The purpose of this article is to describe the development of a model of moral distress in military nursing. The model evolved through an analysis of the moral distress and military nursing literature, and the analysis of interview data obtained from US Army Nurse Corps officers (n = 13). Stories of moral distress (n = 10) given by the interview participants identified the process of the moral distress experience among military nurses and the dimensions of the military nursing moral distress (...) phenomenon. Models of both the process of military nursing moral distress and the phenomenon itself are proposed. Recommendations are made for the use of the military nursing moral distress models in future research studies and in interventions to ameliorate the experience of moral distress in crisis military deployments. (shrink)
``What Does a Right to Physician-Assisted Suicide (PAS) Legallyentail?''''Much of the bioethics literature focuses on the morality ofPAS but ignores the legal implications of the conclusions thereby wrought. Specifically, what does a legal right toPAS entail both on the part of the physician and the patient? Iargue that we must begin by distinguishing a right to PAS qua``external'''' to a particular physician-patient relationship from a right to PAS qua ``internal'''' to a particular physician-patientrelationship. The former constitutes a negative claim right (...) inrem that prohibits outside interference with the exercise of aright to PAS while the latter can provide the patient witha positive claim right in personam to obligatory assistancefrom his physician. Importantly, I argue that the creation of sucha patient right, however, originates with the physician who may exercise an unqualified right of first refusal prior to promisingto help her patient commit suicide. In doing so, I hope to establishthat explicit physician promises of assistance in dying shouldbecome legally binding. As such, current PAS law in both theNetherlands and Oregon is in need of substantive modification. (shrink)
In many research studies, tumor biopsies are an unavoidable requirement for achieving key scientific aims. Yet some commentators view mandatory research biopsies as coercive and suggest they should be optional, or at least optional until further data are obtained regarding their scientific usefulness. Further complicating the ethical picture is the fact that some research biopsies offer a potential for clinical benefit to trial participants. We interviewed and surveyed a convenience sample of participants in phase I clinical trials at a single (...) institution. Our primary aim was to describe phase I participants’ understanding of whether a research biopsy offered them the prospect of medical benefit. We also endeavored to describe participants’ views about biopsies—specifically, the benefits of biopsies, if any, and whether biopsies were acceptable, risky, or discouraged trial participation. Finally, we collected data on demographics and attitudes to see if any strong correlations with misunderstanding, acceptability, or riskiness existed. Overall, the respondents tended to view research biopsies as acceptable, though they did not succeed in identifying the lack of benefit of a research biopsy. These findings call for renewed efforts in consent conversations and documents to carefully describe the benefits, or lack thereof, of research biopsies. (shrink)
Surgical devices are often marketed before there is good evidence of their safety and effectiveness. Our paper discusses the ethical issues associated with the early marketing and use of new surgical devices from the perspectives of the six groups most concerned. Health Canada, which is responsible for licensing new surgical devices, should amend their requirements to include rigorous clinical trials that provide data on effectiveness and safety for each new product before it is marketed. Industry should comply with all Health (...) Canada requirements to obtain licenses for new products. Until Health Canada requires effectiveness and safety data, industry should cooperate with physicians in appropriate studies before releasing new products and should make balanced presentations of all the available evidence. Surgeons should, before using a new surgical device, assess the evidence on its effectiveness and safety and ensure they are properly trained and competent in using the device. Surgeons should provide their patients with an evaluation of the available evidence and inform them about possible complications and the surgeon's level of experience with the new device. Patients, who should be given an honest evaluation of the available evidence, possible complications, and the surgeon's experience, should be encouraged to evaluate the evidence and information to their own satisfaction to ensure that fully informed consent is given. Health institutions, responsible for regulating practice within their walls, should review new devices for safety, effectiveness, and economic impacts, before allowing their use. They should also limit the use of new surgical devices to surgeons trained and competent in the new technology. Professional societies should provide guidance on the early adoption of new surgical devices and technologies. We urge all those involved in the development, licensing, and use of new surgical devices to aim for higher ethical standards to protect the health and safety of patients requiring surgery. The lowest acceptable ethical standard would require device manufacturers to provide surgeons with accurate and timely information on the efficacy and safety of their products, allowing surgeons and patients to evaluate the evidence (and the significance of information not yet available) before surgery. (shrink)
Bhattacharyya, K. The Advaita concept of subjectivity.--Deutsch, E. Reflections on some aspects of the theory of rasa.--Nakamura, H. The dawn of modern thought in the East.--Organ, T. Causality, Indian and Greek.--Chatterjee, M. On types of classification.--Lacombe, O. Transcendental imagination.--Bahm, A. J. Standards for comparative philosophy.--Herring, H. Appearance, its significance and meaning in the history of philosophy.--Chang Chung-yuan. Pre-rational harmony in Heidegger's essential thinking and Chʼan thought.--Staal, J. F. Making sense of the Buddhist tetralemma.--Enomiya-Lassalle, H. M. The mysticism of Carl Albrecht (...) and Zen.--Parrinder, G. The nature of mysticism.--Cairns, G. E. Axiological contributions of East and West to the spiritual development of mankind.--Mayeda, S. Śaṇkara's view of ethics.--Mercier, A. On peace.--Barlingay, S. S. A discussion of some aspects of Gaudapāda's philosophy. (shrink)
In this work, the author presents the work of Allama M.T. Jafari, an Iranian, contemporary social thinker who worked within the parameters of Primordial School of Social Theory. This work is an attempt to enrich the existing literature on comparative sociology and social philosophy.
A Greek English Lexicon of the New Testament, being Grimm's Wilke's Clavis Novi Testamenti. Translated, Revised and Enlarged by Joseph Henry Thayer, D.D., Bussey Professor of New Testament Criticism and Interpretation in the Divinity School of Harvard University. Edinburgh, T. and T. Clark. 1886. 4to. pp. 726. 36s.Biblico Theological Lexicon to New Testament Greek. by Hermann Cremer, D.D., Professor of Theology in the University of Greifswald. Third English Edition. With Supplement. Translated from the latest German Edition by William Uewick, M.A. (...) Edinburgh, T. and T. Clark. 1886. 4to. pp. 943. 38s. (shrink)
This is a longer critical notice of T.M. Scanlon's book Moral Dimensions. The main crux of the article is to investigate how Scanlon's claims about the moral significance of intentions and reactive attitudes in this book fit with the earlier contractualist ethical theory which he presented in What We Owe to Each Other.
This paper is a short review of T.M. Scanlon's book What We Owe to Each Other. The book itself is already a philosophical classic. It defends a contractualist ethical theory but also has many interesting things to say about reasons, value, well-being, promises, relativism, and so on.
I present here a modal extension of T called KTLM which is, by several measures, the simplest modal extension of T yet presented. Its axiom uses only one sentence letter and has a modal depth of 2. Furthermore, KTLM can be realized as the logical union of two logics KM and KTL which each have the finite model property (f.m.p.), and so themselves are complete. Each of these two component logics has independent interest as well.
w a y s h a v e b e e n . W e a l l r e m e m b e r M a r x ' s p o l e m i c a g a i n s t P r o u d h o n , t h e Manifesto's critique of "historical action [yielding] to personal inventive action, historically created conditions of emancipation to fantastic ones, and the gradual spontaneous class (...) organizations of the proletariat to an organization of society specially contrived by these inventors" (Marx and Engels, 1986, 64), and the numerous other occasions when the fathers of "scientific socialism" went a f t e r t h e " u t o p i a n s . " I n general this Marxian aversion to drawing up blueprints has been healthy, fueled at least in part by a respect for the concrete specificity of the revolutionary situation and for the agents engaged in revolutionary activity: it is not the business of Marxist intellectuals to tell the agents of revolution how they are to construct their postrevolutionary economy. (shrink)
Ronald Dworkin argues on the basis of a theory of well-being that critical paternalism is self-defeating. People must endorse their lives if they are to benefit. This is the endorsement constraint and this paper rejects it. For certain kinds of important mistakes that people can make in their lives, the endorsement constraint is either incredible or too narrow to rule out as much paternalism as Dworkin wants. The endorsement constraint cannot be interpreted to give sensible judgements when people change their (...) minds about the value of their lives. And the main argument for the endorsement constraint, which is based on the value of integrity, does not support Dworkin's anti-paternalism. (shrink)
For close to forty years now T.M. Scanlon has been one of the most important contributors to moral and political philosophy in the Anglo-American world. Through both his writing and his teaching, he has played a central role in shaping the questions with which research in moral and political philosophy now grapples. Reasons and Recognition brings together fourteen new papers on an array of topics from the many areas to which Scanlon has made path-breaking contributions, each of which develops a (...) distinctive and independent position while critically engaging with central themes from Scanlon's own work in the area. Contributors include well-known senior figures in moral and political philosophy as well as important younger scholars whose work is just beginning to gain wider recognition. Taken together, these papers make evident the scope and lasting interest of Scanlon's contributions to moral and political philosophy while contributing to a deeper understanding of the issues addressed in his work. (shrink)