Euthanasia and physician assisted-suicide are terms used to describe the process in which a doctor of a sick or disabled individual engages in an activity which directly or indirectly leads to their death. This behavior is engaged by the healthcare provider based on their humanistic desire to end suffering and pain. The psychiatrist's involvement may be requested in several distinct situations including evaluation of patient capacity when an appeal for euthanasia is requested on grounds of terminal somatic illness or when (...) the patient is requesting euthanasia due to mental suffering. We compare attitudes of 49 psychiatrists towards euthanasia and assisted suicide with a group of 54 other physicians by means of a questionnaire describing different patients, who either requested physician-assisted suicide or in whom euthanasia as a treatment option was considered, followed by a set of questions relating to euthanasia implementation. When controlled for religious practice, psychiatrists expressed more conservative views regarding euthanasia than did physicians from other medical specialties. Similarly female physicians and orthodox physicians indicated more conservative views. Differences may be due to factors inherent in subspecialty education. We suggest that in light of the unique complexity and context of patient euthanasia requests, based on their training and professional expertise psychiatrists are well suited to take a prominent role in evaluating such requests to die and making a decision as to the relative importance of competing variables. (shrink)
Decision making capacity (DMC) is a fundamental concept grounding the principle of respect for autonomy and the practice of obtaining informed consent. DMC must be determined and documented every time a patient undergoes a hospital procedure and for routine care when there is reason to believe decision making ability is compromised. In this paper we explore a path toward ethically informed development and implementation of a hospital policy related to DMC assessment. We begin with a review of the context of (...) DMC assessment before discussing some considerations relevant to policy creation by healthcare ethics committees. The discussion concludes in a presentation of a typology of capacity assessment policies, which draws upon a sampling of currently used hospital policies to illustrate relevant ethical considerations. (shrink)
If stem cell-based therapies are developed, we will likely confront a difficult problem of justice: for biological reasons alone, the new therapies might benefit only a limited range of patients. In fact, they might benefit primarily white Americans, thereby exacerbating long-standing differences in health and health care.
The nanomedicine field is fast evolving toward complex, “active,” and interactive formulations. Like many emerging technologies, nanomedicine raises questions of how human subjects research (HSR) should be conducted and the adequacy of current oversight, as well as how to integrate concerns over occupational, bystander, and environmental exposures. The history of oversight for HSR investigating emerging technologies is a patchwork quilt without systematic justification of when ordinary oversight for HSR is enough versus when added oversight is warranted. Nanomedicine HSR provides an (...) occasion to think systematically about appropriate oversight, especially early in the evolution of a technology, when hazard and risk information may remain incomplete. This paper presents the consensus recommendations of a multidisciplinary, NIH-funded project group, to ensure a science-based and ethically informed approach to HSR issues in nanomedicine, and to integrate HSR analysis with analysis of occupational, bystander, and environmental concerns. We recommend creating two bodies, an interagency Human Subjects Research in Nanomedicine (HSR/N) Working Group and a Secretary's Advisory Committee on Nanomedicine (SAC/N). HSR/N and SAC/N should perform 3 primary functions: (1) analysis of the attributes and subsets of nanomedicine interventions that raise HSR challenges and current gaps in oversight; (2) providing advice to relevant agencies and institutional bodies on the HSR issues, as well as federal and federal-institutional coordination; and (3) gathering and analyzing information on HSR issues as they emerge in nanomedicine. HSR/N and SAC/N will create a home for HSR analysis and coordination in DHHS (the key agency for relevant HSR oversight), optimize federal and institutional approaches, and allow HSR review to evolve with greater knowledge about nanomedicine interventions and greater clarity about attributes of concern. (shrink)
The Elements of Philosophy: Readings from Past and Present is a comprehensive collection of historical and contemporary readings across the major fields of philosophy. With depth and quality, this introductory anthology offers a selection of readings that is both extensive and expansive; the readings span twenty-five centuries. They are organized topically into five parts: Religion and Belief, Moral and Political Philosophy, Metaphysics and Epistemology, Philosophy of Mind and Language, and Life and Death. The product of the collaboration of three highly (...) respected scholars in their fields - Tamar Szabó Gendler, Susanna Siegel, and Steven M. Cahn - The Elements of Philosophy also includes introductions from the editors, explanatory footnotes, and a glossary. (shrink)
Siegel defends "Limited Intentionism", a theory of what secures the semantic reference of uses of bare demonstratives ("this", "that" and their plurals). According to Limited Intentionism, demonstrative reference is fixed by perceptually anchored intentions on the part of the speaker.
Using data from interviews with high school students, I first adduce evidence that lends support to Schourup's (1985) claim that the United States English adolescent hedge like is a discourse particle signalling a possible slight mismatch between words and meaning. Such a particle would generally be included in a grammar in a post‐compositional pragmatic component, but, surprisingly, like also affects basic semantic attributes. These include both truth‐conditions and the weak/strong distinction—though only in existential there and sluicing sentences. I argue that (...) the differential behaviour of like in various constructions selecting weak NP's stems from the restricted free variable it introduces, a variable which only there and sluicing require. This variable is available for binding, quantifier interpretation and other syntactic‐semantic processes, yet is pragmatically conditioned. Indeed, I show that, due to its formal properties, like can be interpreted only during the assignment of model‐theoretic denotations to expressions, along the lines of Lasersohn's (1999) pragmatic haloes. These results support the idea that weak/strong is not a unitary distinction and suggest that the various components of grammars must be organized to allow information from pragmatic/discourse elements to affect basic compositional semantics. (shrink)
To help academic associations in management develop, refine, and implement a code of ethics, we conducted a survey of management educators’ perception of the ethicality of 142 specific behaviors in teaching, research, and service. The results of the survey could be used to inform ethics committees of these associations regarding the level of acceptability of such conduct. The potential value of our study for the Academy of Management or similar management associations lie in our (1) systematically involving the members in (...) building support for the code of ethics, (2) assessing members’ ethical judgments on both cross-sectional and longitudinal bases so as to identify areas needing particular attention in ethical training, (3) providing an extensive list of specific examples of questionable and potentially unethical behaviors so as to make it easier to implement the code, and (4) providing a template survey document for potential use in involving more stakeholder groups in the development of codes of ethics. (shrink)
The current paper reports on a descriptive study involving a survey of accounting educators. Survey respondents were asked to rate the extent to which certain behaviors are deemed acceptable or unacceptable. The survey identified “hypernorms” (norms reflecting a high degree of consensus of what is acceptable or unacceptable behavior). These hypernorms were used to develop example ethical standards that can be used by a professional or academic association of accountants to develop a code of ethics for accounting educators.
We report on the deliberations of an interdisciplinary group of experts in science, law, and philosophy who convened to discuss novel ethical and policy challenges in stem cell research. In this report we discuss the ethical and policy implications of safety concerns in the transition from basic laboratory research to clinical applications of cell-based therapies derived from stem cells. Although many features of this transition from lab to clinic are common to other therapies, three aspects of stem cell biology pose (...) unique challenges. First, tension regarding the use of human embryos may complicate the scientific development of safe and effective cell lines. Second, because human stem cells were not developed in the laboratory until 1998, few safety questions relating to human applications have been addressed in animal research. Third, preclinical and clinical testing of biologic agents, particularly those as inherently complex as mammalian cells, present formidable challenges, such as the need to develop suitable standardized assays and the difficulty of selecting appropriate patient populations for early phase trials. We recommend that scientists, policy makers, and the public discuss these issues responsibly, and further, that a national advisory committee to oversee human trials of cell therapies be established. **NB we did not reccommend a NAC, we think it might be appropriate**. (shrink)
There is wide agreement that the derivation and use of human embryonic stem cells from embryos remaining after infertility treatment morally require the informed consent of the IVF patients who undertook the treatment. However, there continues to be controversy over whether hESC research involving leftover embryos created with eggs or sperm from third-party donors requires the consent of these donors. In the United States, the lack of consensus on this issue manifests itself in a conflict between two entities that play (...) an important role in hESC research policy: the National Institutes of Health, which federally funds the research, and the National Academy of Sciences, which has produced.. (shrink)
Initial claims that REM sleep is important in the consolidation of all memories have been revised and reduced to the claim that sleep has a role only in the consolidation of procedural learning. Now, Walker hypothesizes that sleep has no role in the “stabilization phase of consolidation” but only in the “enhanced learning” phase of procedural learning. Evidence for this vague, truncated hypothesis remains as inconsistent as that for prior claims.
The phylogenetic data are inconsistent with the hypothesis that REM sleep duration is correlated with learning or learning ability. Humans do not have uniquely high amounts of REM sleep. The platypus, marsupials, and other mammals not generally thought to have extraordinary learning abilities have the largest amounts of REM sleep. The whales and dolphins (cetaceans) have the lowest amounts of REM sleep and may go without REM sleep for extended periods of time, despite their prodigious learning abilities. Vertes & Eastman].
This book taps the best American thinkers to answer the essential American question: How do we sustain our experiment in government of, by, and for the people? Authored by an extraordinary and politically diverse roster of public officials, scholars, and educators, these chapters describe our nation's civic education problem, assess its causes, offer an agenda for reform, and explain the high stakes at risk if we fail.