The right of adults with sound mind to consent to treatment or risk their own health for the benefit of the community in a clinical trial is unequivocally recognised by the law. But what about those vulnerable by virtue of their age, nature or position in society? Experts from the fields of medicine, philosophy, theology and law, explore the ethical and legal principles which seek to reconcile the individual's right to autonomy with the need to protect vulnerable groups. Discussions refer (...) both to specific groups and specific issues. (shrink)

Protecting the Vulnerable explores the reality of patient control and choice in health care and analyzes how decisions should be made on behalf of those deemed incapable of making decisions. The contributors, distinguished experts from the disciplines of medicine, ethics, theology, and law, look at the complex problem of autonomy and consent in health care and clinical research today from an illuminating perspective--its impact on the vulnerable members of society. The essays move from the exploration of lingering paternalism in health (...) care to the acute dilemma of treatment of and research on newborn babies. In covering both general and specific problems the collection reveals how exploitation can occur when the right of autonomy is eroded and where informed consent is illusory. Particularly vulnerable groups, such as children and people with mental handicaps, are discussed alongside cases where the vulnerability is itself an issue. Other areas covered include: `gesture' suicides, the practical problems of doctors in dealing with dependent patients, and the limits of proxy consent. All health care professionals, ethicists, policy makers, and lawyers currently engaged in the study or practice of health care ethics will find Protecting the Vulnerable to be a vital source of information for many years to come. (shrink)

The right of adults with sound mind to consent to treatment or risk their own health for the benefit of the community in a clinical trial is unequivocally recognised by the law. But what about those vulnerable by virtue of their age, nature or position in society? Experts from the fields of medicine, philosophy, theology and law, explore the ethical and legal principles which seek to reconcile the individual's right to autonomy with the need to protect vulnerable groups. Discussions refer (...) both to specific groups and specific issues. (shrink)

Medical Ethics has many unsung heros and heroines. Here we celebrate one of these and on telling part of her story hope to place modern medical ethics and bioethics in the UK more centrally within its historical and human contex.

Literaturkritikerinnen und -kritiker, die das Neue der Gegenwartsliteratur beobachten und filtern, sind im Vergleich zur Zeit der,Kritikerpäpste‘ mit einem deutlichen Relevanzverlust konfrontiert. Beobachter sprechen ihnen die Unabhängigkeit ihres Urteils ab, und das betrifft nicht nur die Legitimität ihrer literarischen Kriterien, sondern auch ihre Souveränität über ihre medialen Plattformen. Die Frage, was den Blick der Literaturkritik lenkt, ist deswegen auch eine nach ihren ökonomischen und systemischen Bedingungen. Die haben sich im vergangenen Jahrzehnt vor allem durch die Digitalisierung fundamental verändert. Feuilletons und (...) Kritiken, die in der herkömmlichen Landschaft der Massenmedien ihren Ort,unter dem Strich` auf den Zeitungsseiten hatten, finden sich jetzt im Feed, im konstanten Nachrichtenstrom, in Konkurrenz zu Ereignissen und Angeboten höchst unterschiedlicher Dimension wieder. Wie können sie sich behaupten? (shrink)

Jean-Luc Nancy is a philosopher. He is not simply a “thinker” or a “theorist”. Of course, philosophers spend their time thinking, often in the most theoretical and abs...

La Colombiade war bis zur französischen Revolution ein in Frankreich und in den westeuropäischen Ländern vielbeachtetes Epos. Aus heutiger Sicht ist das gut lesbare Gedicht erneut von Interesse: es wägt Segnungen und Schäden der Kolonialisierung gegeneinander ab, propagiert die Idee eines auf wissenschaftlichem und humanistischem Ethos gegründeten Europas, und artikuliert das aufklärerische Selbstbewusstsein einer schreibenden Frau. Die Einführung der Herausgeberin stellt das Gedicht in den Wissenshorizont der Entstehungszeit und skizziert die Rezeption. Der Anhang informiert über Textvarianten, bringt erläuternde Anmerkungen und (...) einen bibliographischen Informationsteil. (shrink)

Whether considering vegetarianism, women's rights, or the "humanity" of pets, this book goes to the heart of the question of why all animals matter.

Some commentators have condemned Kant’s moral project from a feminist perspective based on Kant’s apparently dim view of women as being innately morally deficient. Here I will argue that although his remarks concerning women are unsettling at first glance, a more detailed and closer examination shows that Kant’s view of women is actually far more complex and less unsettling than that attributed to him by various feminist critics. My argument, then, undercuts the justification for the severe feminist critique of Kant’s (...) moral project. (shrink)

The development of transplantation technology increasingly places before society a multitude of diverse, complex ethical and legal problems. The subject is the more complex because of the various divergent interests involved. There are the interests of the donor of organs, who has a right to protection of his legal position, and those of the patient in need of an often lifesaving organ. There are also the interests of the donor’s relatives, after his death, and those of the transplantation surgeons. The (...) international dimension of transplantation technology makes the picture even more complicated. Though this article is devoted to the European situation, the problems are similar all over the world. (shrink)

The development of transplantation technology increasingly places before society a multitude of diverse, complex ethical and legal problems. The subject is the more complex because of the various divergent interests involved. There are the interests of the donor of organs, who has a right to protection of his legal position, and those of the patient in need of an often lifesaving organ. There are also the interests of the donor’s relatives, after his death, and those of the transplantation surgeons. The (...) international dimension of transplantation technology makes the picture even more complicated. Though this article is devoted to the European situation, the problems are similar all over the world. (shrink)

This paper explores difficulties around consent in the context of organ retention and return. It addresses the proposals of the Independent Review Group in Scotland on the Retention of Organs at Post Mortem to speak of authorisation rather than consent. Practical problems about whose consent determines disputes in relation to organ retention are explored. If a young child dies and his mother refuses consent but his father agrees what should ensue? Should the expressed wishes of a deceased adult override the (...) objections of surviving relatives? The paper suggests much broader understanding of the issues embedded in organ retention is needed to provide solutions which truly meet families' and society's needs. (shrink)

Classical logic has proved inadequate in various areas of computer science, artificial intelligence, mathematics, philosopy and linguistics. This is an introduction to extensions of first-order logic, based on the principle that many-sorted logic (MSL) provides a unifying framework in which to place, for example, second-order logic, type theory, modal and dynamic logics and MSL itself. The aim is two fold: only one theorem-prover is needed; proofs of the metaproperties of the different existing calculi can be avoided by borrowing them from (...) MSL. To make the book accessible to readers from different disciplines, whilst maintaining precision, the author has supplied detailed step-by-step proofs, avoiding difficult arguments, and continually motivating the material with examples. Consequently this can be used as a reference, for self-teaching or for first-year graduate courses. (shrink)

Prolonging neonatal lifeThe paradox that medicine’s success breeds medicine’s problems is well known to readers of the Journal of Medical Ethics. Advances in neonatal medicine have worked wonders. Not long ago, extremely premature birth babies, or those born with very serious health problems, would inevitably have died. Today, neonatologists can resuscitate babies born at ever-earlier stages of gestation. And very ill babies also benefit from advances in neonatal intensive care. Infant lives can be prolonged. Unfortunately, several such babies will not (...) survive for long whatever is done for them. Others will live to leave hospital, but face severe health problems. Doctors have gained the ability to prolong neonatal life. But should they always do so? This question is central to the recent report of the Nuffield Council on Bioethics, Critical care decisions in fetal and neonatal medicine.1 In many quarters, the report received a very positive response, commended in The Lancet as “thoughtful, sensitive and sensible” and welcomed by the premature baby charity BLISS. Critics attacked on both flanks. The report goes too far—ushering in a culture of “throw away babies”. Or it does not go far enough—failing to endorse the Dutch precedent to sanction active neonatal euthanasia.TOO FAR?One of the key recommendations of the report is that guidelines be developed in relation to the institution of intensive neonatal care. It is these guidelines, which have been savaged by some parts of the media. The BMA called them “blanket rules” smothering clinical discretion. The guidelines on resuscitation at birth apply to babies born at the borderline of viability, that is, at or before a gestational age of 25 weeks 6 days. The earlier the baby is born, the lower are the chances that he/she will survive to leave hospital. Before 21 weeks 6 days, none of …. (shrink)

"A potent source of inspiration for anyone interested in the therapeutic potential of Buddhism. David Brazier writes with clarity and authority about the Zen way."—Mark Epstein, M.D. author of Thoughts Without a Thinker: Psychotherapy from a Buddhist Perspective. "Comprehensive and readable... should appeal to anyone broadly interested in Buddhism."—Helen Sieroda psychosynthesis psychotherapist. In this book, psychotherapist David Brazier offers readers in the West a fresh perspective on Buddhist psychology and demonstrates how Zen Buddhist techniques are integrated into psychotherapy. (...) Writing from the viewpoint of a Western psychotherapist, Dr. Brazier successfully demystifies Buddhist psychology, explains the conceptual foundations of Buddhist thought, and with the help of vivid case studies, clearly demonstrates how a Buddhist approach can provide a practical path to personal growth. (shrink)

The Human Tissue Act 2004 is designed to regulate the storage and use of organs and tissues from the living, and the removal, storage and use of the same material from the deceased. It repeals much criticized legislation, including the Human Tissue Act 1961, and establishes a Human Tissue Authority to ensure compliance with the Act via a licensing and monitoring regime. When the Act comes into force, probably in April 2006, it will be a criminal offence not to comply (...) with certain provisions of the Act, and a new offence of DNA 'theft' will be introduced. Importantly, the Act places consent at the centre of the system, both from the living and from or on behalf of the deceased. (shrink)

InWisdom, Information and Wonder, Mary Midgley tackles the question at the root of our civilization: What is knowledge for?

When Gautama Buddha first set forth the principles of what came to be known as Buddhism, it was, above all, in an effort to help people achieve freedom from mental suffering. In the twenty-five hundred years since the death of the "Great Physician", his disciples have continued to expand upon his teachings and to develop sophisticated psychotherapeutic methodologies. Yet, only recently has Western medicine begun to take its first tentative steps toward recognizing and embracing the therapeutic potential of Buddhism. In (...) a book that will do much to advance the fusion of two great psychotherapeutic traditions, psychotherapist David Brazier offers mental health practitioners in the West a fresh perspective on Buddhist psychology and demonstrates how Zen Buddhist techniques can be integrated successfully into their clinical practices. Writing from the perspective of a Western psychotherapist, Dr. Brazier successfully demystifies Buddhist psychology for fellow practitioners. He carefully explains the conceptual foundations of Buddhist thought, and with the help of numerous case studies, he clearly demonstrates their clinical applications. (shrink)

Developing a simple test to identify swiftly neonates with sepsis who carry the genetic variant which means that one dose of the recommended antibiotic, gentamicin, will cause the child to become profoundly deaf looks like an admirable objective. The baby needs antibiotics and needs them within 1 hour of admission to the neonatal intensive care unit. Conventional genetic tests take much longer to yield results. The test being trialled produces results in 25 min; a baby who carries the variant can (...) be treated with a different antibiotic. All the test requires is a gentle swab of the baby’s inner cheek. Babies can be treated for potentially fatal sepsis without the risk that the drugs designed to save their lives will cost them their hearing. Parents and healthcare staff are relieved of worry—a great idea? PALOH is not a trial of the safety or efficacy of the test, only to assess how feasible it will be to carry out this test in a busy NICU, without disrupting the care of the baby. A tiny painless ‘scrape’ will take a sample of DNA—what’s the fuss about? Several other invasive and painful procedures will be carried out without a fuss.1 The problem is DNA. Genetic information must be safeguarded from falling into the wrong hands. In section 45 of Human Tissue Act 2004, Parliament legislated to prohibit non-consensual DNA testing.1 It fits uncomfortably in a statute designed to regulate retention and uses of human material, after revelations that organs and tissue from the …. (shrink)

Formulated by Aquinas, commented on by post-Copernican philosophers and theologians, analysed in depth by C.S. Lewis, and deliberated by some contemporary writers, the question of multiple incarnations either within humanity or amongst extra-terrestrial sentient species is all too intermittently examined: ‘Can the Christ be incarnated more than once in our reality, or somewhere else in the universe, or another reality?’ In this paper, we examine the debate and the conclusions: that is, Lewis’s position within his philosophical theology and his analogical (...) narratives; also, some contemporary philosophers of religion and theologians (Karl Rahner, with Christopher L. Fisher and David Fergusson; Sjoerd L. Bonting and William B. Drees; E.L. Mascall and Brian Hebblethwaite; Oliver Crisp and Keith Ward). How do they relate to Aquinas’s handling of the question and how do they compare with Lewis’s approach based on a theology of the imagination (grounded in Augustine and Alice Meynell)? Can Lewis resolve the argument? Could alien species have witnessed wholly different acts, equally unique, costly to God, and necessary to the process of salvation? Any answer or explanation relates to the function and purpose of the incarnation: the Fall, original sin—therefore, how we define the boundaries, limits, of atonement. (shrink)

In the Philippines, all transplant centers are mandated by the Department of Health (DOH) to have a Hospital Transplant Ethics Committee (HTEC) to ensure that donations are altruistic, voluntary and free of coercion/commercial transactions. This study was undertaken primarily to describe the organizational and functional profile of existing HTECs and identify areas for improvement. This is a descriptive cross‐sectional study. There was variation in their logistical arrangements (support from hospital, filing systems, office spaces), operations (length and frequency of meetings, number (...) of referrals) and membership (composition, qualifications, occupation, training). The approval rate for donor‐recipient pairs is high with the majority of cases made by living non‐related donors. Appropriate reasons were cited for rejection. The perception of HTECs is that they are competent and confident in their decision‐making. However, there is a need to standardize HTEC composition, provide operating procedures and additional training which can be done by the DOH. (shrink)

En quoi consiste, ou devrait consister, l'éthique professionnelle en enseignement? Comment se manifeste-t- elle dans les gestes pédagogiques? Selon quels critères peut-on la juger? Comment développer l'éthique professionnelle dans le cadre des formations initiale et continue en enseignement? En tenant compte du contexte social et culturel du Québec, des principes éthiques déjà énoncés par le ministère de l'Education ainsi que des lois, codes et conventions ayant des incidences sur la pratique enseignante, les auteures présentent des éléments à considérer pour la (...) réflexion éthique sur l'agir professionnel. Elles proposent des clarifications conceptuelles et un certain nombre de repères et de balises afin de guider les enseignants et de stimuler la discussion sur l'éthique professionnelle, non seulement dans la classe, mais aussi dans l'école et dans la société. (shrink)

We know we have thoughts, but are we aware that we have styles of thought? This book, written by one of the most gifted and celebrated social thinkers of our time, is a contribution to understanding the rules of the different styles of thinking. Author Mary Douglas takes us through a range of thought styles from the vulgar to the refined. Throughout this fascinating journey, Thought Styles shows us how the different styles work and how outsiders can learn the (...) styles of insiders. The discussion ranges from the style of folklore to the styles of therapy, shopping, religion, and animal rights. The result is a book full of insight. Readers will find themselves thinking in new ways about the mechanics of communication in everyday life. Professionals and researchers in sociology, communication, and anthropology will especially appreciate this auspicious new book. (shrink)

How is hope to be found amid the ethical and political dilemmas of modern life? Writer and philosopher Mary Zournazi brought her questions to some of the most thoughtful intellectuals at work today. She discusses "joyful revolt" with Julia Kristeva, the idea of "the rest of the world" with Gayatri Spivak, the "art of living" with Michel Serres, the "carnival of the senses" with Michael Taussig, the relation of hope to passion and to politics with Chantal Mouffe and Ernesto (...) Laclau. A dozen stimulating minds weigh in with their visions of a better social and political order. The result is a collaboration - of writing, of thinking, and of politics - that demonstrates more clearly than any single-authored project could how ideas encountering one another can produce the vision needed for social change. (shrink)

Modern medicine is built on a long history of medical experimentation. Experiments in the past often exploited more vulnerable patients. Questionable ethics litter the history of medicine. Without such experiments, however, millions of lives would be forfeited. This paper asks whether all the ``unethical'' experiments of the past were unjustifiable, and do we still exploit the poorer members of the community today? It concludes by wondering if Harris is right in his advocacy of a moral duty to participate in medical (...) research. (shrink)

This study of morphological overabundance focuses on the (non-)synonymy of parallel forms in Estonian illative case (‘into’) and the type of entrenchment behind it. We focus on the lexical level, testing whether the form preferred for a lexeme depends on semantic or morphophonological factors, or both. Using multifactorial regression analyses, we compare three corpus datasets: lexemes biased toward long forms, those biased toward short forms and lexemes with balanced form distribution. This is the first study to investigate realised overabundance in (...) this way, and to include inflection class membership in the model, enabling us to test whether declension class subsumes the morphophonological factors found to affect form preference in previous studies. The analysis shows that cell token frequency and inflection class are significant predictors of form preference, while the lexical-semantic features included in the study do not affect formative choice, highlighting the role of cell entrenchment instead of formative entrenchment in guiding form use. In conclusion, the study highlights the important role of inflection class (morphophonology) in the general shaping of form usage patterns in parallel forms and the weak role of semantic factors on the lexical level. (shrink)

Plato famously promised to complement the Sophist and the Statesman with another work on a third sort of expert, the philosopher--but we do not have this final dialogue. Mary Louise Gill argues that Plato promised the Philosopher, but did not write it, in order to stimulate his audience and encourage his readers to work out, for themselves, the portrait it would have contained. The Sophist and Statesman are themselves members of a larger series starting with the Theaetetus, Plato's investigation (...) of knowledge, and the whole series relies on the Parmenides, the second part of which presents a philosophical exercise, introduced as the first step in a larger philosophical program. Gill contends that the dialogues leading up to the missing Philosopher, though they reach some substantive conclusions, are philosophical exercises of various sorts designed to train students in dialectic, the philosopher's method; and that a second version of the Parmenides exercise, closely patterned on it, spans parts of the Theaetetus and Sophist and brings the philosopher into view. This is the exercise about being, the subject-matter studied by Plato's philosopher. Plato hides the pieces of the puzzle and its solution in plain sight, forcing his students (and modern readers) to dig out the pieces and reconstruct the project. Gill reveals how, in finding the philosopher through the exercise, the student becomes a philosopher by mastering his methods. She shows that the target of Plato's exercise is internally related to its pedagogical purpose. (shrink)