Over several decades, ethics and law have been applied to medical education and practice in a way that reflects the continuation during the twentieth century of the strong distinction between facts and values. We explain the development of applied ethics and applied medical law and report selected results that reflect this applied model from an empirical project examining doctors’ decisions on withdrawing/withholding treatment from patients who lack decision-making capacity. The model is critiqued, and an alternative “constitutive” model is supported on (...) the basis that medicine, medical law, and medical ethics exemplify the inevitable entanglement of facts and values. The model requires that ethics and law be taught across the medical education curriculum and integrated with the basic and clinical sciences and that they be perceived as an integral component of medical evidence and practice. Law, in particular, would rank as equal in normative authority to the relevant clinical scientific “facts” of the case, with graduating doctors having as strong a basic command of each category as the other. The normalization of legal knowledge as part of the clinician’s evidence base to be utilized in practice may provide adequate consolation for clinicians who may initially resent further perceived incursions on their traditional independence and discretion. (shrink)

The Exclusion Argument for physicalism maintains that since (1) every physical effect has a sufficient physical cause, and (2) cases of causal overdetermination are rare, it follows that if (3) mental events cause physical events as frequently as they seem to, then (4) mental events must be physical in nature. In defence of (1), it is sometimes said that (1) is supported if not entailed by conservation laws. Against this, I argue that conservation laws do not lend sufficient support to (...) (1) to render its denial ‘unscientific’, and that those who accept (3) and deny (4) may consequently respond to the Exclusion Argument by denying (1) without thereby setting themselves at odds with current science. I also argue that conservation laws are compatible with (3) and the negation of (4), and that one can therefore accept conservation laws and (3) while denying both (1) and (4). (shrink)

A popular response to the Exclusion Argument for physicalism maintains that mental events depend on their physical bases in such a way that the causation of a physical effect by a mental event and its physical base needn’t generate any problematic form of causal overdetermination, even if mental events are numerically distinct from and irreducible to their physical bases. This paper presents and defends a form of dualism that implements this response by using a dispositional essentialist view of properties to (...) argue that the psychophysical laws linking mental events to their physical bases are metaphysically necessary. I show the advantages of such a position over an alternative form of dualism that merely places more “modal weight” on psychophysical laws than on physical laws. The position is then defended against the objection that it is inconsistent with dualism. Lastly, some suggestions are made as to how dualists might clarify the contribution that mental causes make to their physical effects. (shrink)

Much of the commentary in the wake of the Charlie Gard litigation was aimed at apparent shortcomings of the law. These include concerns about the perceived inability of the law to consider resourcing issues, the vagueness of the best interests test and the delays and costs of having disputes about potentially life-sustaining medical treatment resolved by the courts. These concerns are perennial ones that arise in response to difficult cases. Despite their persistence, we argue that many of these criticisms are (...) unfounded. The first part of this paper sets out the basic legal framework that operates when parents seek potentially life-sustaining treatment that doctors believe is against a child’s best interests, and describes the criticisms of that framework. The second part of the paper suggests an alternative approach that would give decision-making power to parents, and remove doctors’ ability to unilaterally withhold or withdraw life-sustaining treatment that they regard is futile. This proposal is grounded in several values that we argue should guide these regulatory choices. We also contend that the best interests test is justifiable and since the courts show no sign of departing from it, the focus should be on how to better elucidate the underlying values driving decisions. We discuss the advantages of our proposed approach and how it would address some of the criticisms aimed at the law. Finally, we defend the current role that the judiciary plays, as an independent state-sanctioned process with a precedent-setting function. (shrink)

Heidegger is perhaps best known for stressing the function of time as temporality on the phenomena of life. There is a sense, however, in which the full significance of these insights can be best understood only through an exploration of the function of space as spatiality in the phenomena of life. At their juxtaposition, there is a privileged perspective on the meaning of life, and most importantly on what is the most meaningful life on the Heideggerian account, thephilosophical life. The (...) following short exploration uncovers this standpoint through an analysis of the word “clearing” as temporally expansive space. Through this device, there is a clear view of the role of philosophy, of truth, and of the meaning of life in Heidegger’s Being and Time. (shrink)