_Lost Lullaby_ makes one think the unthinkable: how a loving parent can pray for the death of her child. It is Deborah Alecson's story of her daughter, Andrea, who was born after a full-term, uneventful pregnancy, weighing 7 pounds 11 ounces, perfectly formed and exquisitely featured. But an inexplicable accident at birth left her with massive and irreversible brain damage. On a vitality scale of one to ten, her initial reading was one. And so begins Deborah Alecson's heart-rending struggle to (...) come to terms with two desperately conflicting and powerful emotions: her desire to nurture and love Andrea, and her desire to do everything in her power to bring about her death. Told in a mother's voice, with a simplicity and directness that heighten the intensity of the drama that unfolds, _Lost Lullaby_ reaffirms the human dimension of what is too often an abstract and purely theoretical discussion. During the two months that Andrea spent in the Infant Intensive Care Unit, Ms. Alecson spoke with lawyers, doctors, and ethicists in an effort to understand the legal, medical and ethical implications of her plight. She recounts those discussions and describes legal cases that have a direct bearing on her own situation. Her battle—both in coming to the agonizing decision to let her child die and in convincing the medical and legal establishments to respect that decision—will engender empathy for the plight of many families, and an awareness of the need to use medical technology with restraint. It is a must-read for everyone who cares about how we make life-and-death decisions on these new medical, legal, and moral frontiers. (shrink)

Transplantation of tissue from fetal cadavers threatens ethical values and our social ethos in complex and subtle ways, requiring restraints that can prevent harmful normative and attitudinal shifts yet permit pursuit of medical benefits for those desperately in need.

The powerful new methods, expansive scope, and accelerated pace of human molecular genetics combine to catapult us into ethically unfamiliar territory. These features lend special urgency to questions of genetic ownership and privacy, disease and normalcy, identity and genetic determinism, and early diagnosis and therapy.

Many of the controversies surrounding the withholding of resuscitation are illuminated when we examine the language of resuscitation and resuscitative decisionmaking, and the contexts in which these decisions are made. Resuscitation and its withholding have multiple and often conflicting symbolic and emotional meanings for patients, families, and clinicians, and recognizing this divergence is essential to communication and to decisionmaking.

Many of the controversies surrounding the withholding of resuscitation are illuminated when we examine the language of resuscitation and resuscitative decisionmaking, and the contexts in which these decisions are made. Resuscitation and its withholding have multiple and often conflicting symbolic and emotional meanings for patients, families, and clinicians, and recognizing this divergence is essential to communication and to decisionmaking.

The line between Germ-Line genetic therapy and somatic cell is more and more difficult to discern. With new abilities to effect Germ-Line genetic therapy it is less clear why such therapy should not be undertaken. Nonetheless, questions persist as to who is the patient in such therapy and about the extent of discretion that should be allowed prospective parents and the physician/researcher. Keywords: embryo, Germ-Line, patient, somatic therapy CiteULike Connotea Del.icio.us What's this?

This paper advances a new paradigm in clinical ethics education that not only emphasizes development of individual cli but also focuses on the institutional context within which health care professionals work. This approach has been applied to the goal of improving the care provided to critically and terminally ill adults. The model has been adopted by about thirty hospitals and nursing homes; additional institutions will soon join the program, entitled Decisions Near the End of Life. Here, we describe the history (...) and rationale for this approach, its goals, pedagogical assumptions, and design. (shrink)

Reasoning about situations we take to be impossible is useful for a variety of theoretical purposes. Furthermore, using a device of impossible worlds when reasoning about the impossible is useful in the same sorts of ways that the device of possible worlds is useful when reasoning about the possible. This paper discusses some of the uses of impossible worlds and argues that commitment to them can and should be had without great metaphysical or logical cost. The paper then provides an (...) account of reasoning with impossible worlds, by treating such reasoning as reasoning employing counterpossible conditionals, and provides a semantics for the proposed treatment. (shrink)

A lot of philosophers engage in debates about what claims are “metaphysically necessary”, and a lot more assume with little argument that some classes of claims have the status of “metaphysical necessity”. I think we can usefully replace questions about metaphysical necessity with five other questions which each capture some of what people may have had in mind when talking about metaphysical necessity. This paper explains these five other questions, and then discusses the question “how much of metaphysics is metaphysically (...) necessary?”, and each of its five replacements. (shrink)

This article focuses on the main methods used in analytic metaphysics. It first considers five important sources of constraints on metaphysical theorizing: linguistic and conceptual analysis, consulting intuitions, employing the findings of science, respecting folk opinion, and applying theoretical virtues in metaphysical theory choice such as preferring simpler theories, or preferring more explanatory theories. It then examines the role of formal methods in metaphysics as well as the role of metaphysical communities, traditions, and the place of the history of metaphysics (...) in contemporary work. It also discusses the issue of whether metaphysics should be seen as an enterprise that will yield knowledge of metaphysical matters or whether it should have more modest epistemic goals. Finally, it explores the question of how much of metaphysics is a priori. (shrink)

After his father passed away, James Nolan's mother gave him a box of materials that his dad had kept private. To Nolan's complete surprise, the contents revealed the role his grandfather had played as a doctor in the Manhattan Project. Dr. Nolan, it turned out, had been a significant figure. A talented radiologist, he cared for the scientists on the Project, helped organize the safety and evacuation plans for the Trinity Test at Alamogordo, escorted the "Little Boy" (...) bomb from Los Alamos to Japan, and was one of the first Americans to enter the irradiated ruins of Hiroshima and Nagasaki. The documents set Nolan on a hunt for more information about his grandfather and more generally about the conflicted role that medical personnel played in the early years of atomic testing. The result is a compelling history of the dawn of the atomic age as seen through the eyes of men and women torn between their duty and desire to win the war and their oath to protect life. Nolan follows his grandfather and medical colleagues as they seek to maximize safety while serving leaders determined to minimize delays, and as they consider the ethics of ending the deadliest of all wars with the most lethal of all weapons. The result, Nolan shows, was a very human pattern of caution, co-optation, and complicity. A vital and vivid account of a largely unknown chapter in atomic history, Delivering Little Boy is also a profound meditation on the professional and moral dilemmas that ordinary people face in extraordinary times. (shrink)

One model for creating artificial consciousness is replicating every fine detail of the brain on computers and setting the model in motion. Consciousness has been experimentally demonstrated to be a much more fragmented experience than we think it to be, perhaps we only need snippets of ourselves to feel conscious. Perhaps consciousness is nothing less and nothing more than story, and all we need do to continue to feel conscious is maintain identity through computer‐based narrative. Applied nanotechnology has generated uncountable (...) applications in electronics, pharmacology, and materials engineering. The best approach to life extension and consciousness expansion might lie in our own marvelously complex and entire bodies, meshed with and augmented by tiny bionan machines that become a part of us, rather than the opposite vision of humans migrating into a machine substrate. (shrink)

Fourteen newly commissioned essays trace the historical development of the distinction between primary and secondary qualities, which lies at the intersection of issues in metaphysics, epistemology, and philosophy of perception. 'Primary and Secondary Qualities' focuses on the age of the Scientific Revolution, the 'locus classicus' of the distinction, but begins with chapters on ancient Greek and Scholastic accounts of qualities in an effort to identify its origins. The remainder of the volume is devoted to philosophical reflections on qualities from the (...) seventeenth century to the present day. Virtualliy every major figure is represented from Gassendi to Kant, and special attention is paid to Locke, Descartes, and Hume. The essays collected here cover a wide range of topics, including the foundation for the distinction, the question of whether it is lmetaphysical or merely epistemic, the status of secondary qualities, the nature of sensoriy representation, the relation between philosophy and science, the status of dispositions, and the semantics of sensible-quality terms"--Publisher's description, p. [4] of dust jacket. (shrink)

This paper responds to commentaries by Kaiserman and Magidor, and Hawthorne. The case of the infinite clowns can teach us several things.

It is almost universally believed that some infinite regresses are vicious, and also almost universally believed that some are benign. In this paper I argue that regresses can be vicious for several different sorts of reasons. Furthermore, I claim that some intuitively vicious regresses do not suffer from any of the particular aetiologies that guarantee viciousness to regresses, but are nevertheless so on the basis of considerations of parsimony. The difference between some apparently benign and some apparently vicious regresses, then, (...) turns out to be a matter of a more general assessment of costs and benefits, making viciousness of regresses in some cases less of a local matter than is usually thought. (shrink)

Thought experiments are common where infinitely many entities acting in concert give rise to strange results. Some of these cases, however, can be generalized to yield almost omnipotent systems from limited materials. This paper discusses one of these cases, bringing out one aspect of what seems so troubling about "New Zeno" cases. -/- This paper is in memory of Josh Parsons.

Methodological naturalism arises as a topic in metaethics in two ways. One is the issue of whether we should be methodological naturalists when doing our moral theorising, and another is whether we should take a naturalistic approach to metaethics itself. Interestingly, these can come apart, and some naturalist programs in metaethics justify a non-scientific approach to our moral theorising. This paper discusses the range of approaches that fall under the general umbrella of methodological naturalism, and how naturalists view the role (...) of science in ethics and metaethics. It discusses how naturalism interacts with the use of intuitions, using conceptual analysis, and reflective equilibrium methods. Finally, it discusses some ways using scientific investigation can make distinctive contributions to ethics and metaethics. (shrink)

This book explores how shamanic Daoist practices help cultivate the skills of an elicitive peaceworker. Author Kathleen McGoey uses embodied writing to describe her direct experiences with qigong and other meditation forms, and to explain the creation of inner peace that ultimately extends far beyond the individual. A trans-rational understanding of peace weaves together transpersonal interpretations of intuition with ancient Daoist wisdom. By relating the outcomes of such approaches to real world conflict transformation, McGoey proposes a practical personal consciousness (...) that strives for harmony with our's and others' environments. (Series: Masters of Peace - Vol. 9). (shrink)

This paper makes a case that we should believe in the existence of worldly states of affairs.

Zurvanism was an ancient variant of Zoroastrianism. According to Zurvanism, the great powers of good and evil, Ahura Mazda and Angra Mainyu, were the sons of a greater god Zurvan, associated with time. According to Eudemus of Rhodes, some Persian thinkers, presumably Zurvanists, took there to be three great principles underlying the world: light, darkness, and greatest of all time (or perhaps, according to Eudemus, space). This paper explores what metaphysics might underlie these doctrines, and what contemporary options we have (...) for making sense of a metaphysics where time is the ultimate principle. Among the options explored is the option that despite appearance many of the entities of the concrete world are identical to stretches of time, or are somehow aspects of stretches of time; that they include times as parts, or are included in times as parts; that they are somehow properties of time; or hylomorphic compounds of which time is the matter; that the world is somehow a mixture of time, light, and dark; or that somehow the ends or teloi of everyday objects and processes are to be found among good, evil, and time. (shrink)

The Architecture Machine: Industrial Design and Theories of Racial Evolution -- The Bauhaus and the Aura of Authorship: Class and Race in the Age of Technological Reproducibility -- Post-War European Modernism: Or, What the Primitive Hut Really Said -- Bricolage, Megastructure, Interface: Yona Friedman and the Humanitarian Machine -- The Earth Unfolded: Aspen, Africa, and the Geopolitics of Environment -- Harlem Speaks to Aspen: Environmental Politics versus Environmental Design -- Pentecostal Technologies: The Architecture Machine (Again) -- Technological Sovereignty and the (...) Global South -- Conclusion: The Present and Future of Spiritual Ergonomics. (shrink)

Palliative Care Nursing: Caring for Suffering Patients explores the concept of suffering as it relates to nursing practice. This text helps practicing nurses and students define and recognize various aspects of suffering across the lifespan and within various patient populations while providing guidance in alleviating suffering. In addition, it examines spiritual and ethical perspectives on suffering and discusses how witnessing suffering impacts nurses' ability to assume the professional role. Further, the authors discuss ways nurses as witnesses to suffering can optimize (...) their own coping skills and facilitate personal growth. Rich in case studies, pictures, and reflections on nursing practice and life experiences, Palliative Care Nursing: Caring for Suffering Patients delves into key topics such as how to identify when a patient is suffering, whether they are coping, sources of coping facades, what to do to ease suffering, and how to convey the extent of suffering to members of the health care team.Palliative Care Nursing: Caring for Suffering Patients helps practicing nurses and students define and recognize various aspects of suffering across the lifespan and within various patient populations while providing guidance in alleviating suffering. (shrink)

Possible worlds have found many applications in contemporary philosophy: from theories of possibility and necessity, to accounts of conditionals, to theories of mental and linguistic content, to understanding supervenience relationships, to theories of properties and propositions, among many other applications. Almost as soon as possible worlds started to be used in formal theories in logic, philosophy of language, philosophy of mind, metaphysics, and elsewhere, theorists started to wonder whether impossible worlds should be postulated as well. In many applications, possible worlds (...) face limitations that can be dealt with through postulating impossible worlds as well. This chapter examines some of the uses of impossible worlds, and philosophical challenges theories of impossible worlds face. (shrink)

Teilhard's words divided into a "Book of Hours" of eight days, according to Dawn, Day, Dusk, and Dark.

In lieu of an abstract, here is a brief excerpt of the content:Christ's Human Nature and the Cry from the Cross:St. Thomas Aquinas on Psalm 22:2Philip Nolan O.P.Christ's cry from the Cross quoting Psalm 22 (Mark 15:34; Matt 27:46) has become a central focus for contemporary Christological debates.1 A number of modern thinkers have read this verse as expressing in Christ an experience of dereliction incompatible with traditional positions concerning divine impassibility Christ's beatific knowledge, and Trinitarian relations.2 Thomas Joseph (...) White has recently offered an insightful Thomistic critique of these interpretations: [End Page 1219]The final cry of Christ on the cross cannot be interpreted as a cry of either despair or of spiritual separation from God. By contrast, it must be understood theologically as a prayer of desire related to Christ's abandonment to the Father and his hope to introduce humanity into the eschatological gift of redemption.3In his work, White is concerned to engage with modern Christological themes using principles derived from the Thomistic tradition. For this reason, he articulates a rather original alternative to modern theologies of dereliction—especially those marked by divine kenoticism and Luther's theology of the Cross. In offering a view inspired by Thomistic principles, White presents his own creative retrieval of Aquinas's ideas concerning the cry from the Cross.At times, however, White's argument leaves somewhat obscure the literal meaning of the words of that cry: "My God, my God, why have you abandoned me?"4 For example, in pushing back against radical interpretations [End Page 1220] of dereliction, he shifts the language of "abandonment" from God's abandonment of Christ to Christ's abandonment to the Father. My argument in this article is that the textual commentaries on Psalm 225 by Augustine and Aquinas—material that White does not consider specifically—can provide an alternate and somewhat complementary Thomistic approach to the one White proposes, and one more soundly based on Aquinas's texts themselves.6 Christ's cry is a quote from this psalm, and Aquinas's commentary on Ps 22:27 develops the Augustinian interpretation of this verse in order to give greater emphasis to Christ's human nature. This emphasis helps to explain, in a classical way, what it can mean that Christ is abandoned. Thus, Aquinas's exegesis bolsters the orthodox response to contemporary revisionist theologians by providing a clear literal understanding of this contested biblical passage without applying an experience of damnation to Christ or denying classical positions concerning divine impassibility, Christ's beatific knowledge, and the nature of Trinitarian relations.To make this argument, I will first look at the rich tradition of reflection on the Christological meaning of the Psalms, and Psalm 22 in particular, inherited by Thomas. This tradition includes a series of psalm commentaries, conciliar documents, and a variety of other theological works. In this tradition, I argue, we see two primary interpretative approaches. The first is what I will call the Augustinian approach, which insists that Christ is speaking on the Cross for sinners and in the voice of sinners. The second interpretation places more weight on Christ's own voice and insists that he is speaking in a real way for himself—Christ in some way truly is abandoned by God. These interpretations need not and should not be read as contradictory. In fact, all the authorities I examine insist on the first approach. Differences emerge, however, in how they coordinate the latter interpretation with the former. I will discuss Thomas's synthesis of these interpretations, a synthesis that he grounds in the reality of Christ's human nature. Finally, I will suggest [End Page 1221] how a close reading of Thomas's mature treatment of Ps 22:2 supplements contemporary Thomist responses to modern Christological concerns and misguided interpretations of Christ's cry on the Cross.Thomas's Sources for Reading Psalm 22:2Thomas's primary source for understanding Ps 22:2 is Scripture itself Both Mark and Matthew report that Christ spoke the words of this psalm from the Cross, a fact which necessitates for Thomas a Christological interpretation of the psalm.8 Augustine links Ps 22:2 with passages in... (shrink)

This introduction to the roles infinity plays in metaphysics includes discussion of the nature of infinity itself; infinite space and time, both in extent and in divisibility; infinite regresses; and a list of some other topics in metaphysics where infinity plays a significant role.