Demands by Patients or their Families for treatment thought to be inappropriate by health care providers constitute an important set of moral problems in clinical practice. A variety of approaches to such cases have been described in the literature, including medical futility, standard of care and negotiation. Medical futility fails because it confounds morally distinct cases: demand for an ineffective treatment and demand for an effective treatment that supports a controversial end (e.g., permanent unconsciousness). Medical futility is not necessary in (...) the first case and is harmful in the second. Ineffective treatment falls outside the standard of care, and thus health care workers have no obligation to provide it. Demands for treatment that supports controversial ends are difficult cases best addressed through open communication, negotiation and the use of conflict-resolution techniques. Institutions should ensure that fair and unambiguous procedures for dealing with such cases are laid out in policy statements. (shrink)

OBJECTIVE: To describe the issues faced, and how they were addressed, by the University of Toronto Critical Care Medicine Program/Joint Centre for Bioethics Task Force on Appropriate Use of Life-Sustaining Treatment. The clinical problem addressed by the Task Force was dealing with requests by patients or substitute decision makers for life-sustaining treatment that their healthcare providers believe is inappropriate. DESIGN: Case study. SETTING: The University of Toronto Joint Centre for Bioethics/Critical Care Medicine Program Task Force on Appropriate Use of Life-Sustaining (...) Treatment. PARTICIPANTS: The 24-member Task Force included physician and nursing leaders from five critical care units, bioethicists, a legal scholar, a health administration expert, a social worker, and a hospital public relations professional. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Our specific lessons learned include a) a policy focus on process; b) use of a negotiation and mediation model, rather than a hospital ethics committee model, for this process; and c) the policy development process is itself a negotiation, so we recommend equal involvement of interested groups including patients, families, and the public. CONCLUSIONS: This article describes the key issues faced by the Task Force while developing its policy. It will provide a useful starting point for other groups developing policy on appropriate use of life-sustaining treatment. (shrink)

Interaction between Peter Singer and Christian ethics, to the extent that it has happened at all, has been unproductive and often antagonistic. Singer sees himself as leading a 'Copernican Revolution' against a sanctity of life ethic, while many Christians associate his work with a 'culture of death'. Charles Camosy shows that this polarized understanding of the two positions is a mistake. While their conclusions about abortion and euthanasia may differ, there is surprising overlap in Christian and Singerite (...) arguments, and disagreements are interesting and fruitful. Furthermore, it turns out that Christians and Singerites can even make common cause, for instance in matters such as global poverty and the dignity of non-human animals. Peter Singer and Christian ethics are far closer than almost anyone has imagined, and this book is valuable to those who are interested in fresh thinking about the relationship between religious and secular ethics. (shrink)

Background Intensivists must provide enough analgesia and sedation to ensure dying patients receive good palliative care. However, if it is perceived that too much is given, they risk prosecution for committing euthanasia. The goal of this study is to develop consensus guidelines on analgesia and sedation in dying intensive care unit patients that help distinguish palliative care from euthanasia. Methods Using the Delphi technique, panelists rated levels of agreement with statements describing how analgesics and sedatives should be given to dying (...) ICU patients and how palliative care should be distinguished from euthanasia. Participants were drawn from 3 panels: 1) Canadian Academic Adult Intensive Care Fellowship program directors and Intensive Care division chiefs (N = 9); 2) Deputy chief provincial coroners (N = 5); 3) Validation panel of Intensivists attending the Canadian Critical Care Trials Group meeting (N = 12). Results After three Delphi rounds, consensus was achieved on 16 statements encompassing the role of palliative care in the intensive care unit, the management of pain and suffering, current areas of controversy, and ways of improving palliative care in the ICU. Conclusion Consensus guidelines were developed to guide the administration of analgesics and sedatives to dying ICU patients and to help distinguish palliative care from euthanasia. (shrink)

In its comprehensive overview of Alain Locke's pragmatist philosophy this book captures the radical implications of Locke's approach within pragmatism, the critical temper embedded in Locke's works, the central role of power and empowerment of the oppressed and the concept of broad democracy Locke employed.

The debate over surgical abortion is certainly one of the most divisive in ethical discourse and for many it seems interminable. However, this paper argues that a primary reason for this is confusion with regard to what issues are actually under dispute. When looking at an entrenched and articulate figure on one side of the debate, Peter Singer, and comparing his views with those of his opponents, one finds that the disputed issue is actually quite a narrow one: the (...) moral status of potential persons. Finding this common ground clears the conceptual space for a fruitful argument: the thesis of which is that most, including Singer, who argue that potential persons do not have full personal moral status fail to make the necessary distinction between natural potential and practical potential. (shrink)

This chronological collection of Moore's most compelling and dramatic images, taken as the movement progressed through Alabama, Mississippi, Tennessee, and Georgia, highlights activity from 1958 to 1965. Included are the iconic scenes of black protestors huddled in a doorway to escape the crippling blasts of fire hoses in Birmingham; a white bigot swinging a baseball bat seconds before cracking it on the head of a black woman during the desegregation of the Capitol Cafeteria in Montgomery; a young and stunned Dr. (...) Martin Luther King Jr. pinned to the counter of a police precinct, his arm twisted behind his back; the devastating aftermath of "Bloody Sunday" on the Edmund Pettus Bridge in Selma; and Bull Connor's police dogs tearing mercilessly at the legs of a protestor in downtown Birmingham. Celebrity protestors--comedian Dick Gregory, poet Galway Kinnell, singers Joan Baez, Mary Travers, Pete Seeger, and Harry Bellafonte, actor Pernell Roberts, and writer James Baldwin--are featured alongside the many nameless but committed participants and the recognized major leaders of the movement. (shrink)

Singer points out that Santayana was a professional philosopher who addressed immediate problems of existence, a materialist in philosophy who believed in both a life of spirit and a life of reason, a product of American pragmatism who nevertheless rebelled against it, a Spaniard who wrote only in English, an American author who spent the last forty years of his life in different European countries.

Presidential addresses offer an opportunity to reflect on the history of our subject and where the history of science stands in our own day. Such reflections are particularly appropriate with the fiftieth anniversary of the founding of the British Society for the History of Science which is marked in 1997. Some may consider that looking back over our past is either an unacceptable luxury or an occasion for the kind of celebration that can all too easily degenerate into hagiography and (...) an excuse to rake over the past in a thoroughly uncritical manner. This address – and I trust the events of 1997 – will try to avoid such excesses and instead contribute to the historiography of our subject. (shrink)

In the eighteenth century the category of the aesthetic sought to bridge the gap between the prevalent dualities of Cartesian thought: art and science, history and science, prejudice and truth. This special issue of _boundary 2_ addresses current debates about the status of art in the context of global modernity. The range of arguments represented here cover a broad historical scope—from Cartesianism to present-day global modernity—of cultural discourse on the aesthetic to bring a focus to contemporary discussions of the corollary (...) concepts of beauty, virtue, taste, and truth. These essays present a rich and provocative account of the place of the aesthetic in late-twentieth-century culture. Included in this volume are considerations of the relation between theories of art and the avant-garde; art’s relation to cognition; the aesthetic as history; the aesthetic as a unique access to modernity; and its impact on problems of identity formation, ideology, and resistances to the institutional powers inherent in dominant social formations. _Contributors. _Charles Altieri, Peter Burger, David Carroll, Anthony J. Cascardi, Howard Caygill, Allen Dunn, Eric Gans, Agnes Heller, Ronald A. T. Judy, Marie-Rose Logan, Daniel T. O’Hara, Donald E. Pease, Alan Singer. (shrink)

The contributors examine the distinctive aspects of American philosophy, cultural and historical experience.

Distinguished by its readability and scope, Moral Reasons analyzes issues in moral and political philosophy with careful attention to the role of argumentation in the study of ethics. After a comprehensive overview of moral reasoning--including dozens of examples and exercises--Charles K. Fink guides readers through the theories and arguments of philosophers from Plato to Peter Singer, covering such diverse topics as moral skepticism, abortion, euthanasia, political authority, punishment and war. Ideal as a main text for courses on applied (...) ethics or as a supplemental text for courses on social and political philosophy, this book offers one of the most diverse investigations of moral philosophy there is to date. (shrink)

Six keynote papers presented at TSC 2009 — by Susan Greenfield, Wolf Singer, Stuart Hameroff, Jonathan Schooler, Hakwan Lau, and David Chalmers—are reviewed below in order to investigate to what extent social analysis can be usefully applied in different areas of consciousness studies. The six papers did not ostensibly address social aspects of consciousness; nevertheless I hope to show that it is often beneficial to consider the possible social implications in any consciousness- related work.

This book is a volume in the Penn Press Anniversary Collection. To mark its 125th anniversary in 2015, the University of Pennsylvania Press rereleased more than 1,100 titles from Penn Press's distinguished backlist from 1899-1999 that had fallen out of print. Spanning an entire century, the Anniversary Collection offers peer-reviewed scholarship in a wide range of subject areas.

In Practical Ethics Peter Singer argues for an ‘obligation to assist’: First premise: If we can prevent something bad without sacrificing anything of comparable significance, we ought to do it. Second premise: Absolute poverty is bad. Third premise: There is some absolute poverty we can prevent without sacrificing anything of comparable moral significance. Conclusion: We ought to prevent some absolute poverty. This paper is dedicated to a criticism of four readings of the first premise and an undesirable link the (...) first premise has with the third. The paper ends by offering a alternative formulation of an ‘obligation to assist,’ which suffers from none of these problems. (shrink)

... LIMITS OF MEANING Arthur O. Lovejoy Professor Emeritus, Department of Philosophy, The Johns Hopkins University Nearly thirty years ago Professor Singer ...

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Peter Singer and Christian Ethics: Beyond Polarization by Charles E. CamosyWerner WolbertPeter Singer and Christian Ethics: Beyond Polarization CHARLES E. CAMOSY Cambridge: Cambridge University Press, 2012. 278 pp. $29.99Peter Singer’s “Copernican revolution” against a sanctity of life ethic may be regarded, from a Roman Catholic viewpoint, as an expression of the “culture of death” denounced by John Paul II. One must keep in (...) mind, however, that “we know that historically there have been times where those participating in discussions about ethics disagree deeply about theory, but nevertheless come to important and even broad agreement about applied or practical ethics” (179). The aim of Camosy’s book is to sketch the various areas of agreement and disagreement between Peter Singer and Catholic moral theology as well as the possibilities of working together.There are issues even about the subject of abortion on which Singer and the Church agree: that moral relativism is wrong; that it is seriously wrong to kill a person; that the right to privacy (see Roe vs. Wade) does not apply to acts harming others; and that the right to abortion is not a constitutional matter (chapter 1). Both positions see a connection between abortion and infanticide, but both draw different conclusions. The disagreements between them are about who is to count as a person, which Camosy comments on in the rest of chapter 1 (27–37). In the area of euthanasia, the Church and Singer share some skepticism about brain death (chapter 2). Camosy discusses the church’s position on one’s moral status at the end of life and the Roman Catholic understandings of ordinary and extraordinary means, acts, and omissions. Commenting on public policy in that field, Camosy gives some useful and convincing illustrations of the slippery slope effect in different countries that have legalized active euthanasia or assisted suicide (68–81).With regard to problems of killing, however, Helga Kuhse’s The Sanctity of Life Doctrine in Medicine (Oxford University Press, 1987) should perhaps have been considered. On the subject of acting and refraining, I would recommend Dieter Birnbacher’s Tun und unterlassen (Reclam 1995).Commenting on Singer’s championing of the moral status of nonhuman animals, Camosy points to elements in the Christian tradition that may support Singer’s issue of animal liberation (chapter 3). I wonder why the discussion concentrates on domestic animals and the problems of eating meat or [End Page 225] vegetarianism but omits problems of environmental ethics (e.g., ecological balance). Would the aim of avoiding animal harm include saving animals from predators? And if some animals are to be regarded as persons, we may get in trouble with our basic conviction of the equality (of the dignity) of human beings—as the debate on the margins of human life shows.Duties to the poor are not in dispute except for “partial preferences” (166) for members of our family, kinship, or country (chapter 4). Speaking of “partiality” in this context is, however, a bit misleading. Since no one can care for all people, preferences of an ordo caritatis (order of love) are a necessary part of a system of coordination from which—ideally—all humans can benefit. (Recall Augustine in De doctrina Christiana, 1.28–29: “The interests of society, however, and its common bonds will be best conserved if kindness be shown to each individual in proportion to the closeness of his relationship.”) Chapter 5, which compares Singer’s ethical theory with Catholic moral theology, would need more discussion (e.g., on double effect, object, and act), which I cannot cover within the limits of this review. Overall, Camosy’s book makes a valuable contribution to the dialogue between Christian and secular ethics.Werner WolbertUniversity of SalzburgCopyright © 2014 Society of Christian Ethics... (shrink)