As the gap between the need for and supply of human organs continues to widen, the aim of securing additional sources of these “gifts of the body” has become a seemingly overriding moral imperative, one that could—and some argue, should—override the widespread ban on organ markets. As a medical practice, organ transplantation entails the inherent risk that one human being, a donor, will become little more than a means to the end of healing for another human being and that he (...) or she will come to have a purely instrumental value. With the establishment of organ markets, not only will the harms of instrumentalization be a reality—the ends of medicine will be further compromised and confused. (shrink)
Background: Decisions of patients, families, and health care providers about medical care at the end of life depend on many factors, including the societal culture. A pan-European study was conducted to determine the frequency and types of end of life practices in European intensive care units , including those in Israel. Several results of the Israeli subsample were different to those of the overall sample.Objective: The objective of this article was to explore these differences and provide a possible explanation based (...) on the impact of culture on end of life decision making.Method: All adult patients admitted consecutively to three Israeli ICUs who died or underwent any limitation of life saving interventions between 1 January 1999 and 30 June 2000 were studied prospectively . These patients were compared with a similar sample taken from the larger study carried out in 37 European ICUs. Patients were followed until discharge, death, or 2 months from the decision to limit therapy. End of life decisions were prospectively organised into one of five mutually exclusive categories: cardiopulmonary resuscitation , brain death, withholding treatment, withdrawing treatment, and active shortening of the dying process . The data also included patient characteristics , specific therapies limited, and the method of SDP.Results: The majority of patients had treatment withheld, none underwent SDP, 62 received CPR , 31 had brain death , and 18 underwent withdrawal of treatment . The primary reason given for limiting treatment was that the patient was unresponsive to therapy . End of life discussions were held with 132 families , the vast majority of which revolved around withholding treatment and the remainder concerned withdrawing treatment .There was a statistically significant association between the type of end of life decision and region—that is, the northern region of Europe, the central region, the southern region, and Israel.Conclusions: Regional culture plays an important part in end of life decision making. Differences relating to end of life decision making exist between regions and these differences can often be attributed to cultural factors. Such cultures not only affect patients and their families but also the health care workers who make and carry out such decisions. (shrink)
There is concern that human applications of modern genetic technologies may lead inexorably to eugenic abuse. To prevent such abuse, it is essential to have clear, formal principles as well as algorithms for distinguishing genetics from eugenics. This work identifies essential distinctions between eugenics and genetics in the implied nature of the social contract and the importance ascribed to individual welfare relative to society. Rawls's construction of 'justice as fairness' is used as a model for how a formal systems of (...) ethics can be used to proscribe eugenic practices. Rawls's synthesis can be applied to this problem if it is assumed that in the original condition all individuals are ignorant of their genetic constitution and unwilling to consent to social structures which may constrain their own potential. The principles of fairness applied to genetics requires that genetic interventions be directed at extending individual liberties and be applied to the greatest benefit of individuals with the least advantages. These principles are incompatible with negative eugenics which would further penalize those with genetic disadvantage. These principles limit positive eugenics to those practices which are designed to provide absolute benefit to those individuals with least advantage, are acceptable to its subjects, and further a system of basic equal liberties. This analysis also illustrates how simple deviations from first principles in Rawls's formulation could countenance eugenic applications of genetic technologies. (shrink)
F. D. Maurice was a distinguished Christian theologian, much respected by academics and artists of his day and afterwards. This volume, originally published in 1951, contains the text of seven lectures delivered in his honour in 1942 by Arthur Ramsey, later Archbishop of Canterbury, and covers Maurice's career and his impact on later students of theology. This book will be of value to anyone with an interest in Christian socialism or in Maurice's wider work.
In this monograph R. W. Beardsmore presents a lucid and readable presentation of what he takes moral reasoning to be and what he expects moral reasoning to accomplish. It is another in the long list of works which attempt to apply later-Wittgensteinian insights to the problems of ethics. The common moves run this way: Wittgenstein insists that to say that something is justified, or to say there are justifiable reasons for some position implies some fundamental agreement in our language game. (...) Moral argumentation can only take place within the context of a shared ethical language game. This moral viewpoint invests, what appear to be facts with value. According to Beardsmore the importance of shared moral viewpoints is missed by R. M. Hare with his dichotomizing of fact and value and his insistence on a decision of principle. Beardsmore also attacks the position of Phillipa Foot whom he sees on the opposite side of the issue from Hare. He sees Foot as insisting on the necessary dependence of values upon facts, which leads to her inability to account for changing moral viewpoints. Beardsmore tries to show that these views of Foot and Hare agree at least on one point, that there must be one specific way to give reasons for moral positions and hence solve moral disputes. Beardsmore has made a significant contribution by offering an illuminating application of Wittgenstein's insights to the problems of ethical theory. If they did nothing more, these insight's would be important in so far as they help to unlock the hold that the fact-value dichotomy has imposed on ethical theory for so long.--R. F. D. (shrink)
With his usual conciseness and lucidity, Körner attempts to show what philosophy is by looking at what it does, i.e., by investigating its problems, its branches and its history. Körner begins by setting out classic problems ranging from the problem of class-existence to the problem of freedom, and follows this by an investigation of various methodologies. After this introductory material the bulk of the book ranges over the central problems of most branches of philosophy and concludes with a brief sketch (...) of the history of philosophy. Of special note is Körner's treatment of metaphysics to which he gives an entire section of almost seventy pages. Those familiar with Körner's other work will find it a concise summary of his notion of metaphysics as exhibition and/or replacement-analysis of categorial frameworks. Also of note is his refreshing treatment of philosophy of mind. He sees the problem of intentionality as the chief consideration for that branch of philosophy. Although he makes mention of the linguistic approach to philosophy of mind his main thrust is to set the problems in Brentano's terms and show how the mind-body problem and theories of truth are handled from that framework. There are some drawbacks in the book. First: given the length of his treatment of metaphysics one could wish that somewhere Körner in his explication of metaphysics had given some recognition to the realistic alternatives to his transcendental metaphysics. Second: one must wonder to whom the book is addressed. The conciseness of Körner's style allows him to range over an unbelievably large area, but in such a pithy manner that it seems almost unimaginable that the educated layman will be able to follow the presentations and arguments, particularly those interspersed with logical notation. For example, how much value is there in condensing the logic of truth-functions, quantification and axiomatization into less than ten pages? For those in the field it is repetitive, for those not, it must be nearly unintelligible. One feels Körner really wanted to write a defense of metaphysics. This may have been a more efficacious project eliminating the need to write first for one audience then for another. The book is concise, lucid, and illuminating.--R. F. D. (shrink)
The Routledge Companion to Social and Political Philosophy is a comprehensive, definitive reference work, providing an up-to-date survey of the field, charting its history and key figures and movements, and addressing enduring questions as ...