In recent years a growing trend has emerged which has argued for a greater priority to be placed upon patient autonomy within the doctor-patient relationship. The patient self determination movement, which first began to emerge in the 1960s, helps to mark the start of this ground swell of patient power sentiment. In keeping with this idea, the recent book by Robert M. Veatch, Patient heal thyself: How the new medicine puts the patient in charge addresses this very idea, arguing for (...) and promoting a new paradigm for medicine which places the patient firmly at the centre of all decision making in terms of medical treatment and care. Veatch is one of the leading bioethicists in the USA, having previously held the position of Senior Associate at the Hastings Center before moving to the Kennedy Institute of Ethics where he has served as director and Professor of Medical Ethics. (shrink)
On a certain blindness in human beings.--The gospel of relaxation.--The energies of men.--Habit.--The will.--Philosophy and its critics.--The will to believe.--The sentiment of rationality.--Great men and their environment.--What pragmatism means.--Humanism and truth.--The positive content of religious experience.
The new class of anti-inflammatory drugs, the COX-2 inhibitors, have been commercially successful to the point of market dominance within a short time of their launch. They attract a price premium on the basis that they are associated with fewer adverse gastric events than traditional anti-inflammatory drugs. This marketing continues even though a pivotal safety study with one of the COX-2 inhibitors, rofecoxib, showed a significant increase in myocardial infarction with rofecoxib use compared with a traditional anti-inflammatory drug. This finding (...) has led to a series of publications containing pooled analyses of existing data that both support and refute the possibility of increased cardiovascular risk with COX-2 inhibitors.These medical journal publications have served to obfuscate rather than provide guidance for medical practitioners. Consideration of a research ethics committee approach to this issue suggests that it would deal with the controversy in a straightforward manner—namely, it would simply inform research participants of the trial results with rofecoxib. The certainty of this research ethics committee approach raises the issue of whether it should be applied in normal medical practice outside of the research environment. A consideration of the legal tests for disclosure of information suggests that therapeutic medical practice should mirror that within the research environment, in this case. (shrink)
This response offers an interpretation of James Gustafson's “Participation: A Religious Worldview,” which thinks with Gustafson on the theme of “participation,” while highlighting points where my own thoughts diverge from his. The essay begins by drawing the reader's attention to Gustafson's style, arguing that the simple elegance of his writing constitutes part of his larger claim about the need to remove ourselves from the center of our thought. Next, the essay analyzes Gustafson's use of “participation” by putting it in (...) context and connecting it with his broader methodology. Finally, I draw the reader's attention to important loci in the text in order to show how Gustafson's essay helps address various extant misinterpretations of his thought but also to point to ways in which my “thinking with” Gustafson leads me to think otherwise than he does. (shrink)
Applied ethics work seems to me to be of three main kinds. There is participatory work, where a person whose specialism is ethics participates in a process leading to ethical judgments or decisions. And there are two kinds of teaching work where the teaching objective is to make learners better placed to participate in such processes; one kind of teaching work relates to matters which are specific to the future occupation of the learner, the other kind relates to matters which (...) are not specific to it. (shrink)
I take it as my assignment to criticize the Gauthier enterprise. At the outset, however, I should express my general agreement with David Gauthier's normative vision of a liberal social order, including the place that individual principles of morality hold in such an order. Whether the enterprise is, ultimately, judged to have succeeded or to have failed depends on the standards applied. Considered as a coherent grounding of such a social order in the rational choice behavior of persons, the enterprise (...) fails. Considered as an extended argument implying that persons should adopt the moral stance embodied in the Gauthier structure, the enterprise is, I dunk, largely successful. Considered as a set of empirically falsifiable propositions suggesting that persons do, indeed, choose as the Gauthier precepts dictate, the enterprise offers Humean hope rather than Hobbesian despair. (shrink)
Contributions in modern theoretical physics and chemistry on the behavior of nonlinear systems, exemplified by Ilya Prigogine's work on the thermodynamics of open systems, attract growing attention in economics. Our purpose here is to relate the new orientation in the natural sciences to a particular nonorthodox strand of thought within economics. All that is needed for this purpose is some appreciation of the general thrust of the enterprise, which involves a shift of perspective from the determinism of conventional physics to (...) the nonteleological open-endedness, creative, and nondetermined nature of evolutionary processes. (shrink)
John L. Austin believed that in the illocution he had discovered a fundamental element of our speech, the understanding of which would disclose the significance of all kinds of linguistic action: not only proposing marriage and finding guilt, but also stating, reporting, conjecturing, and all the rest of the things men can do linguistically. 2 We claim that the illocution, the full-fledged speech-act, is central to religious utterances as well, and that it provides a perspicuity in understanding them not elsewhere (...) provided in the work of recent philosophy of religion. In particular we hold that understanding religious talk through the illocution shows the way in which the representative and affective elements are connected to one another and to the utterance as a whole. There may, further, be features in such an analysis which can be extended to other forms of discourse than religious. (shrink)
The ontological argument appears in a multiplicity of forms. Over the past ten or twelve years, however, the philosophical community seems to have been concerned principally with those versions of the proof which claim that God is a necessary being. In contemporary literature, Professors Malcolm and Hartshorne have been the chief advocates of this view, both men holding that God must be conceived as a necessary being and that, as a result, his existence is able to be demonstrated a priori (...) . This claim has not gone unchallenged; indeed, numerous writers have argued that neither Malcolm nor Hartshorne has exercised due care in his use of ‘necessary’. That is, critics charge that the arguments of both men have only the appearance of validity, for in their reasonings the defenders of the a priori proof have tacitly assumed that God is a logically necessary being. Whether or not a being can be logically necessary, however, is a quaestio disputata . In fact, until recently the question was not in dispute at all—virtually all ‘competent judges’ agreed that only propositions could be spoken of as logically necessary, and thus that God must be defined as a physically or factually necessary being. But is the statement, ‘a physically necessary being exists’, logically true? Critics of the ontological argument think not; and in support of this view they offer analyses of ‘physical necessity’ which, they feel, not only give meaning to the phrase, but also show that a physically necessary being's existence can be proven only by some kind of a posteriori investigation. (shrink)
To commence any answer to the question “Can democracy promote the general welfare?” requires attention to the meaning of “general welfare.” If this term is drained of all significance by being defined as “whatever the political decision process determines it to be,” then there is no content to the question. The meaning of the term can be restored only by classifying possible outcomes of democratic political processes into two sets – those that are general in application over all citizens and (...) those that are discriminatory. (shrink)
In a detailed and spirited critique, Professor James M. Humber has found my defence of the ontological argument unconvincing. Humber's case rests upon his claim that my ‘error’ is due to my ‘having accepted an incorrect definition of “physically necessary being” … ’. Now I do indeed claim that God must be conceived as a factuall necessary being, i.e. as eternally independent. I take the notion of God's aseity or eternal independence to be relatively straightforward and uncontroversial; it is (...) accepted as an essential component of the concept God by many philosophers who also insist that there is no acceptable form of demonstrative theism. Thus, it is widely held that ‘God is a factually necessary being’ does not imply ‘God is a logically necessary being’; that God is eternally independent does not imply that he exists in all possible worlds. But it is precisely this view that I have argued is incorrect. While I concur that there is an intelligible concept of God as factually necessary, I deny that the existence of such a being is logically contingent, a mere matter of empirical fact. Indeed, a rigorous inspection of the concept of an eternally independent being reveals that whether that concept is instantiated, i.e. whether there exists a being exemplifying that concept, is knowable a priori . My claim is in fact stronger than this. I argue that the existence of an eternal, independent, omniscient and omnipotent being is demonstrable by conceptual analysis. It is Humber's contention that my alleged demonstration of God's existence crumbles upon the discovery of the unacceptability of my definition of ‘factually necessary being’. Let us see. (shrink)
The burgeoning field of medical ethics raises complicated questions for mental health researchers. The critical issues of risk assessment, beneficence, and the moral duties researchers owe their patients are analyzed in James DuBois's well written Ethics in Mental Health Research.