The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions.” By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the (...) other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency. (shrink)

Mental health professionals rightfully experience significant anxiety regarding their duty to protect when working with potentially dangerous individuals. This work dispels myths and provides readers with a resource addressing the situations where a duty to protect may apply.

Case studies and first-person stories about decision-making, written by professionals in the field, bring a uniquely personal touch to this valuable text.

A PERSONAL PHILOSOPHY FOR WAR TIME BY THE AUTHOR OF STREAMLINE YOUR MIND A Personal Philosophy for War Time JAMES L. MURSELL Professor of Education Teachers ...

After his father passed away, James Nolan's mother gave him a box of materials that his dad had kept private. To Nolan's complete surprise, the contents revealed the role his grandfather had played as a doctor in the Manhattan Project. Dr. Nolan, it turned out, had been a significant figure. A talented radiologist, he cared for the scientists on the Project, helped organize the safety and evacuation plans for the Trinity Test at Alamogordo, escorted the "Little Boy" bomb from (...) Los Alamos to Japan, and was one of the first Americans to enter the irradiated ruins of Hiroshima and Nagasaki. The documents set Nolan on a hunt for more information about his grandfather and more generally about the conflicted role that medical personnel played in the early years of atomic testing. The result is a compelling history of the dawn of the atomic age as seen through the eyes of men and women torn between their duty and desire to win the war and their oath to protect life. Nolan follows his grandfather and medical colleagues as they seek to maximize safety while serving leaders determined to minimize delays, and as they consider the ethics of ending the deadliest of all wars with the most lethal of all weapons. The result, Nolan shows, was a very human pattern of caution, co-optation, and complicity. A vital and vivid account of a largely unknown chapter in atomic history, Delivering Little Boy is also a profound meditation on the professional and moral dilemmas that ordinary people face in extraordinary times. (shrink)

Scepticism about ought simpliciter is the view that there is no such thing as what one ought simpliciter to do. Instead, practical deliberation is governed by a plurality of normative standpoints, each authoritative from their own perspective but none authoritative simpliciter. This paper aims to resist such scepticism. After setting out the challenge in general terms, I argue that scepticism can be resisted by rejecting a key assumption in the sceptic’s argument. This is the assumption that standpoint-relative ought judgments bring (...) with them a commitment to act in accordance with those judgments. Instead, I propose an alternative account of our normative concepts according to which only ought simpliciter judgments commit one to acting in accordance with those judgments. In addition to answering the sceptical challenge, the proposal offers an independently motivated account of what makes a concept normatively authoritative. (shrink)

Organ donation after the circulatory determination of death requires the permanent cessation of circulation while organ donation after the brain determination of death requires the irreversible cessation of brain functions. The unified brain-based determination of death connects the brain and circulatory death criteria for circulatory death determination in organ donation as follows: permanent cessation of systemic circulation causes permanent cessation of brain circulation which causes permanent cessation of brain perfusion which causes permanent cessation of brain function. The relevant circulation that (...) must cease in circulatory death determination is that to the brain. Eliminating brain circulation from the donor ECMO organ perfusion circuit in thoracoabdominal NRP protocols satisfies the unified brain-based determination of death but only if the complete cessation of brain circulation can be proved. Despite its medical and physiologic rationale, the unified brain-based determination of death remains inconsistent with the Uniform Determination of Death Act. (shrink)

In this interview, James L. McClelland responds to questions regarding connectionist models of cognition, a theory inspired by information processing in the brain. McClelland explains the distinction between symbolic and non-symbolic processing for a better understanding of mental processes. He argues that connectionist models can perform the computations which we know the brain can perform. In addition, he responds to several general questions on the perspectives of computational models of cognition.

The concept of whole‐brain death is under attack again. Scholars are arguing that the concept of brain death per se—regardless of the focus on “higher,” “stem” or “whole”—is fundamentally flawed. These scholars have identified what they believe are serious discrepancies between the definition and criterion of brain death, and have pointed out that medical professionals and lay persons remain confused about its meaning. Yet whole‐brain death remains the standard for determining death in much of the Western world and its defenders (...) believe this concept best maps onto our everyday conception of death. (shrink)

The lesson is familiar. Kripke’s arguments in favor of a posteriori necessary truths annul the idea that conceivability is a guide to metaphysical possibility because determining that which is a priori is a separate issue from determining that which is necessary. Modal rationalists do not completely agree with this conclusion. Following recent work on two-dimensional semantics, David Chalmers suggests that two distinct semantic values can be assigned to a statement, depending on whether we consider possible worlds as counterfactual or counteractual. (...) The idea is that counterfactual possibilities yield familiar Kripkean intuitions, but that counteractuals fulfill the desired link between a priori conceivability and metaphysical possibility. In this paper, I discuss a problem for modalrationalism that arises through the use of material conditionals, or conditionals in the indicative mood. I then turn to Chalmers’ response, and suggest reasons why it is inadequate. I turn to another response from Chalmers, and suggest that, whilst it solves the fi rst issue, it is incapable of grounding modal rationalism. In conclusion I will suggest a way in which a tempered version of modal rationalism can be salvaged. (shrink)

The distinction between the "permanent" (will not reverse) and "irreversible" (cannot reverse) cessation of functions is critical to understand the meaning of a determination of death using circulatory–respiratory tests. Physicians determining death test only for the permanent cessation of circulation and respiration because they know that irreversible cessation follows rapidly and inevitably once circulation no longer will restore itself spontaneously and will not be restored medically. Although most statutes of death stipulate irreversible cessation of circulatory and respiratory functions, the accepted (...) medical standard is their permanent cessation because permanence is a perfect surrogate indicator for irreversibility, and using it permits a more timely declaration. Therefore, patients properly declared dead in donation after circulatory death (DCD) protocols satisfy the requirements of death statutes and do not violate the dead donor rule. The acronym DCD should represent organ "donation after circulatory death" to clarify that the death standard is the permanent cessation of circulation, not heartbeat. Heart donation in DCD does not retroactively negate the donor's death determination because circulation has ceased permanently. (shrink)

The definition of death is one of the oldest and most enduring problems in biophilosophy and bioethics. Serious controversies over formally defining death began with the invention of the positive-pressure mechanical ventilator in the 1950s. For the first time, physicians could maintain ventilation and, hence, circulation on patients who had sustained what had been previously lethal brain damage. Prior to the development of mechanical ventilators, brain injuries severe enough to induce apnea quickly progressed to cardiac arrest from hypoxemia. Before the (...) 1950s, the loss of spontaneous breathing and heartbeat were perfect predictors of death because the functioning of the brain and of all other organs ceased rapidly and nearly simultaneously thereafter, producing a unitary death phenomenon. In the pretechnological era, physicians and philosophers did not have to consider whether a human being who had lost certain “vital functions” but had retained others was alive, because such cases were technically impossible. (shrink)

Metaethical expressivism is typically characterised as the view that normative statements express desire-like attitudes instead of beliefs. However, in this paper I argue that expressivists should claim that normative statements express beliefs in normative propositions, and not merely in some deflationary sense but in a theoretically robust sense explicated by a theory of propositional attitudes. I first argue that this can be achieved by combining an interpretationist understanding of belief with a nonfactualist view of normative belief content. This results in (...) a view I call ‘interpretative expressivism’. I then argue that traditional arguments employed by expressivists that normative statements express noncognitive attitudes can just as well support the claim that normative statements express nonfactual or nonrepresentational beliefs. Finally, I argue that this view has a number of advantages to versions of expressivism that deny that normative statements express non-deflationary normative beliefs. (shrink)

Presents a North American philosophy of liberation that defends both metaphysics and philosophy of religion, and acts as a critique of neo-imperialism.

Considering the play written by Daniel Berrigan about his own civil disobedience (burning hundreds of draft files in Catonsville, Maryland), the author asks whether Catholics have adopted the American dream at the expense of Christianity. How should we live and philosophize in an age of American empire? Philosophy must be both practical and transformative. We need to question our political situation since 2001, and arrive at a liberatory philosophy and social theory “from below” so as to meet Berrigan’s liberatory, prophetic (...) theology “from above,” resulting in a philosophy and theology of liberation of and from the seductive imperialist center. The author further stresses individual self-appropriation and the critique of imperialism through a Marxist understanding of surplus value (as arising from labor time for which workers are not paid). There is a link between capitalistic imperialism and militarism, and President Bush has made illegitimate use of religion in the attempt to legitimate empire. Liberation is the good and the happiness that together result from doing the work of justice, free from capitalist corruption. In challenging capitalist empire, we ought to aim for the “downward mobility” of a simpler lifestyle, where self-appropriation leads to moral, religious, and practical conversion. An inhumane, capitalist society is fundamentally at odds with us as human beings, as philosophers, and as Christians. (shrink)

Abstract:Disturbing cases continue to be published of patients declared brain dead who later were found to have a few intact brain functions. We address the reasons for the mismatch between the whole-brain criterion and brain death tests, and suggest solutions. Many of the cases result from diagnostic errors in brain death determination. Others probably result from a tiny amount of residual blood flow to the brain despite intracranial circulatory arrest. Strategies to lessen the mismatch include improving brain death determination training (...) for physicians, mandating a test showing complete intracranial circulatory arrest, or revising the whole-brain criterion. (shrink)