In the early days of ethics consultation, two pioneer consultants noted that one of their important functions was to gather missing information and correct misinformation relevant to the facts of t...

Written by a non-Jewish analytic philosopher, this book addresses the issue of whether, and to what extent, current opposition to Israel on the liberal-left embodies anti-Semitic stances. It argues that the dominant climate of liberal opinion disseminates, however inadvertently, a range of anti-Semitic assertions and motifs of the most traditional kind. It advocates a return to an unrestricted anti-racism which would allow liberals to defend Palestinian interests without demonizing Jews.

The Physician Orders for Life-Sustaining Treatment Paradigm is designed to improve end-of-life care by converting patients' treatment preferences into medical orders that are transferable throughout the health care system. It was initially developed in Oregon, but is now implemented in multiple states with many others considering its use. An observational study was conducted in order to identify potential legal barriers to the implementation of a POLST Paradigm. Information was obtained from experts at state emergency medical services and long-term care organizations/agencies (...) in combination with a review of relevant state law. (shrink)

The Physician Orders for Life-Sustaining Treatment Paradigm is designed to improve end-of-life care by converting patients’ treatment preferences into medical orders that are transferable throughout the health care system. It was initially developed in Oregon, but is now implemented in multiple states with many others considering its use. Accordingly, an observational study was conducted in order to identify potential legal barriers to the implementation of a POLST Paradigm. Information was obtained from experts at state emergency medical services and long-term care (...) organizations/agencies in combination with a review of relevant state law. Legal analysis of survey responses and existing laws identified several potential state legal barriers to a POLST Paradigm implementation. The most potentially problematic barriers are detailed statutory specifications for out-of-hospital DNR protocols. Other potential barriers include limitations on the authority to consent to forgo life-sustaining treatments, medical preconditions, and witnessing requirements for out-of-hospital DNR protocols. (shrink)

In this fresh and powerfully argued book, Mark Bernstein identifies the qualities that make an entity deserving of moral consideration. It is frequently assumed that only (normal) human beings count. Bernstein argues instead for "experientialism"--the view that having conscious experiences is necessary and sufficient for moral standing. He demonstrates that this position requires us to include many non-human animals in our moral realm, but not to the extent that many deep ecologists champion.

Received opinion has it that humans are morally superior to non-human animals; human interests matter more than the like interests of animals and the value of human lives is alleged to be greater than the value of nonhuman animal lives. Since this belief causes mayhem and murder, its de-mythologizing requires urgent attention.

Some carnivores defend the position that the opportunistic consumption of meat is morally permissible even under the assumption that it is morally wrong to act in ways that ause unnecessary suffering to sentient beings. Ordering and consuming chicken once a week, they argue, will not increase the numbers of chickens suffering or slaughtered, since the system of purchasing and farming chickens is not sufficiently fine‐tuned to register differences at margin. We argue that, insensitivity of the market notwithstanding, consistent consequentialists are (...) morally prohibited from each additional purchase and consumption of meat. (shrink)

The principle of gratuitous suffering -- The value of humans and the value of animals -- The holocaust of factory farming -- Hunting -- Animal experimentation -- The law and animals -- Women and animals.

The recent Minnesota case of In re Emergency Guardianship of Albert Barnes illustrates an emerging class of cases where a dispute between a family proxy and a hospital over “medical futility” requires legal resolution. The case was further complicated by the patient’s spouse who fraudulently claimed to be the patient’s designated health care proxy and who misrepresented the patient’s previously expressed treatment preferences. Barnes demonstrates the degree of significant administrative and institutional support to the health care team, ethics consultants, and (...) futility committees that is required when a futility dispute escalates to the need for judicial resolution. An institutional futility policy, especially one that is endorsed by other regional medical centers and organizations, is an important foundation for a hospital that seeks judicial support in a dispute over medical futility in end of life care. (shrink)

Futility disputes are increasing and courts are slowly abandoning their historical reluctance to engage these contentious issues, particularly when confronted with inappropriate surrogate demands for aggressive treatment. Use of the judicial system to resolve futility disputes inevitably brings media attention and requires clinicians, hospitals, and families to debate these deep moral conflicts in the public eye. A recent case in Minnesota, In re Emergency Guardianship of Albert Barnes, explores this emerging trend and the complex responsibilities of clinicians and hospital administrators (...) seeking to replace an unfaithful surrogate demanding aggressive therapy. Use of the courts requires the coordinated commitment of significant institutional resources, management of intense media scrutiny and individual and organizational courage to enter the unpredictable world of litigation. Given the dearth of legislative guidance on medical futility, individual clinicians and institutions will continue to bear the difficult responsibility for resolution of individual futility disputes. The Barnes case illustrates how one institution successfully used the judicial system to replace an unfaithful surrogate, cease the provision of inappropriate aggressive care, and stimulate a community dialogue about appropriate care at the end of life. (shrink)

Physical environmental factors – or ‘artifacts’ – are linked to healthcare outcomes in the field of social psychology. However, the role of artifacts remains rarely examined in the burgeoning discipline of placebo studies. In this paper, we argue that a careful consideration of artifacts – such as provider clothing and office décor – may carry significant potential in eliciting placebo effects in clinical settings. We discuss three potential mechanisms by which artifacts may enhance or diminish placebo (or nocebo) effects: classical (...) conditioning, response expectancy, and mindsets. We propose testable hypotheses and conclude by providing innovative research designs that might help to better advance this novel research agendum. (shrink)

Virtually all persons—philosophers and laypersons alike—agree that, special circumstances aside, killing humans is more morally objectionable than killing animals. I argue for a radical inversion of this dogma: all else being equal, killing nonhuman animals is more morally objectionable than killing humans. We will discover that the dominant reason for the pervasive belief that killing humans is worse than killing animals—that the human kind of animal uniquely has the capacities for self-consciousness and self-reflection—can be implemented to demonstrate the very opposite (...) conclusion. (shrink)

Received opinion attributes greater value to the lives of humans than to the lives of animals. Arguably, this conviction allows the continuation of the institutions of factory farming, hunting, and animal experimentation. After all, if we believe that the value of animal lives is at least equal to the value of human lives, we would presumably be quick to renounce and abolish these activities. My aim is to show that we have no good reason to sustain our common belief in (...) the hierarchy of value concerning animal lives. (shrink)

In this Introduction, I have two goals. First, I try to contextualize the reasons most people believe both that, all else being equal, killing animals is wrong, and that some justification is needed, at least implicitly, to perform these killings. In the course of this discussion, I briefly discuss the comparative badness of killing human and nonhuman animals. Second, I provide short summaries of all of the papers in this section of the Handbook.

A problem closely related to the perennial free will question is whether autonomy of persons can be reconciled with socialization. If this latter compatibilism can be established, It would have great bearing on the more general issue of freedom being reconcilable with determinism. In several recent articles robert young has tried to demonstrate the consistency of autonomy with socialization, But the author argues that he has failed to notice the depth and global nature of the socialization critic's position, And as (...) such fails in his attempt. As a result, There are no beneficial consequences reaped for the free will problem. (shrink)

In "Size Matters" in this issue, Joel MacClellan argues for three claims: according to utilitarianism, faced with a choice of eating large or small animals, we should eat the large; utilitarianism may ground obligations to eat meat; and we justifiably attract greater moral responsibility for the "direct" killing of our food animals than we do for "indirect" killing. MacClellan tends to underestimate the resources available even to hedonistic utilitarianism and oversimplifies the conditions in the food industry. His second claim has (...) merit but is merely an instance of utilitarianism’s problem with providing a satisfying account of justice. (shrink)

Randomised placebo-controlled trials (RPCTs) are the gold standard for evaluating novel treatments. However, this design is rarely used in the context of orthopaedic interventions where participants are assigned to a real or placebo surgery. The present study examines attitudes towards RPCTs for orthopaedic surgery among 687 orthopaedic surgeons across the USA. When presented with a vignette describing an RPCT for orthopaedic surgery, 52.3% of participants viewed it as ‘completely’ or ‘mostly’ unethical. Participants were also asked to rank-order the value of (...) five different types of evidence supporting the efficacy of a surgery, ranging from RPCT to an anecdotal report. Responses regarding RPCTs were polarised with 26.4% viewing it as the least valuable (even less valuable than an anecdote) and 35.7.% viewing it as the most valuable. Where equipoise exists, if we want to subject orthopaedic surgeries to the highest standard of evidence (RPCTs) before they are implemented in clinical practice, it will be necessary to educate physicians on the value and ethics of placebo surgery control conditions. Otherwise, invasive procedures may be performed without any benefits beyond possible placebo effects. (shrink)

Depression is theorized to be caused in part by biased cognitive processing of emotional information. Yet, prior research has adopted a reductionist approach that does not characterize how biases i...