The aim of this study is to gain an understanding of why employees misuse information systems resources in the workplace. Rather than consider “intention,” as existing behavioral research commonly does, this study investigates actual behavior and employs IS resource misuse as the dependent variable. Data from a web-based survey are analyzed using the partial least squares approach. In light of the dual-process approach and the theory of planned behavior, the findings suggest that IS resource misuse may be both an intentional (...) type of behavior and an unreasoned action. Perceived behavioral control influences employees’ IS resource misuse actions via their desires or intentions, whereas attitude toward such misuse affects these actions via employees’ desires alone. Subjective norm is found not to affect employees’ IS resource misuse via either desires or intentions. In terms of its theoretical contribution, this study considers unethical behavior in information systems by incorporating a dual-process model and the theory of planned behavior. With regard to its managerial significance, the study’s results will help managers to better understand why employees commit IS resource misuse within organizations. (shrink)

Takanat ha-shavim, Magen ṿa-shemesh. Ṿa-yaged Moshesh, hosafot ṿe-heʻarot ʻal sefer Takanat ha-shavim.

_The purpose_ of this study is the reflection on ways of philosophical legitimation for the "Self-made-man" idea in the worldview of the Renaissance and Reformation. _Theoretical basis._ Historical, comparative, and hermeneutic methods became the basis for this. The study is based on the works of Nicholas of Cusa, G. Pico della Mirandola, N. Machiavelli, M. Montaigne, E. Roterodamus, M. Luther, J. Calvin together with modern researchers of this period. _Originality._ The analysis allows us to come to the conclusion that casts (...) doubt on the still widespread belief according to which the emergence of the "Self-made-man" idea is localized by the process of forming the American cultural code and the ideological heritage of Benjamin Franklin. It is highlighted that the formation of this idea is the result of a long process that originated in the ancient world and gains a special impetus in the Renaissance and Reformation. Precisely in the cultural context of the latter, the ancient intention to recognize the individual’s right to self-determination and self-government, which in the depths of Christian theology acquires only a potentially universal character, becomes not only acceptable but also, in the context of Protestantism worldview, the only admissible, in fact, individual’s obligatory life guidelines. _Conclusions._ Humanistic and reformation thoughts quite naturally led to further ideological legitimation of the person’s idea of who is creating oneself. This legitimation was during the complex interaction of numerous factors of culture in the Late Middle Ages, as well as ideas and intentions inherited from Antiquity. Key among them was the gradual formation of a new social order, in essence, indifferent to paternalistic rudiments, together with the ethics of Protestantism corresponding to it. The latter does not only legalize but, de facto, sacralizes the individual’s reorientation from hopes for the synergy of God’s grace and own free will in personal salvation, toward the self-reliance and personal efforts, awareness of personal responsibility for the own fate as key principles of the "Self-made-man" concept. (shrink)

In this paper, we propose a new model for development, one that transcends the North–South dichotomy and goes beyond a narrow conception of development as an economic process. This model requires a paradigm shift toward a new metaphor that develops sustainability, rather than sustains development. We conclude by defending a ‘report card on development’ as a means for evaluating how countries perform within this new paradigm.

Sunnybrook Health Sciences Centre, Toronto and University of Toronto Ross E. G. Upshur * Sunnybrook Health Sciences Centre, Joint Centre for Bioethics University of Toronto, Toronto * Corresponding author: Ross E. G. Upshur, Primary Care Research Unit, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, #E-349, Toronto, Ontario, Canada M4N 3M5. Tel.: 416-480-4753; Fax: 416-480-4536; Email: ross.upshur{at}sunnybrook.ca ' + u + '@' + d + ' '//--> Abstract Are restrictive measures and duties to care ethically reasonably acceptable to faith-based organizations? This (...) study describes the perceptions of individually interviewed spiritual leaders of the disease control measures used during the recent SARS outbreak in Toronto. Four central themes were identified: the relationship between religious obligation and civic responsibilities; the role of faith-based organizations in supporting public health restrictive measures; the reciprocal obligations of public health and religious communities during restrictions; and justifiable limits to duties to care. We conclude that, within certain constraints, spiritual leaders find restrictive measures ethically reasonable and that spiritual leaders can play an important role during pandemic and epidemic control planning. Public health officials should therefore include them in the early and ongoing deliberations of the criteria and logistics for implementation during public health emergencies. CiteULike Connotea Del.icio.us What's this? (shrink)

In this paper, we explore the role of reciprocity in the employment of restrictive measures in contexts of contagion. Reciprocity should be understood as a substantive value that governs the use, level and extent of restrictive measures. We also argue that independent of the role reciprocity plays in the legitimisation the use of restrictive measures, reciprocity can also motivate support and compliance with legitimate restrictive measures. The importance of reciprocity has implications for how restrictive measures should be undertaken when preparing (...) and evaluating public health responses to contagion. (shrink)

Are restrictive measures and duties to care ethically reasonably acceptable to faith-based organizations? This study describes the perceptions of individually interviewed spiritual leaders of the disease control measures used during the recent SARS outbreak in Toronto. Four central themes were identified: the relationship between religious obligation and civic responsibilities; the role of faith-based organizations in supporting public health restrictive measures; the reciprocal obligations of public health and religious communities during restrictions; and justifiable limits to duties to care. We conclude that, (...) within certain constraints, spiritual leaders find restrictive measures ethically reasonable and that spiritual leaders can play an important role during pandemic and epidemic control planning. Public health officials should therefore include them in the early and ongoing deliberations of the criteria and logistics for implementation during public health emergencies. (shrink)

Codes of medical ethics (codes) are part of a longstanding tradition in which physicians publicly state their core values and commitments to patients, peers, and the public. However, codes are not static. Using the historical evolution of the Canadian Medical Association's Code of Ethics as an illustrative case, we argue that codes are living, socio-historically situated documents that comprise a mix of prescriptive and aspirational content. Reflecting their socio-historical situation, we can expect the upheaval of the COVID-19 pandemic to prompt (...) calls to revise codes. Indeed, Alex John London has argued in favour of specific modifications to the World Medical Association's International Code of Medical Ethics (which has since been revised) in light of moral and scientific failures that occurred during the COVID-19 pandemic. Responding to London, we address the more general question: should codes be modified to reflect lessons drawn from the COVID-19 pandemic or future such upheavals? We caution that codes face limitations as instruments of policy change because they are inherently interpretive and ‘multivocal’, that is, they usually underdetermine or provide more than one answer to the question, ‘What should I do now?’ Nonetheless, as both prescriptive and aspirational documents, codes also serve as tools for reflection and deliberation—collective practices that are necessary to engaging with and addressing the moral and scientific uncertainties inherent to medicine. (shrink)

_The purpose _is to study that period of evolution of Gogol’s position, in which his ideas of russian messianism are most clearly outlined ("Selected Passages" and "The Author’s Confession"). To delineate the forms of determining the influence of messianism on his negative assessments of the anthropology of the Early New Age and the Enlightenment. Realization of the specified purpose presupposes, first, the analysis of his way of interpreting humanism in the European classical philosophy, and, secondly, to clarify the nature of (...) his connection with the way of substantiating the idea of the Russian messianism. _Theoretical basis._ Our view of Gogol’s heritage is based on the conceptual positions of phenomenology, existentialism, and hermeneutics. _Originality._ It is revealed, that period of evolution of Gogol’s position, which most clearly outlines his ideas of russian messianism ("Selected Passages" and "The Author’s Confession"), his position on human nature and its calling is fundamentally different from the position of philosophy of Early New Age and the Enlightenment. If in the first case, it is a question of service to the russian empire, in the last one, it is a question of self-development of the person. Gogol’s dehumanization of those perceptions about the man that have occurred in European classical philosophy is a precondition in justification of russian messianism for him. One of its key factors is a narrow understanding of insight the ideas concerning the spiritual foundation of the world, namely – its reduction to the russian empire. _Conclusions._ Gogol’s philosophical doctrine of man is only partially described as belonging to the "philosophy of the heart". The disadvantage of this qualification is the impossibility of explaining the question of the origins in Gogol’s attempt to substantiate russian messianism. The article demonstrates that the deformation of the basic idea about the connectivity of man with the spiritual arche of the world is its substantive precondition for the philosophy of the Early New Age and the Enlightenment. Gogol narrows it down to the Russian Empire, which makes it impossible to positively delineate the orientations of the russian people. Therefore, his oeuvre during the work on "Selected Passages" and "The Author’s Confession" for future generations is a warning about the futility of a single russian path of development, isolated from European civilization. As the further development of russian thought and history proves, Gogol’s warning as a Ukrainian thinker really has not been heard. A vivid manifestation of this is the cave nationalism that we see today during the russian-Ukrainian war. (shrink)

_Purpose._ The main purpose of this research is to comprehend the philosophical principles in the spread and legitimation of the Self-made-man idea in the worldview transformations of the 17th century. _Theoretical basis._ Historical and comparative methods became fundamental ones for the research. The research is based on the creative heritage of R. Descartes, T. Hobbes, J. Locke, as well as the works of modern researchers. _Originality._ The analysis shows that the Self-made-man idea, which originated in the ancient world and gradually (...) spreads in the Christian Middle Ages, gained a powerful impetus in the philosophical and moral-legal metamorphoses of the 17th century. These metamorphoses theoretically substantiated and radically accelerated the transition from mystical to rational, from theocentric to the anthropocentric worldview, and, as a result, to the recognition of the intellectual autonomy of the individuals and the freedom of their own will, the emergence of the construct of natural human rights, the requirements of religious tolerance and freedom of conscience, ultimately, to the principle of reliance on one’s own strength and the individual’s personal responsibility for one’s own destiny. Exactly these ideas in interaction with the ideas of Puritanism became the theoretical basis for the formation of B. Franklin’s views and the corresponding cultural code. _Conclusions._ The philosophy of the 17th century, having laid the principles of a new – subject-centric – metaphysics, as well as the philosophical and legal foundations of liberal ideology, provided philosophical and moral-legal legitimation to the sporadic attempts of man to break out of the triple circle of fatalism, paternalism, and conformity to a rationally founded and the ever-growing orientation of the individual towards active self-determination and self-realization, self-reliance and personal responsibility for their own destiny as key principles of the Self-made-man concept. (shrink)

Some of the environmental crises can be avoided, but others come unannounced and the adverse effects affect the communities as a whole with women, children and people with disabilities being affected the most. The world is in constant flux where climate changes are affecting the daily lives of humanity and the ecosystem as a whole. Global efforts towards environmental crises are in place including the Sustainable Development Goals (SDGs), Hyogo protocol and Sendai framework among other legislations, safeguarding the environment as (...) a whole. Women have played many roles when responding, preparing and mitigating the adverse effects of environmental crises with some of the roles visible and others invisible and unpaid. Women have been involved in identifying hazards through their indigenous knowledge systems and manoeuvring ways for the continuity of lives in their local communities. This study utilised a qualitative research methodology. A case study of Cyclone Idai in Chipinge was explored. Moser’s triple framework and the African Ecofeminist theory guided the discussions in this article.Contribution: The article concluded by recommending that concerted efforts should be made to emancipate women and pragmatically embrace gender as an essential variable in the environmental crisis. (shrink)

BackgroundAs a number of commentators have noted, SARS exposed the vulnerabilities of our health care systems and governance structures. Health care professionals (HCPs) and hospital systems that bore the brunt of the SARS outbreak continue to struggle with the aftermath of the crisis. Indeed, HCPs – both in clinical care and in public health – were severely tested by SARS. Unprecedented demands were placed on their skills and expertise, and their personal commitment to their profession was severely tried. Many were (...) exposed to serious risk of morbidity and mortality, as evidenced by the World Health Organization figures showing that approximately 30% of reported cases were among HCPs, some of whom died from the infection. Despite this challenge, professional codes of ethics are silent on the issue of duty to care during communicable disease outbreaks, thus providing no guidance on what is expected of HCPs or how they ought to approach their duty to care in the face of risk.DiscussionIn the aftermath of SARS and with the spectre of a pandemic avian influenza, it is imperative that we (re)consider the obligations of HCPs for patients with severe infectious diseases, particularly diseases that pose risks to those providing care. It is of pressing importance that organizations representing HCPs give clear indication of what standard of care is expected of their members in the event of a pandemic. In this paper, we address the issue of special obligations of HCPs during an infectious disease outbreak. We argue that there is a pressing need to clarify the rights and responsibilities of HCPs in the current context of pandemic flu preparedness, and that these rights and responsibilities ought to be codified in professional codes of ethics. Finally, we present a brief historical accounting of the treatment of the duty to care in professional health care codes of ethics.SummaryAn honest and critical examination of the role of HCPs during communicable disease outbreaks is needed in order to provide guidelines regarding professional rights and responsibilities, as well as ethical duties and obligations. With this paper, we hope to open the social dialogue and advance the public debate on this increasingly urgent issue. (shrink)

Children with autism spectrum disorder show marked difficulties in reading comprehension, a complex cognitive skill fundamental to successful daily functioning that is associated with core executive functions. However, the neurophysiological mechanisms underlying reading comprehension deficits in these children remain elusive. Twenty-one right-handed males with high-functioning ASD and 23 age-, IQ-, educational level-, sex- and handedness-matched typically developing individuals underwent a reading comprehension test and the semantic verbal fluency test that tapped core executive functions underlying reading comprehension during concurrent prefrontal functional (...) near-infrared spectroscopy measurement. Participants’ information processing efficiency was also assessed. High-functioning ASD children exhibited general reading comprehension [main effect of group: F = 7.58, p = 0.009], selective verbal fluency deficits [Group × category interaction: F = 4.90, p = 0.032] and slower processing speed. Regarding the hemodynamics of the prefrontal cortex, although ASD individuals showed comparable patterns of PFC brain activation to their healthy counterparts, lower PFC intrahemispheric [main effect of group: F = 11.36, p = 0.002] and interhemispheric [main effect of group: F = 7.79, p = 0.008] functional connectivity were evident during the semantic verbal fluency test. At the whole-group level, poorer reading comprehension performance was associated with poorer performance in the semantic verbal fluency test. Moreover, poorer semantic verbal fluency test performance was associated with slower information processing speed, which is associated with reduced left medial PFC functional connectivity. Abnormal intrahemispheric and interhemispheric prefrontal hypoconnectivity is associated with deficits in executive processes essential for reading comprehension in ASD. Our study has provided important implications for the neuropsychological and neurophysiological mechanisms underlying reading comprehension deficits in ASD. (shrink)

Cultural competence, a clinical skill to recognise patients' cultural and religious beliefs, is an integral element in patient‐centred medical practice. In the area of death and dying, physicians' understanding of patients' and families' values is essential for the delivery of culturally appropriate care. Dementia is a neurodegenerative condition marked by the decline of cognitive functions. When the condition progresses and deteriorates, patients with advanced dementia often have eating and swallowing problems and are at high risk of developing malnutrition. Enteral tube (...) feeding is a conventional means of providing artificial nutrition and hydration to meet nutritional needs, but its benefits to the frail population are limitedly shown in the clinical evidence. Forgoing tube feeding is ethically challenging when patients are mentally incompetent and in the absence of an advance directive. Unlike some developed countries, like the United States of America, death and dying is a sensitive issue or even a taboo in some cultures in developing countries that forgoing enteral tube feeding is clinically and ethically challenging, such as China and Malaysia. This article in three parts 1) discusses the clinical and ethical issues related to forgoing tube feeding among patients with advanced dementia, 2) describes how Hong Kong Chinese, North American, and Malaysian Islamic cultures respond differently in the decision‐making patterns of forgoing tube feeding for patients with advanced dementia, and 3) reiterates the clinical implications of cultural competence in end‐of‐life care. (shrink)

We have lost one of the giants of the twentieth century physics when Yoichiro Nambu passed away in July, 2015, at the age of 94. Today's Standard Model, though still incomplete in many respects, is the culmination of the most successful theory of the Universe to date, and it is built upon foundations provided by discoveries made by Nambu in the 1960s: the mechanism of spontaneously broken symmetry in Nature (with G Jona-Lasinio) and the hidden new SU(3) symmetry of quarks (...) and gluons (with M-Y Han). In this volume honoring Nambu's memory, World Scientific Publishing presents a unique collection of papers written by his former colleagues, collaborating researchers and former students and associates, not only citing Nambu's great contributions in physics but also many personal and private reminiscences, some never told before. This book is a volume for all who benefited not only from Nambu's contributions toward understanding the Universe but also his warm and kind persona. It is a great addition to the history of contemporary physics. (shrink)

Background Psychiatric electroceutical interventions (PEIs) use electrical or magnetic stimulation to treat mental disorders and may raise different ethical concerns than other therapies such as medications or talk therapy. Yet little is known about stakeholders’ perceptions of, and ethical concerns related to, these interventions. We aimed to better understand the ethical concerns of a variety of stakeholder groups (patients with depression, caregivers of patients, members of the public, and psychiatrists) regarding four PEIs: electroconvulsive therapy (ECT), repetitive transcranial magnetic stimulation (rTMS), (...) deep brain stimulation (DBS), and adaptive brain implants (ABI).Methods We conducted a national survey of these four stakeholder groups, using an embedded video vignette experiment depicting a patient with treatment-resistant depression and her psychiatrist discussing the possibility of treatment with one of the four PEIs.Results Participants’ ethical concerns varied by stakeholder group, by PEI, and by the interaction of the two. The three non-clinician groups tended to have similar ethical concerns, but to differ from psychiatrists. Similar concerns were raised with regard to the two implantable technologies, DBS and ABI. Overall, there was relatively little concern about the involuntary use of PEIs, though some expressed concern about the adequacy of information provided during the consent process. There was also significant concern that patients may not receive helpful therapies.Conclusions To our knowledge, this is the first national survey that includes multiple stakeholder groups and multiple PEI modalities. A better understanding of the ethical concerns of stakeholders can help to shape clinical practice and health care policy regarding PEIs. (shrink)

The historical development of the famous Einstein formula \ is briefly discussed. In this paper, on the basis of the Einstein viewpoint a new general approach is proposed for demonstrating the correctness of the formula \ . It is can be seen that the generalized approach leads to Einstein’s famous formula, too. During recent years, various papers have been published concerning the incompleteness of this famous formula. It is demonstrated that the presented claims in these articles are not mathematically legitimate. (...) It is clear that there are still some important misunderstandings concerning the interpretation of Einstein’s mass-energy equivalence formula. (shrink)

Evidence from our research on young children's temporal understanding supports Hoerl & McCormack's view that young children rely on a temporal updating system to change representations over time. We propose that the shift from temporal updating to temporal reasoning is enabled by children's expanding representations of event sequences, along with developments in language, memory, and other cognitive competencies.

The required professional and ethical pronouncements of accountants mean that auditors need to be competent and exercise due care and skill in the performance of their audits. In this study, we examine what happens when auditors take on more clients than they should, thus raising doubts about their ability to maintain competence and audit quality. Using 2803 observations of Malaysian companies from 2010 to 2013, we find that auditors with multiple clients are associated with lower earnings quality, proxied by total (...) accruals and discretionary accruals. Our results demonstrate that associating client firms’ reported discretionary accruals with individual auditors, rather than their firms or offices, is important in determining audit quality. Moreover, we demonstrate that the disclosure of auditors’ signatures on their reports is useful for assessing auditor quality at the individual level, thus contributing to the debate on the usefulness of having auditor identities on reports. (shrink)

AbstractWhen considering the manner of death, two categories can be distinguished, namely natural death and unnatural death. Though most physicians think that the distinction between the two is evident, this is not the case.When comparing the Netherlands, Belgium, England and Germany it is noticed that the terms natural and unnatural might be used in law but are not defined by law. In practice, the term unnatural death is used when there is an external cause of death, but even that turns (...) out to not be sufficient in making an obvious difference between the two terms. Different countries may even label the same death differently. A, at times philosophical and semantic, discussion shows that when it comes to causes of death a very large grey area exists between natural and unnatural causes of death. The Netherlands, Belgium and Germany even have the possibility to label a death as natural without actually knowing the cause of death.In conclusion, we recommend a new system in which the circumstances surrounding a death are properly investigated. This should lead to a report to an independent legal expert, who is able to decide if and what conclusion can be drawn, from a judicial and a public point of view, thereby, making the distinction and the use of the terms natural and unnatural/nonnatural obsolete. (shrink)

Background Moral sensitivity and academic integrity discernment hold paramount importance for healthcare professionals. Owing to distinct undergraduate educational backgrounds, nurses and physicians may exhibit divergent moral perspectives, academic integrity cognisance, and moral sensitivity within clinical environments. A limited number of studies have investigated the disparities and congruencies pertaining to moral sensitivity and academic ethical awareness among nursing and medical students. Objective The study compares moral sensitivity and academic ethical awareness of undergraduate nursing and medical students with and without clinical exposure. (...) Research design A self-administered cross-sectional survey conducted from January to February 2022 was used to collect data from a medical school in Hong Kong. Participants and research context A total of 545 respondents, including 137 nursing students and 408 medical students, completed the questionnaire. Ethical consideration Ethics approval of the study was obtained. Written consent was waived to maintain anonymity because completing the questionnaire was considered implied consent. Findings Both groups of undergraduates demonstrated a high level of bioethics knowledge. In terms of academic integrity, medical students were found to have a less concerned attitude towards punctuality, attendance, and skipping classes. Regarding moral sensitivity, senior medical students with clinical experience put less emphasis on decision-making involving patient participation, while senior nursing students were more hesitant in withholding treatment for incompetent patients who refused treatment. Both nursing and medical students showed decreased moral sensitivity in the ‘conflicts’ domain with increased clinical exposure. Conclusion Study findings contribute to the discussion comparing the ethical attitudes of nursing and medical students. More effort should be made in nursing and medical education to promote practices in line with high academic integrity and to develop the ability to be morally sensitive in professional settings. (shrink)

Trust is a key component in delivering quality and respectful care within health care systems. However, a growing lack of confidence in health care, particularly among specific subgroups of the population in the United States, could further widen health disparities. In this essay, we explore one approach to building trust and reaching diverse communities to promote health: engaging community‐based organizations (CBOs) as trusted community messengers. We present case studies of partnerships in health promotion, community education, and outreach that showcase how (...) CBOs’ programs build and leverage trust in health care systems through their workforce, services, and engagement with the community. (shrink)

Contemporary bioethics education has been developed predominately within Euro-American contexts, and now, other global regions are increasingly joining the field, leading to a richer global understanding. Nevertheless, many standard bioethics curriculum materials retain a narrow geographic focus. The purpose of this article is to use local cases from the Asia-Pacific region as examples for exploring questions such as ‘what makes a case or example truly local, and why?’, ‘what topics have we found to be best explained through local cases or (...) examples?’, and ‘how does one identify a relevant local case?’ Furthermore, we consider the global application of local cases to help extend the possible scope of the discussion, opening new avenues for the development of practical bioethics educational materials. We begin with a background description and discussion of why local cases enhance bioethics education, move to an overview of what is currently available and what is not for the region, and then outline a discussion of what it means to be local using example cases drawn from Hong Kong, Australia, Pakistan, and Malaysia. We are not creating a casebook but rather constructing by example a toolbox for designing active and dynamic learning cases using regional diversity as contextualised cases with generalised principles. (shrink)

Producing content-related gestures has been found to impact students’ learning, whether such gestures are spontaneously generated by the learner in the course of problem-solving, or participants are instructed to pose based on experimenter instructions during problem-solving and word learning. Few studies, however, have investigated the effect of (a) performing instructed gestures while learning concepts or (b) producing gestures without there being an implied connection between the gestures and the concepts being learned. The two studies reported here investigate the impact of (...) instructed hand movements on students’ subsequent understanding of a concept. Students were asked to watch an instructional video—focused on the concept of statistical model—three times. Two experimental groups were given a secondary task to perform while watching the video, which involved moving their hands to mimic the placement and orientation of red rectangular bars overlaid on the video. Students were told that the focus of the study was multitasking, and that the instructed hand movements were unrelated to the material being learned. In the content-match group the placement of the hands reinforced the concept being explained, and in the content-mismatch group it did not. A control group was not asked to perform a secondary task. In both studies, findings indicate that students in the content-match group performed better on the posttest, and showed less variation in performance, than did students in the content-mismatch group, with control students falling in between. Instructed hand movement—even when presented as an unrelated, secondary task—can affect students’ learning of a complex concept. (shrink)

Ben Saunders claims that actual consent is not necessary for organ donation due to ‘normative consent’, a concept he borrows from David Estlund. Combining normative consent with Peter Singer's ‘greater moral evil principle’, Saunders argues that it is immoral for an individual to refuse consent to donate his or her organs. If a presumed consent policy were thus adopted, it would be morally legitimate to remove organs from individuals whose wishes concerning donation are not known. This paper disputes Saunders' arguments. (...) First, if death caused by the absence of organ transplant is the operational premise, then, there is nothing of comparable moral precedence under which a person is not obligated to donate. Saunders' use of Singer's principle produces a duty to donate in almost all circumstances. However, this premise is based on a flawed interpretation of cause and effect between organ availability and death. Second, given growing moral and scientific agreement that the organ donors in heart-beating and non-heart-beating procurement protocols are not dead when their organs are surgically removed, it is not at all clear that people have a duty to consent to their lives being taken for their organs. Third, Saunders' claim that there can be good reasons for refusing consent clashes with his claim that there is a moral obligation for everyone to donate their organs. Saunders' argument is more consistent with a conclusion of ‘mandatory consent’. Finally, it is argued that Saunders' policy, if put into place, would be totalitarian in scope and would therefore be inconsistent with the freedom required for a democratic society. (shrink)