After severe brain injury, one of the key challenges for medical doctors is to determine the patient’s prognosis. Who will do well? Who will not do well? Physicians need to know this, and families need to do this too, to address choices regarding the continuation of life supporting therapies. However, current prognostication methods are insufficient to provide a reliable prognosis. -/- Functional Magnetic Resonance Imaging (MRI) holds considerable promise for improving the accuracy of prognosis in acute brain injury patients. Nonetheless, (...) research on functional MRI in the intensive care unit context is ethically challenging. These studies raise several ethical issues that have not been addressed so far. In this article, Prof. Charles Weijer and his co-workers provide a framework for researchers and ethics committees to design and review these studies in an ethically sound way. (shrink)

Discourse between pupils represents a core element of citizenship education in England. However, as it is currently presented within the curriculum, discourse adopts the form of the rather broad terms of 'discussion' and 'debate'. These terms are diffuse, and in themselves offer little pedagogical guidance for teachers implementing the curriculum in schools. Moreover, there has been little academic reflection in England as to how theoretical ideas on civic dialogue may usefully inform approaches to pupil discourse. For this reason, how pupils (...) experience discursive learning activities is likely to depend on how individual schools and teachers understand the terms 'discussion' and 'debate' and the way in which this understanding is translated into pupil learning activities. This article explores how recourse to deliberative democratic theory, and in particular to the principle of contestatory deliberative democracy found within recent republican writing, may be useful in helping educators to consider critically the capacities needed for effective civic discourse as a well as the outcomes of pupils' dialogical engagement. (shrink)

In this article, I present an argument that suggests neuroscience should inform judgments of decision-making capacity. First, I review key behavioral and neurocognitive data to demonstrate that neuroscientific tests might be predictive of decision-making capacity, and that these tests might inform clinical judgments of capacity. Second, I argue that, consistent with the principles of autonomy and justice, such data should inform judgements of decision-making capacity. While the neuroscience of decision-making capacity still requires time to mature, there is strong reason to (...) believe that neuroscience might assist clinicians in adjudicating difficult cases in the future. This article focuses on the assessment of capacity in brain injury patients who have profound communication impairments, however, the overarching aim of the article is to highlight the potential use of neuroscience to improve our understanding of the relationship between cognition and decision-making capacity. (shrink)

Patient outcome after serious brain injury is highly variable. Following a period of coma, some patients recover while others progress into a vegetative state (unresponsive wakefulness syndrome) or minimally conscious state. In both cases, assessment is difficult and misdiagnosis may be as high as 43%. Recent advances in neuroimaging suggest a solution. Both functional magnetic resonance imaging and electroencephalography have been used to detect residual cognitive function in vegetative and minimally conscious patients. Neuroimaging may improve diagnosis and prognostication. These techniques (...) are beginning to be applied to comatose patients soon after injury. Evidence of preserved cognitive function may predict recovery, and this information would help families and health providers. Complex ethical issues arise due to the vulnerability of patients and families, difficulties interpreting negative results, restriction of communication to “yes” or “no” answers, and cost. We seek to investigate ethical issues in the use of neuroimaging in behaviorally nonresponsive patients who have suffered serious brain injury. The objectives of this research are to: (1) create an approach to capacity assessment using neuroimaging; (2) develop an ethics of welfare framework to guide considerations of quality of life; (3) explore the impact of neuroimaging on families; and, (4) analyze the ethics of the use of neuroimaging in comatose patients. (shrink)

The notion of the common good has been cited as a key constituent of citizenship education in England, within which the development of a concern for the common good represents a key disposition. The term has, however, received little critical attention to date within the discourse of the subject, either in terms of its theoretical basis or its educational function and form. For this reason to develop the common good represents an ill?defined aim of the citizenship education in schools. This (...) article seeks to redress this by critically engaging with different formulations of the common good within recent civic republican political theory. More specifically, it attempts to delineate between notions of the common good that are essentially moral and notions that emphasise political understandings of the term, and which, in so doing, minimise the moral. On the basis of this exploration a number of issues are raised for citizenship education in England and it is suggested that to fail to view the common good as a moral enterprise is inherently problematic. (shrink)

The aim of this paper is to consider the ways in which civic republican theory can provide a meaningful and useful account of social justice, one that is which holds resonance for educational debates. Recognising the need for educationalists interested in civic republicanism to pay greater attention to ideas of justice—and in particular social justice as it concerns relationships between citizens —it is argued that a form of civic republicanism committed to freedom as non-domination is capable of providing a substantive (...) model for analysing social justice within educational arenas. After positioning the contribution offered here within existing educational literature on civic republicanism, salient elements of social justice as freedom as non-domination are identified. On this basis, debates concerning the existence and potential expansion of state grammar schools in England are considered in relation to the account of republican social justice as non-domination. It is argued that from this republican position grammar schools represent an arbitrary domination of the interests of those less well off by those with greater material and cultural capital and in doing so lead to advantages for some at the expense of others. Though the focus of the paper is on grammar schools in England, it is suggested that republican justice may be a useful frame for considering similar educational cases in England and elsewhere. (shrink)

Cosmopolitanism has become an influential theory in both political and, increasingly, educational discourse. In simple terms cosmopolitanism can be understood as a response to the globalised and diverse world in which we live. Diverse in nature, cosmopolitan ideas come in many forms. The focus here is on what have been termed 'strong' ethical forms of cosmopolitanism; that is, positions which conceptualise moral bonds and obligations as resulting from a shared, common humanity. The view that pupils should be taught that all (...) human beings are equal and, crucially, that this entails a responsibility to take action when human equity is challenged or transgressed, is finding increasing expression within educational literature. The suggestion explored here is that strong forms of ethical cosmopolitanism are limited in ways which seriously restrict their educational worth. In the final section, it is argued that forms of cultural and political cosmopolitanism (which are part of the lived experiences of intra- and supra-national citizenship) are best responded to by developing the requisite virtues in pupils to engage with diverse and dialogic communities. (shrink)

In his early work on the problem of coordination, Hans Reichenbach introduced axioms of coordination to describe the relationship between theory and observation. His insistence that these axioms are determinable a priori, however, causes him to ignore the normative dimensions of scientific inquiry and, in turn, generates a misleading interpretation of the theory-observation relationship. In response, I propose an alternative approach that describes this relationship through the framework of scientific practices. My argument will draw on two examples that have not (...) been explored by the philosophical literature in the context of coordination problems: the clinical definition of death and Stanley Prusiner’s prion hypothesis. (shrink)