In February 2020, the British Medical Association will be surveying members for their views on what the BMA’s position on physician-assisted dying should be. The BMA is currently opposed to physician-assisted dying in all its forms, a position that was agreed in 2006 at the annual representative meeting, the Association’s policy-making conference.1 As previously reported in Ethics briefing,2 the decision to survey members follows a motion passed at last year’s ARM which called on the BMA to “carry out a poll (...) of members to ascertain their views on whether the BMA should adopt a neutral position with respect to a change in the law on assisted dying”. The results from the survey will not determine BMA policy. Rather, the results be published ahead of this year’s ARM and provided to those attending to inform a debate and discussion on the BMA’s policy position. More information about the survey, including a briefing pack of useful information, and information for BMA members on how to participate can be found online at www.bma.org.uk/PAD. ### High Court rejects Judicial reviews on assisted suicide The High Court has refused permission for two separate challenges to the law on assisted suicide in the UK to proceed to a full hearing. In the first case, Phil Newby, who has motor neuron disease, applied for judicial review of the law on assisted suicide and asked for the court to carry out a detailed examination of what he termed “legislative facts” – that is, an examination of the existing evidence on the “costs, risks and benefits” of regulating assisted suicide – including a cross-examination of relevant expert witnesses.1 Handing down the judgement, Lord Justice Irwin and Mrs Justice May, held that assisted dying …. (shrink)

Among the scanty remains of poetry attributed to Eumelus of Corinth two lines 2 stand out as different from the rest, first because they are concerned not with the legendary past but with an actual, present occasion, and secondly because they are composed not for Corinthians but for Messenians. Our evidence comes from Pausanias and may be set out at the start.

These guide-lines were produced for the Social Concern Track at Lausanne II. Their aim is to enable people who are engaged in evangelism in social action ministries to write up their experiences so that they and others can reflect on the theology underlying their approach. The guide-lines have since been widely used by people in different parts of the world. The findings of the case studies at Lausanne II were published in Transformation, January 1990.

The combination of genuine ethical concerns and fear of learning to use germ-line therapy for human disease must now be confronted. Until now, no established techniques were available to perform this treatment on a human. Through an integration of several fields of science and medicine, we have developed a nine step protocol at the germ-line level for the curative treatment of a genetic disease. Our purpose in this paper is to provide the first method to apply germ-line therapy to treat (...) those not yet born, who are destined to have a life threatening, or a severely debilitating genetic disease. We hope this proposal will initiate the process of a thorough analysis from both the scientific and ethical communities. As such, this proposal can be useful for official groups studying the advantages and disadvantages of germ-line therapy. (shrink)

In his Romanes Lecture of 1907, Lord Curzon emphasized the overwhelming influence of “natural” and “artificial” frontiers in the political history of the modern world. As Barry Smith has shown, the same could be said, more generally, of the natural and artificial boundaries that are at work in articulating every aspect of the reality with which we have to deal, not only in the world of geography, but the world of human experience at large. Moreover, once the natural/artificial distinction has (...) been recognized, it can be drawn across the board: not merely in relation to boundaries but also in relation to those entities that may be said to have boundaries. If something enjoys a natural boundary, its identity and survival conditions do not depend on us; it is a bona fide, mind-independent entity of its own. By contrast, if its boundary is artificial, then the entity itself is to some degree a fiat entity, a product of our worldmaking. Here I am interested in limit case: what if, pace Curzon and pace Smith, all entities turned out to be of the latter sort? (shrink)

There is a strong tendency in the scholarly and sub-scholarly literature on terrorism to treat it as something like an ideology. There is an equally strong tendency to treat it as always immoral. Both tendencies go hand in hand with a considerable degree of unclarity about the meaning of the term ‘terrorism’. I shall try to dispel this unclarity and I shall argue that the first tendency is the product of confusion and that once this is understood, we can see, (...) in the light of a more definite analysis of terrorism, that the second tendency raises issues of inconsistency, and even hypocrisy. Finally, I shall make some tentative suggestions about what categories of target may be morally legitimate objects of revolutionary violence, and I shall discuss some lines of objection to my overall approach. (shrink)

Germ-line therapy has long been regarded with great caution both by scientists and by ethicists. Even those who do not reject germ-line therapy in principle have tended to reject it in practice as carrying unacceptable risks in our current state of knowledge. For this reason, a recent paper by Rubenstein, Thomasma, Shon, and Zinaman is unusual in putting forward a serious proposal for the use of germ-line therapy in the foreseeable future.

It is a pleasure for me to give this opening address to the Royal Institute of Philosophy Conference on ‘Explanation’ for two reasons. The first is that it is succeeded by exciting symposia and other papers concerned with various special aspects of the topic of explanation. The second is that the conference is being held in my old alma mater , the University of Glasgow, where I did my first degree. Especially due to C. A. Campbell and George Brown there (...) was in the Logic Department a big emphasis on absolute idealism, especially F. H. Bradley. My inclinations were to oppose this line of thought and to espouse the empiricism and realism of Russell, Broad and the like. Empiricism was represented in the department by D. R. Cousin, a modest man who published relatively little, but who was of quite extraordinary philosophical acumen and lucidity, and by Miss M. J. Levett, whose translation of Plato's Theaetetus formed an important part of the philosophy syllabus. (shrink)

What exactly is a genetic disease? For a phrase one hears on a daily basis, there has been surprisingly little analysis of the underlying concept. Medical doctors seem perfectly willing to admit that the etiology of disease is typically complex, with a great many factors interacting to bring about a given condition. On such a view, descriptions of diseases like cancer as genetic seem at best highly simplistic, and at worst philosophically indefensible. On the other hand, there is clearly some (...) practical value to be had by classifying diseases according to their predominant cause when this can be accomplished in a theoretically satisfactory manner. The question therefore becomes exactly how one should go about selecting a single causal factor among many to explain the presence of disease. When an attempt to defend such causal selection is made at all, the standard accounts offered (Koch's postulates, Hill's epidemiological criteria, manipulability) are all clearly inadequate. I propose, however, an epidemiological account of disease causation which walks the fine line between practical applicability and theoretical considerations of causal complexity and attempts to compromise between patientcentered and population-centered concepts of disease. The epidemiological account is the most basic framework consistent with our strongly held intuitions about the causal classification of disease, yet it avoids the difficulties encountered by its competitors. (shrink)

Psychopathology is the science of what mental illnesses are. Affective psychopathology – or, alternately, the ‘psychopathology of affectivity’ – is the branch of psychopathology devoted to the study of mental disorders that implicate mental states associated with moods and emotions and what used to be called ‘passions’. Some segments of the history of affective psychopathology have been skillfully traced. However, there is one episode in that history that has not received the attention it deserves. It concerns medical writers in France, (...) England, and Scotland, during the latter half of the eighteenth century. The issue at stake is whether affective psychopathology should include or exclude questions of morality. (shrink)

Technical, ethical, and social questions of germ-line gene interventions have been widely discussed in the literature. The majority of these discussions focus on planned interventions executed on the nuclear DNA (nDNA). However, human cells also contain another set of genes that is the mitochondrial DNA (mtDNA). As the characteristics of the mtDNA grossly differ from those of nDNA, so do the social, ethical, psychological, and safety considerations of possible interventions on this part of the genetic substance.

Technical, ethical, and social questions of germ-line gene interventions have been widely discussed in the literature. The majority of these discussions focus on planned interventions executed on the nuclear DNA (nDNA). However, human cells also contain another set of genes that is the mitochondrial DNA (mtDNA). As the characteristics of the mtDNA grossly differ from those of nDNA, so do the social, ethical, psychological, and safety considerations of possible interventions on this part of the genetic substance.

On 26 February 2019, the Organ Donation Bill completed its passage through the Westminster Parliament, creating the legislative basis to introduce an opt-out system for organ donation in England. The Bill now awaits Royal Assent, following which it is anticipated that the new system will come into effect in spring 2020. In the intervening period, there will be a significant publicity campaign to inform the public about the change in the law and the options open to them, which are to: (...) The family will continue to be consulted and as an additional safeguard, will be able to provide information about any unregistered objections held by the individual before they died. The legislation follows a similar model to that which was introduced in Wales on 1 December 2015. While it is too early to draw firm conclusions from the experience in Wales, the early signs are positive. The latest full-year data show an increase from 61 to 74 deceased donors over the previous 12 months;1 and in the first three-quarters of 2018/2019, there have been 72 deceased donors.2 Given the number of donors is small and subject to natural variation year-on-year, National Health Service Blood and Transplant has been analysing cumulative data to identify …. (shrink)

An invaluable work especially for professionals and students in health care, bioethics, humanities, cultural studies, and for the educated lay reader, this volume offers a critical reflection on cultural competence and awareness in health care, an arena where world views and values often collide.