Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC’s ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically (...) and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved. (shrink)

I. We know fairly well how the City Dionysia at Athens was celebrated in classical times. But although the numerous dramatic festivals of the Hellenistic period were in many respects modelled on the Athenian Dionysia, it is not clear how the performances at these festivals were organized. The difficulty arises from the fact that apart from a few great centres which may have had their own theatre production, playwrights, actors, etc., the majority of cities depended on the travelling of Dionysos’.1 (...) It seems that the of Dionysiac artists were formed early in the third century. Three major Dionysiac associations—the Athenian, the Isthmian and Nemean, and the Ionian and Hellespontian—operated in Greece, Asia Minor, and the islands in Hellenistic times. The question is how these associations functioned. Were they theatrical companies as well as professional guilds? Did they undertake the organization of musical and dramatic performances at various festivals? Was there a division of territories between the and were certain festivals dominated by certain guilds? (shrink)

Aristotle argued that you need some wealth to live well. The Stoics argued that you could live well with or without wealth. But the Cynics argued that wealth is a hinderance. For the Cynics, a good life consists in self-sufficiency, or being able to rule and help yourself. You accomplish this by living simply and naturally, and by subjecting yourself to rigorous philosophical exercises. Cynics confronted people to get them to abandon extraneous possessions and positions of power to live better. (...) And while the Cynics were experts in living in this way, their ascetic lifestyles made their message curious to some audiences. This paper reflects on Cynic ascetic practices and the ways others perceived them. (shrink)

There are two fundamentally different approaches to innovation: incremental and radical. In Economics as Anatomy, G.M. Peter Swann argues that economics as a discipline needs both perspectives in order to create the maximum beneficial effect for the economy. Chapters explore how and why mainstream economics is very good at incremental innovation but seems uncomfortable with radical innovation. Swann argues that economics should follow the example of many other disciplines, transitioning from one field to a range of semi-autonomous sub-disciplines. In this (...) book, he compares the missing link in empirical economics to being the economic equivalent of anatomy, the basis of medical discourse. Working as a sequel to Swann's Putting Econometrics in its Place, this book will be a vital resource to those who are discontent with the state of mainstream economics, especially those actively seeking to promote change in the discipline. Students wishing to see progress in the teaching of economics will also benefit from this timely book. (shrink)

Next SectionFollowing the influential Gifford and Reith lectures by Onora O’Neill, this paper explores further the paradigm of individual autonomy which has been so dominant in bioethics until recently and concurs that it is an aberrant application and that conceptions of individual autonomy cannot provide a sufficient and convincing starting point for ethics within medical practice. We suggest that revision of the operational definition of patient autonomy is required for the twenty first century. We follow O’Neill in recommending a principled (...) version of patient autonomy, which for us involves the provision of sufficient and understandable information and space for patients, who have the capacity to make a settled choice about medical interventions on themselves, to do so responsibly in a manner considerate to others. We test it against the patient–doctor relationship in which each fully respects the autonomy of the other based on an unspoken covenant and bilateral trust between the doctor and patient. Indeed we consider that the dominance of the individual autonomy paradigm harmed that relationship. Although it seems to eliminate any residue of medical paternalism we suggest that it has tended to replace it with an equally (or possibly even more) unacceptable bioethical paternalism. In addition it may, for example, lead some doctors to consider mistakenly that unthinking acquiescence to a requested intervention against their clinical judgement is honouring “patient autonomy” when it is, in fact, abrogation of their duty as doctors. (shrink)

In _Violence and Civility_, Étienne Balibar boldly confronts the insidious causes of violence, racism, nationalism, and ethnic cleansing worldwide, as well as mass poverty and dispossession. Through a novel synthesis of theory and empirical studies of contemporary violence, the acclaimed thinker pushes past the limits of political philosophy to reconceive war, revolution, sovereignty, and class. Through the pathbreaking thought of Derrida, Balibar builds a topography of cruelty converted into extremism by ideology, juxtaposing its subjective forms and its objective manifestations. Engaging (...) with Marx, Hegel, Hobbes, Clausewitz, Schmitt, and Luxemburg, Balibar introduces a new, productive understanding of politics as antiviolence and a fresh approach to achieving and sustaining civility. Rooted in the principles of transformation and empowerment, this theory brings hope to a world increasingly divided even as it draws closer together. (shrink)

Exploratory behavior is considered under the following categories: (1) extrinsic exploration in which the animal seeks information about conventional reinforcers such as food, (2) intrinsic exploration which is directed toward stimuli which may have no biological significance, further divided into inspective and inquisitive exploration. In the former the animal inspects a particular object; in the latter, the animal performs behavior to make a change in its environment, rather than merely responding to a change. Extrinsic exploration is synonymous with the ethological (...) term, appetitive behavior. It is shown that much of the behavior indicative of frustration reported in intensively housed animals occurs when the appetitive component of a drive rather than the consummatory component, is prevented. Consideration of inspective exploration is necessary for good husbandry practice, for fear is an important competing response. Inquisitive exploration has not been widely investigated in infraprimate species, but the authors present several possible examples in the species of common agricultural animals. However, they suggest that the propensity to show this type of exploration may vary between closely related species. In environments barren to the extent of stifling exploration, animals may develop apathy, and its relevance to animal welfare is discussed. (shrink)

Do we directly perceive physical objects? What is the significance of the qualification ‘directly’ here? Austin famously denied that there was a unique interpretation by which we could make sense of the traditional debate in the philosophy of perception. I look here at Thompson Clarke’s discussion of G. E. Moore and surface perception to answer Austin’s scepticism.

Biological evolution is a complex blend of ever changing structural stability, variability and emergence of new phe- notypes, niches, ecosystems. We wish to argue that the evo- lution of life marks the end of a physics world view of law entailed dynamics. Our considerations depend upon dis- cussing the variability of the very ”contexts of life”: the in- teractions between organisms, biological niches and ecosys- tems. These are ever changing, intrinsically indeterminate and even unprestatable: we do not know ahead of (...) time the ”niches” which constitute the boundary conditions on selec- tion. More generally, by the mathematical unprestatability of the ”phase space”, no laws of mo- tion can be formulated for evolution. We call this radical emergence, from life to life. The purpose of this paper is the integration of variation and diversity in a sound concep- tual frame and situate unpredictability at a novel theoretical level, that of the very phase space. Our argument will be carried on in close comparisons with physics and the mathematical constructions of phase spaces in that discipline. The role of symmetries as invariant preserving transformations will allow us to under- stand the nature of physical phase spaces and to stress the differences required for a sound biological theoretizing. In this frame, we discuss the novel notion of ”enablement”. Life lives in a web of enablement and radical emergence. This will restrict causal analyses to differential cases. Mutations or other causal differ- ences will allow us to stress that ”non conservation princi- ples” are at the core of evolution, in contrast to physical dynamics, largely based on conservation principles as sym- metries. Critical transitions, the main locus of symmetry changes in physics, will be discussed, and lead to ”extended criticality” as a conceptual frame for a better understanding of the living state of matter. (shrink)

Objective: To evaluate one ethics rounds model by describing nurses’ and doctors’ experiences of the rounds. Methods: Philosopher-ethicist-led interprofessional team ethics rounds concerning dialysis patient care problems were applied at three Swedish hospitals. The philosophers were instructed to promote mutual understanding and stimulate ethical reflection, without giving any recommendations or solutions. Interviews with seven doctors and 11 nurses were conducted regarding their experiences from the rounds, which were then analysed using content analysis. Findings: The goal of the rounds was partly (...) fulfilled. Participants described both positive and negative experiences. Good rounds included stimulation to broadened thinking, a sense of connecting, strengthened confidence to act, insight into moral responsibility and emotional relief. Negative experiences were associated with a sense of unconcern and alienation, as well as frustration with the lack of solutions and a sense of resignation that change is not possible. The findings suggest that the ethics rounds above all met the need of a forum for crossing over professional boundaries. The philosophers seemed to play an important role in structuring and stimulating reasoned arguments. The nurses’ expectation that solutions to the ethical problems would be sought despite explicit instructions to the contrary was conspicuous. Conclusion: When assisting healthcare professionals to learn a way through ethical problems in patient care, a balance should be found between ethical analyses, conflict resolution and problem solving. A model based on the findings is presented. (shrink)

“Free riding,” used as a descriptive term, refers to taking a jointly produced benefit without contributing towards its production. Used as a term of criticism, it refers to the wrongful failure to contribute towards the joint production of benefits that one receives. On either usage, the central interest of moral philosophy in free riding is the same: to specify the conditions under which not contributing towards the joint production of benefits that one receives is wrong, and to explain why.

Individual and Society in Buddhism. W. G. Weeraratne. Metro Printers Ltd., Colombo. 101pp £2.

Sovereigns, students and common people have been suggested as the intended audiences of Leviathan. No one of these groups can be singled out. Rather, Hobbes sought an audience beyond even that of his printed words. This reflects Hobbes's growing concern with the ‘corruption’ of the people, a concern which was spurred on by the events of the Civil War. While his attempt to undo or forestall corruption does not undermine his claims to having developed the ‘science of just and unjust’, (...) it does suggest that Hobbes's science is more than ‘infallible rules and the true science of equity and justice’. (shrink)

A picture held us captive. And we could not get outside it, for it lay in our language and language seemed to repeat it to us inexorably. Wittgenstein.

This paper explores ethical issues relating to the management of patients who are terminally ill and unable to maintain their own nutrition and hydration. A policy of sedation without hydration or nutrition is used in palliative medicine under certain circumstances. The author argues that this policy is dangerous, medically, ethically and legally, and can be disturbing for relatives. The role of the family in management is discussed. This issue requires wide debate by the public and the profession.

To speak of ‘the real subject’ or ‘the primary aim’ of a Platonic dialogue usually means to magnify one aspect of it at the expense of other aspects as important. Such is not my intention. It is quite clear, however, without prejudice to the philosophic value of any of the topics discussed, that the Protagoras is an attack upon the sophists as represented by Protagoras, the greatest of them. Hippias and Prodicus are present and some of the great man's glory (...) is reflected upon them; they are also no doubt to some extent implicated in his defeat, though they seem quite unaware of the fact. (shrink)

This article shows that the various regimes of “real socialism” uniformly failed to transcend the horizon of capitalism. They have remained class societies based on wage labour, commodity production, a money economy and welfare systems fed by redistribution. At the same time, they present peculiar features that are different from other versions of “state capitalism.” Traditional elites were annihilated, private property of capital in the hands of individuals or autonomous groups was prohibited, and the advantages accruing to leading positions were (...) not inherited, although equality in income was very modest. The main political invention of “real socialism” was the Party, a unique institution unlike any other, grounded in theory, but an institution of the state, over the executive, which had unprecedented powers of mobilisation and cultural influence. It had to be intellectual in character, as the system was steered through the Plan which was, in the final analysis, a text. The changes of 1989 took place partly mediated by the Party, partly against its rule. The successor regimes are conspicuously political owing to the nature of the adversary. (shrink)

Research ethics committees are charged with providing an opinion on whether research proposals are ethical. These committees are overseen by a central office that acts for the Department of Health and hence the State. An advisory group has recently reported back to the Department of Health, recommending that it should deal with inconsistency in the decisions made by different RECs. This article questions the desirability and feasibility of questing for consistent ethical decisions.