terms of patient rights is not productive, and should be avoided. Insofar as (...) the ultimate goal of Martha’s Rule is the provision of a clinical service that protects patient safety, an approach that focuses on the obligations of the health system—rather than the individual rights of patients—will better serve this goal. We outline an alternative approach that situates rapid clinical review as part of a suite of services aimed at enhancing and protecting patient care. This approach would make greater progress towards addressing the difficult systemic issues that Martha’s Rule does not, while also better engaging with the constraints of clinical practice. (shrink)

In the Freedom Essay, Schelling provides four different accounts of the copula, two of which are largely implicit. In this paper, I focus on the first of these accounts, which I call the "mediated account." I argue that this explanation of the copula articulates a fundamental ontological structure in Schelling's philosophy. In the first half of the paper, I analyze the structural features of the account, drawing on Schelling's more extensive treatment in the Ages of the World. In the second (...) half of the paper, I argue that Schelling's fundamental distinction between that-which-exists and the ground of existence exhibits the same structure as the mediated account of the copula. This has implications for understanding the enigmatic relationship of these two principles to the Ungrund. I conclude by briefly suggesting other applications of this fundamental structure in Schelling's philosophy. (shrink)

In the study of American law, originalism is primarily a theory about the meaning of the Constitution-that its meaning can only change when its words change. Originalism also appears in biblical theology as a theory on the meaning of the Biblethat its meaning is that intended by the original authors. Originalism in Theology and Law: Comparing Perspectives on the Bible and the Constitution offers a study of originalism in both the Bible and the Constitution. While there are significant connections between (...) originalism as a theory of biblical interpretation and as Constitutional interpretation, there are also differences in the type of text as well as its purpose, function, origins, or authority, which may affect which nuanced version of originalism best fits a particular text, or the best method of interpreting it. (shrink)

Augustine’s sermons on the Psalms of Ascent, part of the Enarrationes in Psalmos, are a unique entry in the venerable tradition of those writings that aim to help us ascend to a higher reality. These sermons transform the ascent genre by giving, in the place of the Platonic account of ascent, a Christian ascent narrative with a Trinitarian structure. Not just the individual ascends, but the community that is the church, the body of Christ, also ascends. The ascent is up (...) to God, the Idipsum or the Selfsame, the ultimate reality, confessed by the church as God the Father, God the Son, and God the Holy Spirit. Through the grace of the Incarnation, God the Son enables us to ascend, making himself the way of ascent from the humility we must imitate at the beginning of the ascent all the way up to Heaven, where he retains his identity as Idipsum. Meanwhile, the Holy Spirit works in the ascending church to convert our hearts to the love of God and neighbor. I review the Platonic ascent tradition in Plato’s Republic and Plotinus’ Enneads; overview ascent in some of Augustine’s earlier writings; introduce the narrative setting of the sermons on the Psalms of Ascent; and analyze the Trinitarian structure of their ascent narrative. I close with some reflections on the difference between a preached Trinitarianism that encourages ascent and a more academic effort to understand God such as we find in Augustine’s de Trinitate. (shrink)

Smith outlines the distinctive features of ecological thought and examines two contentious areas of environmental ethics, the obligations for present generations and the relationship of humans to non-human animals.

In this essay, I give an analysis of the account of non-being in the Weltalter, focusing on the ways in which this account reflects Schelling’s new ontology of revelation. I begin by discussing the connection between non-being and the fundamental distinction between the principles in God. I then turn to the relationship of non-being to being in the Weltalter and show how a new meaning of being allows Schelling to distinguish non-being from nothing. The new meaning of being also makes (...) possible a distinction between essential non-being and de facto non-being; this distinction allows for the temporal sequence of revelation and the possibility of evil. I conclude by showing the implications of Schelling’s theory of non-being for his understanding of creation. (shrink)

Jerry Fodor is one of the most important philosophers of mind in recent decades. He has done much to set the agenda in this field and has had a significant influence on the development of cognitive science. Fodor's project is that of constructing a physicalist vindication of folk psychology and so paving the way for the development of a scientifically respectable intentional psychology. The centrepiece of his engagement in this project is a theory of the cognitive mind, namely, the computational (...) theory of mind, which postulates the existence of a language of thought. Fodor: Language, Mind and Philosophy is a comprehensive study of Fodor's writings. Individual chapters are devoted to each of the major issues raised by his work and contain extensive discussion of his relationships to key developments in cognitive science and to the views of such philosophical luminaries as Dennett, Davidson and Searle. (shrink)

The legal basis of informed consent in Texas may on first examination suggest an unqualified affirmation of persons as the source of authority over themselves. This view of individuals in the practice of informed consent tends to present persons outside of any social context in general and outside of their families in particular. The actual functioning of law and medical practice in Texas, however, is far more complex. This study begins with a brief overview of the roots of Texas law (...) and public policy regarding informed consent. This surface account is then contrasted with examples drawn from the actual functioning of Texas law: Texas legislation regarding out-of-hospital do-not-resuscitate (DNR) orders. As a default approach to medical decision-making when patients lose decisional capacity and have failed to appoint a formal proxy or establish their wishes, this law establishes a defeasible presumption in favor of what the law characterizes as “qualified relatives” who can function as decision-makers for those terminal family members who lose decisional capacity. The study shows how, in the face of a general affirmation of the autonomy of individuals as if they were morally and socially isolated agents, space is nevertheless made for families to choose on behalf of their own members. The result is a multi-tier public morality, one affirming individuals as morally authoritative and the other recognizing the decisional standing of families. (shrink)

Creation of for-profit markets in organs for transplantation ignites in many deep moral repugnance. Proposals to broker organs have been denounced by the US Congress and professional groups alike. Financial incentives are believed to undermine consent, coercing the poor into selling their organs, violating human dignity, and improperly commodifying the human body; such concerns are held to trump the possibility of increasing life-sustaining transplants. While such views summarize the apparent global consensus which marks worldwide prohibition of the sale of human (...) organs, I argue that closer examination reveals significant grounds for concluding that markets would be more successful in preventing exploitation, preserving human dignity, and protecting against improper commodification than governmental bureaucratic procedures for procuring and allocating organs. (shrink)

Perhaps nature is simply a challenge to be addressed, overcome, and set aside.This volume is a critical exploration of natural law theory.

In recent decades cognitive science has revolutionised our understanding of the workings of the human mind. Philosophy has made a major contribution to cognitive science and has itself been hugely influenced by its development. This dynamic book explores the philosophical significance of cognitive science and examines the central debates that have enlivened its history. In a wide-ranging and comprehensive account of the topic, philosopher M.J. Cain discusses the historical origins of cognitive science and its philosophical underpinnings; the nature and role (...) of representations in cognition; the architecture of the mind and the modularity thesis; the nature of concepts; knowledge of language and its acquisition; perception; and the relationship between the brain and cognition. Cain draws upon an extensive knowledge of empirical developments and their philosophical interpretation. He argues that although the field has generated some challenging new views in recent years, many of the core ideas that initiated its birth are still to be taken seriously. Clearly written and incisively argued, The Philosophy of Cognitive Science will appeal to any student or researcher interested in the workings of the mind. (shrink)

This paper critically explores key aspects of the gulf between traditional Christian bioethics and the secular moral reflections that dominate contemporary bioethics. For example, in contrast to traditional Christian morality, the established secular bioethics judges extramarital sex acts among consenting persons, whether of the same or different sexes, as at least morally permissible, affirms sexual freedom for children to develop their own sexual identity, and holds the easy availability of abortion and infanticide as central to the liberty interests of women. (...) Secular bioethics seeks to separate children from the authority of their parents, placing children themselves as in authority to make their own judgments about appropriate lifestyle choices, including sexual behaviors. As I argue, however, absent God, there exists no standpoint outside of our own cultural sociohistorically conditioned understanding from which to communicate any deeper perspective of reality or the bioethics that such a perspective would secure. Consequently, rather than discerning moral truth, secular bioethics merely affirms its own particular cultural sociohistorically conditioned ideological perspective. It is a social and political worldview bereft of definitive moral foundation, independent moral authority, or unambiguous content. (shrink)

Organ procurement policy from the recently deceased recasts families into gatekeepers of a scarce medical resource. To the frustration of organ procurement teams, families do not always authorize organ donation. As a result, efforts to increase the number of organs available for transplantation often seek to limit the authority of families to refuse organ retrieval. For example, in some locales if a deceased family member has satisfied the legal conditions for first-person prior assent, a much looser and easier standard to (...) satisfy than informed consent, organ retrieval may proceed despite the family’s objections. Some countries have replaced voluntary consent to organ donation with forms of organ conscription. Often referred to under the misnomer “presumed consent,” such policies legalize the harvesting of organs at death, unless individuals exercise official options to opt out. As this article explores, however, there are good grounds for affirming the authority of the family to consent to or to deny organ donation on behalf of recently deceased family members, as well as to reject first-person assent and “presumed consent” policies of organ procurement. Insofar as individuals have failed clearly and competently to provide informed consent to organ donation, moral authorization for the use of the person and his body ought to be grounded on the foundational authority of the family, rather than the state’s supposed interests in obtaining organs for transplantation. (shrink)

This paper challenges the foundational claim that the human family is no more than a social construction. It advances the position that the family is a central category of experience, being, and knowledge. Throughout, the analysis argues for the centrality of the family for human flourishing and, consequently, for the importance of sustaining family-oriented practices within social policy, such as more family-oriented approaches to consent to medical treatment. Where individually oriented approaches to medical decision-making accent an ethos of isolated personal (...) autonomy family-oriented approaches acknowledge the central social and moral reality of the family. I argue that the family ought to be appreciated as more than a mere network of personal relations and individual undertakings; the family possesses a being that is social and moral such that it realizes a particular structure of human good and sustains the necessary conditions for core areas of human flourishing. Moreover, since the family exists as a nexus of face-to-face relationships, the consent of persons, including adults, to be members of a particular family, subject to its own respective account of family sovereignty, is significantly more amply demonstrated than the consent of citizens to be under the authority of a particular state. As a result, in the face of a general Western bioethical affirmation of the autonomy of individuals, as if adults and children were morally and socially isolated agents, this paper argues that social space must nevertheless be made for families to choose on behalf of their own members. (shrink)

While many have suggested that to withdraw medical interventions is ethically equivalent to withholding them, the moral complexity of actually withdrawing life supportive interventions from a patient cannot be ignored. Utilizing interplay between expository and narrative styles, and drawing upon our experiences with patients, families, nurses, and physicians when life supports have been withdrawn, we explore the changeable character of boundaries in end-of-life situations. We consider ways in which boundaries imply differences – for example, between cognition and performance – and (...) how the encounter with boundaries can generate altered meanings important for understanding decisions and actions in these contexts. We conclude that the reliance on mere roles to support the moral weight of withdrawing medical interventions is inadequate. Roles that lead us to such moments are exceeded by the responsibility encountered in such moments. And here, we suggest, is the momentous character of withdrawal: it presents the grave astonishment, the trembling awe, in the not-being-there of the other in death. (shrink)

This study explores the ways in which adolescents, even so-called “mature minors”, lack adequate development of the intellectual, affective, and emotional capacities necessary morally to consent to medical research on their own behalf. The psychological and neurophysiological data regarding brain maturation supports the conclusion that adolescents are qualitatively different types of agents than mature adults. They lack full adult maturity and personal agency. As a result, in addition to the usual requirements for IRB approval, one or both parents, or a (...) legal guardian, should provide informed consent for minor children to participate in medical research. (shrink)

This essay addresses two growing edges of the just war tradition. First, theorists have been accused of focusing narrowly on justifying war and governing its conduct, neglecting wider considerations that encompass justice during the years prior to and after war. Second, calling a war "just" allegedly makes it seem "good" so that it is easier to fight a war and to bend or set aside the rules. Based on "imperfect justice," we argue for a "justified" war theory, taking all criteria (...) and categories seriously, including jus ante bellum and jus post bellum. (shrink)

THIS IS A PRE-PUBLICATION VERSION OF THE PAPER. The New Testament speaks of our having faith rather than sight. This distinction is not made to distinguish faith from knowledge. Rather, it is to distinguish one kind of knowledge from another. We may know by trust in reliable authority; this knowledge is necessarily secondhand, but it is knowledge all the same. This, I argue, is the New Testament idea of faith. Another way of knowing is firsthand. Sight in the New Testament, (...) I argue, is a metonym for firsthand knowledge. In this article I consider the meaning of faith and sight in the relevant New Testament passages, with an extended exegesis of 2 Cor. 5:7 and Heb. 11:1. (shrink)

Generalizedn-gons are certain geometric structures (incidence geometries) that generalize the concept of projective planes (the nontrivial generalized 3-gons are exactly the projective planes).In a simplified world, every generalizedn-gon of finite Morley rank would be an algebraic one, i.e., one of the three families described in [9] for example. To our horror, John Baldwin [2], using methods discovered by Hrushovski [7], constructed ℵ1-categorical projective planes which are not algebraic. The projective planes that Baldwin constructed fail to be algebraic in a dramatic (...) way.Indeed, every algebraic projective plane over an algebraically closed field is Desarguesian [12]. In particular, an algebraically closed field (isomorphic to the base field) can be interpreted in every one of them. However, in the projective planes that Baldwin constructed, one cannot even interpret an infinite group.In this article we show that the same phenomenon occurs for the generalizedn-gons ifn≥ 3 is an odd integer. For each suchnwe constructmany nonisomorphic generalizedn-gons of finite Morley rank that do not interpret an infinite group. As one may expect, our method is inspired by Hrushovski and Baldwin, and we follow Baldwin's line of approach. Quite often our proofs are a verification of the fact that the proofs of Baldwin [2] forn= 3 carry over to an arbitrary positive odd integern(which is sometimes far from being obvious). As in [2], we begin by defining a certain collection of finite graphsK* and a binary relation ≤ on these graphs. We show that (K*, ≤) satisfies the amalgamation property. (shrink)

Stereological techniques allow biologists to create quantitative, three-dimensional descriptions of biological structures from two- dimensional images of tissue viewed under the microscope. For example, they can accurately estimate the size of a particular organelle, the total length of a mass of capillaries, or the number of neurons or synapses in a particular region of the brain. This book provides a practical guide to designing and critically evaluating stereological studies of the nervous system and other tissues. It explains the basic concepts (...) behind design-based stereology and how to get started. Also included are detailed descriptions of how to prepare tissue appropriately, perform pilot studies and decide on the appropriate sampling strategy, and account for phenomena such as tissue shrinkage. Numerous examples of applications of stereological methods that are applicable to studies of the central system and a wide variety of other tissues are explained. The book is therefore essential reading for neurobiologists and cell biologists interested in generating accurate representations of cell and tissue architecture. (shrink)

The day-to-day work of clinical ethics consultants and healthcare ethics committees can easily become overly routine. Too much routine, however, comes with a risk that morally important practices will be reduced to mere bureaucratic formalities, while practitioners become desensitized to ethically significant distinctions between cases. Clinical ethics consultation and organizational ethics must be set within the broader social and cultural context of the healthcare environment. This practice requires looking beyond mere legal compliance and the routinely false assumption that there are (...) unambiguous ethical norms that easily govern clinical ethics and hospital policy formation. Together the essays in this issue of HEC Forum challenge readers to rethink taken-for-granted assumptions regarding patient care, physician obligation, clinical ethics consultation, and organizational ethics. (shrink)

Brain transplants have long been no more than the subject of science fiction and engaging thought experiments. That is no longer true. Neuroscientists have announced their intention to transplant the head of a volunteer onto a donated body. Response has been decidedly mixed. How should we think about the moral permissibility of head transplants? Is it a life-saving/life-enhancing opportunity that appropriately expands the boundaries of medical practice? Or, is it a bioethical morass that ought not to be attempted? For the (...) purposes of this paper, I set aside questions regarding the surgical operation’s technological plausibility so as to focus on very basic questions regarding personal identity and the morality of head transplantation. The analysis begins with an exploration of the embodiment of persons. It considers whether persons can be conceptually distinguished from all parts of their body, even if they cannot be physically separated from some parts without loss of personhood. It argues that in most cases replacing body parts with reasonably similar parts will not destroy the conditions for sustaining personhood. However, as I explore, the phenomenology of personhood is such that some physical changes may prove to be too significant to maintain personal identity successfully over time. Given such complexity and the significance of the costs involved, the moral permissibility of head transplantation likely depends on recognizing that persons may give permission to collaborate in common activities, including projects with which others deeply disagree, provided that they only utilize the services and resources of free and consenting others. (shrink)

In this paper I will give some provisional answers to the questions how one can be a Christian philosopher rather than just a philosopher who happens to be a Christian, how one can be a Reformation philosopher rather than just a Christian philosopher whohappens to be a Reformation Christian, and how one can be a Baptist philosopher rather than just a Reformation philosopher who happens to be a Baptist. A good way to be a philosopher is to, like Socrates, seek (...) wisdom concerning spiritual good. A good wayto be a specifically Christian philosopher is to, like Augustine, seek that wisdom in Jesus Christ. A good way to be a specifically Reformation philosopher is to recognize and reflect on a distinction between two inseparable spiritual goods on which we are seeking wisdom: justification and sanctification. A good way to be a specifically Baptist philosopher, taking some inspiration from the likes of Locke and Kierkegaard, is to also recognize and reflect on some signs of these spiritual goods which Baptists emphasize: resistance to the idea of a state church and believer’s baptism. -------------------------- Received: 20/03/2023. Reviewed: 18/04/2023. Accepted: 24/04/2023. (shrink)