In recent years there has been an increasing critique of the philosophically based reasoning in bioethics which is known as principlism. This article seeks to make a postmodern contribution to this emerging debate by using notions of power and discourse to highlight the limits and superficiality of this , rationalistic mode of reflection. The focus of the discussion will be on the principle of autonomy. Recent doctoral research on a hospice organization (Karuna Hospice Service) will be used to contextualize the (...) debate to end-of life ethical dilemmas. The conclusion will be reached that the discursive richness of this organization's notion of autonomy or choice, which incorporates a holistic respect for the individual and the active creation of alternatives, can provide important insights to our understanding of autonomy in bioethics. The concern is raised that if autonomy is reified as a principle outside of the context of discourse, it may only complement the hegemonic power of biomedicine. (shrink)

It is now common in health care for a diverse range of professions and disciplines to work together in regular and close contact. Thus, there are now calls in the literature for research that documents insights on the ethical dimension of multidisciplinary relationships. Recent Australian research has responded to this call by examining how a multidisciplinary team of health professionals define and operationalize the notion of ethics in an acute ward hospital setting. This article provides findings from the research study (...) that indicate that, although there is a shared conceptualization of ethics as "patient-centered care", there can be times of conflict and tension in determining what is best for the patient. The discussion begins to build an understanding of how a multidisciplinary mix of health professionals responds to ethical conflict and tension. The authors' hope and expectation is that, by keeping the research focus on what health professionals in a multidisciplinary team (MDT) actually do, rather than exclusively on how they philosophically think about ethical dilemmas, the insights can be translated into practical strategies that can be utilized to strengthen the process of ethical decision making within the health care system. (shrink)

This paper explores the bioethical issues associated with the diagnosis and treatment of vulvar cancer for Indigenous women in East Arnhem Land, Northern Territory, Australia. Based on a qualitative study of a vulvar cancer cluster of Indigenous women, the article highlights four main topics of bioethical concern drawn from the findings: informed consent, removal of body parts, pain management, and issues at the interface of Indigenous and Western health care. The article seeks to make a contribution towards Indigenous health and (...) bioethics and bring to light areas of further research. (shrink)

This article presents the findings of qualitative research which explored, from the mothers’ perspective, the process of decision-making about mode of delivery for a subsequent birth after a previous Caesarean Section. In contradiction to the clinical literature, the majority of mothers in this study were strongly of the opinion that a vaginal birth after caesarean (VBAC) posed a higher risk than an elective caesarean (EC). From the mothers’ perspective, risk discussions were primarily valuable for gaining support for their pre-determined choice, (...) rather than obtaining information. The findings posit ethical concerns with regards to informed consent and professional obstetric practice at a time when there is a documented and worrying trend towards an increase in births by caesarean section (CS). (shrink)

Although mainstream research institutions and health care organisations are now starting to acknowledge the important contribution of qualitative research, there are still many obstacles to obtaining funding. Consequently, at all points along the continuum of obtaining funds, enrolling participants and conducting the research, qualitative researchers will benefit from being able to refer to, or reference, a body of empirical knowledge that addresses ethical issues raised by those who have responsibility for decision-making about the implementation of research proposals. This article has (...) been written with this strategy in mind. One such ethical issue is a concern about the impact on participants of being involved in qualitative studies when they are in a vulnerable state from a distressing life experience. This article provides empirical data that describes the benefits associated with qualitative research process for parents enrolled in a longitudinal study looking at the issues associated with the diagnosis and treatment for paediatric haematological malignancies. The empirical findings affirm the significant beneficial contribution that qualitative research can make to the lives of those coping with an extremely challenging health care situation. (shrink)

The insights provided by a multi-disciplinary mix of health professionals from an acute medical ward of a regional Australian hospital indicate the value in extending the role of Hospital Ethics Committees to incorporating both ethics consultation and ethics education. It is the hope and expectation that the findings will assist other HECs in a similar stage of development.

The purpose of this article is to share with the reader the specific findings on the role of nurse as consumer advocate from a study on ethical decision-making in an emergency department (ED). Qualitative interviews were conducted with 11 health professionals (doctors and nurses) working in the ED of a hospital. The interviews were audio-recorded, transcribed verbatim and thematically analysed.In ED, where the decision-making is described as medico-centric, advocacy ipso facto necessitates a challenge to doctor decision-making. The findings indicate that (...) ED nurses experience with advocacy varied depending on the democratic qualities and communication skills of the particular doctor who had care of the consumer. It is noted that seeing the need for advocacy does not necessarily translate into effective action, as management support is essential for productive advocacy. A phenomenon of the desire not to rock the boat was reported. The findings indicate that the support of other nurses is essential for advocacy and affirm the importance of focusing on the ethical nature of the organisation as opposed to an exclusive focus on the individual. (shrink)

In recent years the literature on bioethics has begun to pose the sociological challenge of how to explore organisational processes that facilitate a systemic response to ethical concerns. The present discussion seeks to make a contribution to this important new direction in ethical research by presenting findings from an Australian pilot study. The research was initiated by the Clinical Ethics Committee of Redland Hospital at Bayside Health Service District in Queensland, Australia, and explores health professionals’ understanding of the nature of (...) ethics and their experience with ethical decision-making within an acute medical ward. This study focuses on the actual experience, understanding and attitudes of clinical professionals in a general medical ward. In particular, the discussion explores the specific findings from the study concerned with how a multi-disciplinary team of health professionals define and operationalise the notion of ethics in an acute ward hospital setting. The key issue reported is that health professionals are not only able to clearly articulate notions of ethics, but that the notions expressed by a multi-disciplinary diversity of participants share a common definitional concept of ethics as patient-centred care. The central finding is that all professional groups indicated that there is a guiding principle to address their ethical sense of the ‘good’ or the ‘ought’ and that is to act in a way that furthered the interests of patients and their families. The findings affirm the importance of a sociological perspective as a productive new direction in bioethical research. (shrink)

Despite the extensive consideration the notion of informed consent has heralded in recent decades, the unique considerations pertaining to the giving of informed consent by and on behalf of Indigenous Australians have not been comprehensively explored; to the contrary, these issues have been scarcely considered in the literature to date. This deficit is concerning, given that a fundamental premise of the doctrine of informed consent is that of individual autonomy, which, while privileged as a core value of non-Indigenous Australian culture, (...) is displaced in Indigenous cultures by the honouring of the family unit and community group, rather than the individual, as being at the core of important decision-making processes relating to the person. To address the hiatus in the bioethical literature on issues relating to informed consent for Aboriginal peoples, the following article provides findings from a two-year research project, funded by Australia’s National Health and Medical Research Council (NHMRC), conducted in the Northern Territory. The findings, situated in the context of the literature on cultural safety, highlight the difference between the Aboriginal and biomedical perspectives on informed consent. (shrink)

Imagine I hold up a Granny Smith apple for all to see. You would thereby gain justified beliefs that it was green, that it was apple, and that it is a Granny Smith apple. Under classical foundationalism, such simple visual beliefs are mediately justified on the basis of reasons concerning your experience. Under dogmatism, some or all of these beliefs are justified immediately by your experience and not by reasons you possess. This paper argues for what I call the looks (...) view of the justification of simple visual beliefs. According to the looks view, such beliefs are mediately justified on the basis of reasons concerning how the relevant things look. Unlike under classical foundationalism, under the looks view as I develop it, these reasons are public. They are public with respect to both their content and possession: with respect to content, they are not about ourselves and our experiences, and with respect to their possession, many people can have the very same looks-related reasons. (shrink)

Introduction -- Tending the dark fire: the Boehmian notion of drive -- The night-side of nature: the early Schellingian unconscious -- The speculative psychology of dissociation: the later Schellingian unconscious -- Schellingian libido theory.

In the academic year 1920-1921 at the University of Freiburg, Martin Heidegger gave a series of extraordinary lectures on the phenomenological significance of the religious thought of St. Paul and St. Augustine. The publication of these lectures in 1995 settled a long disputed question, the decisive role played by Christian theology in the development of Heidegger’s philosophy. The lectures present a special challenge to readers of Heidegger and theology alike. Experimenting with language and drawing upon a wide range of now (...) obscure authors, Heidegger is finding his way to Being and Time through the labyrinth of his Catholic past and his increasing fascination with Protestant theology. A Companion to Heidegger's Phenomenology of Religious Life is written by an international team of Heidegger specialists. (shrink)

A brief review and classification of technology in general begins the paper, followed by an application of the classification to two specific marathon case studies: the 2018 Boston marathon and the 2017 Nike Breaking2 Project marathon. Then concepts from an array of sport philosophers are discussed to suggest an explanation for why each of the case studies strikes us as problematic. The conclusion provides a reasonable explanation for our misgivings, as well as an indication of how we might evaluate sporting (...) endeavors in the face of increasing technological innovation. (shrink)

This chapter contains sections titled: The Death Zone Summiteers Mountaineers Conclusion Notes.

In this chapter, we follow Edward Craig?s advice: ask what the concept of knowledge does for us and use our findings as clues about its application conditions. What a concept does for us is a matter of what we can do with it, and what we do with concepts is deploy them in thought and language. So, we will examine the purposes we have in attributing knowledge. This chapter examines two such purposes, agent evaluation and informant-suggestion, and brings the results (...) to bear on an important debate about the application conditions of the concept of knowledge?the debate between contextualists and their rivals. (shrink)

We regularly appeal to claims of the form it seems that p in defense of a claim p. When we do so, we typically take it seems that p to be a reason for thinking that p but also a reason that “gets at” a relevant body of facts and its support for p. Other things being equal, we should want to vindicate our ordinary beliefs on this matter. We should want to vindicate the claim that facts about things seeming (...) certain ways can be reasons to think that things are that way while at the same time being somehow derivative reasons, that is, reasons only because they “get at” support from a certain body of facts. However, on the dominant view of how things seem—subjectivism—it is hard to see how to secure this result. Subjectivism takes how things seem to be a matter of how things do or would seem to some relevant subject. What we need is a defensible, nonsubjectivist account of how things seem. I propose and defend an account according to which, roughly, it seems that p iff the body of facts in the relevant perspective supports that p. (shrink)

During the first few years of the twenty-first century, a number of high-profile populist books offering an aggressively atheist critique of religion appeared. This “clustering” of prominent works of atheist apologetics may be attributed to the fact that developments in biology, especially evolutionary biology, have profound negative implications for belief in God. Richard Dawkins' The God Delusion and Daniel Dennett's Breaking the Spell, both published in 2006, argue that the Darwinian theory of evolution erodes many traditional metaphysical notions—such as belief (...) in God—through its “universal acid.” Several saw Darwinism as a potential challenge to at least some aspects of the traditional Christian view of creation, but most early evolutionists, including Charles Darwin himself, rejected the notion that they were promulgating or promoting atheism. Drawing on the recent works of Dennett and Dawkins, this chapter explores how Darwinism has been transposed in recent atheist apologetics from a provisional scientific theory to an antitheistic ideology. In particular, it considers the ideological use of the biological sciences, especially evolutionary biology, in recent atheist apologetics. (shrink)

Alister McGrath has written to great acclaim on both Richard Dawkins and C. S. Lewis. Here he brings these two intriguing and well-known writers into a conversation. They could hardly have more different perspectives! Engaging with their views is a brilliant way of sharpening up our own thinking on the meaning of life.

In Born to Wonder, Alister McGrath, a prolific Oxford scholar, scientist, and theologian, explores the deepest mystery at the heart of life itself. Life is a gift. We never asked to be born. Yet here we are, living in this strange world of space and time, trying to work out what it's all about before the darkness closes in and extinguishes us. We are adrift on a misty, grey sea of ignorance, seeking a sun-kissed island of certainty, on which (...) we might hope to find clear answers to our deepest and most poignant questions. What is the point of life? Why are we here? And what is it about us that makes us want to ask these questions? As far as we know, we're the only species on earth that asks these questions, and dares to hope that we might find an answer. It seems that we are born to wonder, not merely to exist. From time to time, all of us find ourselves overwhelmed by a sense of awe or mystery, often when confronted with the beauty of nature, whether it is a mountain stream or the vast expanse of ocean waters. That is when we see a flicker of a grander vision of reality, perhaps lying beyond the horizons of our experience. It is as if, for only a moment, a veil is removed, and we catch a half-glimpsed sight of a promised land, waiting to be mapped and explored. This sense of wonder fuels much of humanity's creativity and its search for understanding. (shrink)

The problem of the relation between mind and brain has been among the most persistent in modern Western thought, one that even recent advances in neuroscience haven't been able to put to rest. Historian Larry McGrath's Making Spirit Matter is about how a particularly productive and influential generation of late nineteenth- and early twentieth-century French thinkers attempted to answer this puzzle by showing the mutual dependence of spirit and matter. The veritable revolution taking place across disciplines, from philosophy to (...) psychology, located our spiritual powers in the brain and offered a radical reformulation of the meaning of science, spirit, and the self. Pulling out connections between thinkers such as Bergson, Blondel, and Fouille̹e, among others, McGrath plots the intellectual movements that brought back to life themes of agency, time, and experience by putting into action the very sciences that seemed to undermine metaphysics and theology. In so doing, Making Spirit Matter lays bare the long legacy of this moment in the history of ideas and how it might renew our understanding of the relationship between mind and brain. (shrink)

In this book, the second in the Heart of Christian Faith series, Alister E. McGrath provides an exploration of how we can best understand God using analogies, illustrations, and stories. This short, accessible guide also provides a pastoral and spiritual consideration of the difference that our belief in God makes to the way in which we think about ourselves and our world. With future volumes to examine other core Christian principles, McGrath’s new series will define “mere Chrisitianity” to (...) a new generation for many years to come. (shrink)

Because health care professions exist to provide a good for society, ethical questions are inherently part of them. Such professions and their members can be assessed based on how effective they are in developing knowledge and enacting practices that further the health and well‐being of individuals and society. The complexity of contemporary health care environments makes it important to prepare clinicians who can anticipate, recognize, and address problems that arise in practice or that prevent a profession from fulfilling its service (...) goals and obligations. Different health care professions have evolved distinct perspectives about appropriate goals for, and the purposes of, their clinicians, even when the goal of improving health and well‐being for society is shared across professions. While medicine and nursing goals are shared in principle, they differ in the particulars. Given the centrality to nursing of ethical questions, the profession has a collective responsibility to help clinicians at all levels of practice become ethically savvy and to reinforce their moral agency as needed. Both knowledge of nursing ethics and knowledge of the interdisciplinary field of bioethics are critical to nursing work. (shrink)

The ‘death’ of German Idealism has been decried innumerable times since its revolutionary inception, whether it be by the 19th-century critique of Western metaphysics, phenomenology, contemporary French philosophy, or analytic philosophy. Yet in the face of two hundred years of sustained, extremely rigorous attempts to leave behind its legacy, German Idealism has resisted its philosophical death sentence. For this exact reason it is timely ask: What remains of German Idealism? In what ways does its fundamental concepts and texts still speak (...) to us? Drawing together new and established voices from scholars in Kant, Fichte, Hegel, and Schelling, this volume offers a fresh look on this time-honoured tradition. It uses myriad of recently developed conceptual tools to present new and challenging theories of its now canonical figures. (shrink)

Advances in life-sustaining medical technology as applied to neonatal cases frequently present ethical concerns with a strong emotional component. Neonates delivered in the gestation period of approximately 23held hostagemoral distress” regarding aggressive courses of treatment for some patients. Some of this distress results from a feeling of powerlessness regarding treatment decisions, coupled with a high intensity of hands-on contact with the patients and family. Lack of authority coupled with high responsibility may itself be a recipe for a different kind of (...) futility. (shrink)

Suppose that one is at least a minimal realist about a given domain, in that one thinks that that domain contains truths that are not in any interesting sense of our own making. Given such an understanding, what can be said for and against the method of reflective equilibrium as a procedure for investigating the domain? One fact that lends this question some interest is that many philosophers do combine commitments to minimal realism and a reflective equilibrium methodology. Here, for (...) example, is David Lewis on philosophy: Our “intuitions” are simply opinions: our philosophical theories are the same. Some are commonsensical, some are sophisticated; some are particular; some general; some are more firmly held, some less. But they are all opinions, and a reasonable goal for a philosopher is to bring them into equilibrium. Our common task it to find out what equilibria there are that can withstand examination, but it remains for each of us to come to rest at one or another of them… Once the menu of well-worked out theories is before us, philosophy is a matter of opinion. Is that to say that there is no truth to be had? Or that the truth is of our own making, and different ones of us can make it differently? Not at all! If you say flatly that there is no god, and I say that there are countless gods but none of them are our worldmates, then it may be that neither of us is making any mistake of method. We may each be bringing our opinions to equilibrium in the most careful possible way, taking account of all the arguments, distinctions, and counterexamples. But one of us, at least, is making a mistake of fact. Which one is wrong depends on what there is (1983: x-xi). In addition to philosophy in general, the method of reflective equilibrium has also been endorsed as the appropriate procedure for investigating various other subject.. (shrink)

In what follows, I’ll discuss several approaches to suspension. As we’ll see, the issue of whether and in what sense(s) suspension is *question-directed* is important to developing an adequate account. I will argue that suspension isn’t question-directed in the way that curiosity, wondering, and inquiry are. The most promising approach, in my view, takes suspension to be an agential matter; it involves the will. As we’ll see, this view makes sense of a lot of familiar facts about suspension, and it (...) makes sense of its role in curating beliefs. It also raises intriguing questions about how it comes up for epistemic assessment. (shrink)

This article offers a fresh assessment of the views of the American paleontologist and evolutionary biologist Stephen Jay Gould on the relation of science and religion. Gould is best known for his celebrated notion of “nonoverlapping magisteria,” which is often seen in somewhat negative terms as inhibiting dialogue. However, as a result of his critique of the unificationist approach to knowledge developed in Edward O. Wilson's Consilience, Gould later made increased use of the more positive notion of a “consilience of (...) equal regard,” which recognized the porous nature of disciplinary divides and the propriety of interdisciplinary dialogue. Gould's final views on the relation of science and religion, set out in The Hedgehog, the Fox, and the Magister's Pox, published after his death, affirms the distinctiveness and autonomy of science and religion on the one hand, while encouraging their constructive dialogue and productive interaction on the other. This should now be seen as Gould's definitive statement on this question. (shrink)

There is a growing trend in Australia to require lawyers to certify reasonable prospects of success for the cases they bring and defend. New South Wales has led the way with the Legal Profession Act 2004 (NSW) Pt 3.2 Division 10 requiring legal practitioners to certify reasonable prospects of success in all claims for damages. The requirement places a significant onus on lawyers to make a judgment about the merits of a case before it is begun, yet the common law (...) has long provided mechanisms to ensure that cases without prospects of success do not go to trial. This article considers Australian legislative provisions requiring lawyers to certify reasonable prospects of success of cases. It examines the application of the NSW legislation by the courts highlighting the difficulties of interpretation of what constitute 'reasonable prospects of success' and the application of the legislation in the context of the dynamic litigation process. It is argued that these legislated obligations on lawyers will have a detrimental effect on access to justice by denying parties, in particular plaintiffs, the opportunity to have their cases properly and fully determined in the courts. This article examines common law mechanisms for dissuading cases without prospects and argues that the general law is an effective system for ensuring that cases without prospects of success are not maintained. The Australian experience is instructive for consideration of optimal reform packages for the administration of justice and to evaluate the role of any litigation lawyer within the judicial and court process. (shrink)

Issues surrounding the inclusion of transgender and intersex athletes in the women’s category in sport have spurred vigorous, and sometimes vicious, debate. The loudest voices on one edge of the de...