The overwhelming weight of legal authority in the USA and Canada holds that consent is not required for brain death testing. The situation in England and Wales is similar but different. While clinicians in England and Wales may have a prima facie duty to obtain consent, lack of consent has not barred testing. In three recent cases where consent for brain death testing was formally presented to the court, lack of consent was not determinative, and in one case the court (...) questioned whether the clinicians were even required to seek consent from the parents of a child at all. (shrink)

Technological advances in veterinary medicine have produced considerable progress in the diagnosis and treatment of numerous diseases in animals. At the same time, veterinarians, veterinary technicians, and owners of animals face increasingly complex situations that raise questions about goals of care and correct or reasonable courses of action. These dilemmas are frequently controversial and can generate conflicts between clients and health care providers. In many ways they resemble the ethical challenges confronted by human medicine and that spawned the creation of (...) clinical ethics committees as a mechanism to analyze, discuss, and resolve disagreements. The staff of the North Carolina State University Veterinary Hospital, a specialty academic teaching institution, wanted to investigate whether similar success could be achieved in the tertiary care veterinary setting. We discuss the background and rationale for this method, as well as the approach that was taken to create a clinical ethics committee. (shrink)

Edward Keene argues that the conventional idea of an 'anarchical society' of equal and independent sovereign states is an inadequate description of order in modern world politics. International political and legal order has always been dedicated to two distinct goals: to try to promote the toleration of different ways of life, while advocating the adoption of one specific way, that it labels 'civilization'. The nineteenth-century solution to this contradiction was to restrict the promotion of civilization to the world beyond Europe. (...) That discriminatory way of thinking has now broken down, with the result that a single, global order is supposed to apply to everyone, but opinion is still very much divided as to what the ultimate purpose of this global order should be, and how its political and legal structure should be organised. (shrink)

Since it was first published more than forty years ago, _Sources of Japanese Tradition_, Volume 2, has been considered the authoritative sourcebook for readers and scholars interested in Japan from the eighteenth century to the post-World War II period. Now greatly expanded to include the entire twentieth century, and beginning in 1600, _Sources of Japanese Tradition_ presents writings by modern Japan's most important philosophers, religious figures, writers and political leaders. The volume also offers extensive introductory essays and commentary to assist (...) in understanding the documents' historical settings and significance. Wonderfully varied in its selections, this eagerly anticipated expanded edition has revised many of the texts from the original edition and added a great many not included or translated before. New additions include documents on the postwar era, the importance of education in the process of modernization, and women's issues. Beginning with documents from the founding of the Tokugawa shogunate, the collection's essays, manifestos, religious tracts, political documents, and memoirs reflect major Japanese religious, philosophical, social and political movements. Subjects covered include the spread of neo-Confucian and Buddhist teachings, Japanese poetry and aesthetics, and the Meiji Restoration. Other documents reflect the major political trends and events of the period: the abolition of feudalism, agrarian reform, the emergence of poltical parties and liberalism, and the Sino-Japanese and Russo-Japanese Wars. The collection also includes Western and Japanese impressions of each other through Western religious missions and commercial and cultural exchanges. These selections underscore Japanese and Western apprehension of and fascination with each other. As Japan entered the twentieth century, new political and social movements -- Marxism, anarchism, socialism, nationalism, and feminism -- entered the national consciousness. Later readings in the collection look at the buildup to war with the United States, military defeat and American occupation. Documents from the postwar period echo Japan's struggle with its own history and its development as a capitalist democracy. (shrink)

Most jurisdictions require that a mental capacity assessment be conducted using a functional model whose definition includes several abilities. In England and Wales and in increasing number of countries, the law requires a person be able to understand, to retain, to use or weigh relevant information and to communicate one’s decision. But interpreting and applying broad and vague criteria, such as the ability ‘to use or weigh’ to a diverse range of presentations is challenging. By examining actual court judgements of (...) capacity, we previously developed a descriptive typology of justifications used in the application of the Mental Capacity Act criteria. We here critically optimise this typology by showing how clear definitions—and thus boundaries—between the criteria can be achieved if the ‘understanding’ criterion is used narrowly and the multiple rationales that fall under the ability to ‘use or weigh’ are specifically enumerated in practice. Such a typology-aided practice, in theory, could make functional capacity assessments more transparent, accountable, reliable and valid. It may also help to create targeted supports for decision making by the vulnerable. We also discuss how the typology could evolve legally and scientifically, and how it lays the groundwork for clinical research on the abilities enumerated by the MCA. No data are available. This paper does not report any original data. (shrink)

All contemporary frameworks of mental capacity stipulate that we must begin from the presumption that an adult has capacity. This presumption is crucial, as it manifests respect for autonomy and guards against prejudice and paternalism on the part of the evaluator. Given its ubiquity, we might presume that we all understand the presumption’s meaning and application in the same way. Evidence demonstrates that this is not the case and that this has led to harm in vulnerable persons. There is thus (...) strong reason to question our presumptions about the presumption of capacity. We distinguish between two main ways of understanding and applying the presumption of capacity, and advocate for the one that we argue mitigates risk of harm. Our proposed interpretation offers many advantages in that it is consonant with actual practice of capacity evaluations, precludes confused and abusive avoidance of needed evaluations, and preserves the respect for autonomy motivating the presumption in the first place. (shrink)

This paper is an exploration of the state of ‘clinical unease’ experienced by clinicians in contexts where professional judgement—grounded in clinical knowledge, critical reflection and a sound grasp of the law—indicates that there is more than one ethically defensible way to proceed. The question posed is whether the courts can be viewed as an appropriate vehicle to settle clinical unease by providing a ruling that clarifies the legal and ethical issues arising in the case, even in situations where there is (...) no dispute between the patient (or her proxies) and the healthcare team. The concept of ‘clinical unease’ is framed with reference to the broader experience of clinical decision-making, and distinguished from other widely discussed phenomena in the healthcare literature like moral distress and conscientious objection. A number of reported cases are briefly examined where the courts were invited to rule in circumstances of apparent ‘unease’. The respective responsibilities of clinicians and courts are discussed: in particular, their capability and readiness to respond to matters of ethical concern. Four imagined clinical scenarios are outlined where a clinical team might welcome a court adjudication, under current rules. Consideration is given to the likelihood of such cases being heard, and to whether there may be better remedies than the courts. There are final reflections on what clinicians may actually wish for in seeking court involvement, and on whether a willingness to engage with the experience of clinical unease may lead to greater sensitivity towards the value perspectives of others. (shrink)

This volume offers an accessible and wide-ranging introduction to the history of international political thought.

Taken together, Sections 145 and 63 of the Mental Health Act 1983 provide for treatment without consent of physical illness ancillary to the mental disorder with which a patient presents. On a daily basis, clinicians make both the decision that the Act’s authority can be applied to their patient’s case, and that it should be applied. But in the unusual circumstances where there is uncertainty as to the applicability of the MHA to the ancillary treatment of physical illness, the assistance (...) of a court may be sought. In so doing, the law may justify compulsion but never prescribes it; the clinician is presented with authority that he or she could use but is left to decide whether it should be employed. This paper explores how the clinical question is set before the court, and whether the distinction between symptom, manifestation and consequence is sufficiently understood. This has important consequences in the context of self-neglect and its close cousin self-harm: the question whether the relevant ailment was attributable to or exacerbated by neglect or self- inflicted harm will determine whether compulsion under the MHA is applicable; and furthermore, whether or not compulsion is clinically acceptable. No data are available. Not applicable. (shrink)

In February 2022, the Court of Protection was faced with the question of whether a kidney transplant was in the best interests of William Verden. The case highlighted the legal, ethical and clinical complexities of treating potential kidney transplant patients with impaired decision-making. Above all, it exposed the potential risk of discrimination on the basis of disability when treatment decisions in relation to potential kidney recipients with impaired capacity are being made. In this paper, we draw on the Verden case (...) to (1) examine the role of the Court of Protection in cases relating to patients with impaired decision-making capacity who require a transplant, (2) to highlight the lack of empirical data on patients who have faced inequitable access to transplant and (3) highlight the shortcomings of the existing legal and regulatory framework in England and Wales guiding clinical decision making for patients in William’s position. We consequently argue that there is a clear need for action to ensure equitable access to transplant for those in William’s position. Furthermore, we suggest that there is a responsibility incumbent on policy makers and clinicians alike to develop a meaningful, and meaningfully operational, framework centred on preventing discrimination against potential organ recipients based on their decision-making capacity. (shrink)

Guidelines advise that x-rays do not contribute to the clinical management of simple nasal fractures. However, in cases of simple nasal fracture secondary to assault, a facial x-ray may provide additional legal evidence should the victim wish to press charges, though there is no published guidance. We examine the ethical and medico-legal issues surrounding this controversial area.

This paper seeks to show how a missional reading of 2 Corinthians 5:11–6:2 provides support for NT Wright’s largely neglected reading of 2 Corinthians 5:21 and also creates greater immediate contemporary relevance. Instead of seeing the passage as purely polemical or apologetic, the passage is seen as functioning as an exhortation even as it conforms to an apologetic for Paul’s ministry.

Mathematically, Truths have been said to be analytic. Leibniz tried to prove this in a way criticized by frege. The author states: "it is the purpose of this note to exhibit the full force of frege's criticism." frege also attempted to prove the same thing, But concludes the author, In his attempt, Has not "found universal acceptance among mathematical logicians." he finds the value in frege's analysis to be the fact of his attempt at proof and the need for it. (...) (staff). (shrink)

This text unites the logical and philosophical aspects of set theory in a manner intelligible both to mathematicians without training in formal logic and to logicians without a mathematical background. It combines an elementary level of treatment with the highest possible degree of logical rigor and precision. Starting with an explanation of all the basic logical terms and related operations, the text progresses through a stage-by-stage elaboration that proves the fundamental theorems of finite sets. It focuses on the Bernays theory (...) of finite classes and finite sets, exploring the system's basis and development, including Stage I and Stage II theorems, the theory of finite ordinals, and the theory of finite classes and finite sets. This volume represents an excellent text for undergraduates studying intermediate or advanced logic as well as a fine reference for professional mathematicians. (shrink)