Families and clinicians approaching a child’s death in the paediatric intensive care unit (PICU) frequently encounter questions surrounding medical decision-making at the end of life (EOL), including defining what is in the child’s best interest, finding an optimal balance of benefit over harm, and sometimes addressing potential futility and moral distress. The best interest standard (BIS) is often marshalled by clinicians to help navigate these dilemmas and focuses on a clinician’s primary ethical duty to the paediatric patient. This approach does (...) not consider a clinician’s potential duty to the patient’s family. This paper argues that when a child is dying in the PICU, the physician has a duty to serve both the patient and the family, and that in some circumstances, the duty to serve the family becomes as important as that owed to the child. We detail the limitations of the BIS in paediatric EOL care and propose the relational potential standard as an additional ethical framework to guide our decisions. (shrink)

Today the connection between "person" and the "I" is acknowledged in many respects but not always analyzed. The need to relate it to the reality of the human being has sparked the present investigation of the philosophical anthropology of four thinkers from the late ancient, medieval, and contemporary periods. Although it may seem that the question of the role of the "I" with respect to the human being hinges on the larger problem of objectivity v. subjectivity, this does not seem (...) to be the case. Many topics, however, are necessarily entailed in this investigation such as individuality and universality, soul and body, consciousness and action, substance and history, the self and the other, the metaphysical and the phenomenological, and experience and the ethical. At the end of this study we arrive at more than a grammatical use of the "I." From reflection on the contributions of Plotinus, Augustine, Aquinas, and Wojtyla, the ontological role of the "I" is identified. In doing so, one realizes that the ontological does not forsake the concrete, but penetrates it more deeply. Indeed, that was what Plotinian philosophy claimed to be doing: recognizing the richness of human reality. (shrink)

The manner in which the phenomenological method has been applied to the data of ethics by Max Scheler, and his resulting criticisms of the formalism of classical theories of an absolute good and the subjectivity and relativity of the opposing “content theories,” have been discussed in a previous article. It is the purpose of the present paper to present Scheler’s claim to have resolved this dilemma in ethics by laying bare a structure of value too often obscured by the series (...) of falsifications and confusions that he has exposed. (shrink)

Since the appearance, nearly twenty years ago, of the first volume of Husserl”s Jahrbuch für Philosophie und phänomenologische Forschung , philosophers have been watching the development of a movement in Germany that has claimed attention through its opposition on the one side to the still powerful Kantian tradition, on the other to the trend of thought arising under the influence of biological science, aptly named by Meinong Psychologismus . The subtlety and originality of this new line of speculation and the (...) exactness of its method have attracted to it some of the most powerful intellects of the country, whose contributions would repay a more detailed study than they have yet received from English or American scholars. (shrink)

Human Nature offers a wide-ranging and holistic view of human nature from all perspectives: scientific, historical, and sociological. Mary Clark takes the most recent data from a dozen or more fields, and works it together with clarifying anecdotes and thought-provoking images to challenge conventional Western beliefs with hopeful new insights. Balancing the theories of cutting-edge neuroscience with the insights of primitive mythologies, Mary Clark provides down-to-earth suggestions for peacefully resolving global problems. Human Nature builds up a (...) coherent, and above all positive, picture of who we really are. (shrink)

Vaccine refusal occurs for a variety of reasons. In this article we examine vaccine refusals that are made on conscientious grounds; that is, for religious, moral, or philosophical reasons. We focus on two questions: first, whether people should be entitled to conscientiously object to vaccination against contagious diseases ; second, if so, to what constraints or requirements should conscientious objection to vaccination be subject. To address these questions, we consider an analogy between CO to vaccination and CO to military service. (...) We argue that conscientious objectors to vaccination should make an appropriate contribution to society in lieu of being vaccinated. The contribution to be made will depend on the severity of the relevant disease, its morbidity, and also the likelihood that vaccine refusal will lead to harm. In particular, the contribution required will depend on whether the rate of CO in a given population threatens herd immunity to the disease in question: for severe or highly contagious diseases, if the population rate of CO becomes high enough to threaten herd immunity, the requirements for CO could become so onerous that CO, though in principle permissible, would be de facto impermissible. (shrink)

St. Augustine of Hippo wrote the ’De Trinitate’ to explain to critics of the Nicene Creed how the Christian doctrine of the divinity and coequality of Father, Son, and Holy Spirit is present in Scripture. He also wanted to convince philosophers that Christ is the Wisdom they sought. Augustine’s third purpose was to correlate the biblical truth that all human persons are created to image God, a Trinity, a communion of love, with the first two Commandments of the Old and (...) New Testaments. Augustine succeeded in showing the need for combining faith and reason for a greater understanding of Scripture as well as for a greater understanding of the true nature and destiny of human persons. Augustine emphasized the scriptural revelation of God as Father, Son, and Holy Spirit, and used reason to convince philosophers that the one and three-Personed God is philosophically and logically defensible. He concluded that the likeness of human persons to Christ and to the Trinity is accomplished not onl. (shrink)

The Hebrew Scriptures reveal that for the Hebrews the physical body was fundamental. In thinking of human existence they did not isolate mental processes from sense reactions and bodily feelings. The word "heart" was often used instead of a personal pronoun. In Judges 19, "Comfort thy heart with a morsel of bread" means "Give yourself comfort." In Exodus 33:14, "My face will go with thee," means "I will go with thee." The word ruah, or spirit, denoting breath or wind, referred (...) to anyone who by physical energy and mental alertness was full of life. In many cases the word "heart" was used to bring together the feelings, motives, intentions, and other aspects of an individual as a whole. The word "heart" referred to psychic activity, not merely to a physical organ. (shrink)

The prevention, treatment and management of disease are closely linked to how the causes of a particular disease are explained. For multi-factorial conditions, the causal explanations are inevitably complex and competing models may exist to explain the same condition. Selecting one particular causal explanation over another will carry practical and ethical consequences that are acutely relevant for health policy. In this paper our focus is two-fold; the different models of causal explanation that are put forward within current scientific literature for (...) the high and rising prevalence of the common complex conditions of coronary artery disease and type 2 diabetes mellitus ; and how these explanations are taken up within national health policy guidelines. We examine the causal explanations for these two conditions through a systematic database search of current scientific literature. By identifying different causal explanations we propose a three-tier taxonomy of the most prominent models of explanations: evolutionary, lifecourse, and lifestyle and environment. We elaborate this taxonomy with a micro-level thematic analysis to illustrate how some explanations are semantically and rhetorically foregrounded over others. We then investigate the uptake of the scientific causal explanations in health policy documents with regard to the prevention and management recommendations of current National Service Frameworks for CAD and T2D. Our findings indicate a lack of congruence between the complexity and frequent overlap of causal explanations evident in the scientific literature and the predominant focus on lifestyle recommendations found in the mainstream health policy documents. (shrink)

Augustine of Hippo is a giant in the history of Christian thought, commended by St Jerome for having virtually 're-founded the old faith'.

The Western worldview that now dominates the planet embodies beliefs about human nature that are inconsistent with our evolutionarily evolved natures. Its “logic” at best ignores and at worst creates the symptoms of the modern world, which if uncorrected predict severe crises in coming centuries: population growth, environmental destruction, economic collapse, and increasing social violence. In contrast, there are numerous communities today creating alternative solutions based on different understandings of human nature and human needs: cooperation rather than competition; meaningful social (...) identity; and respect for and trust in the autonomous behavior of all persons. There exist optimistic future models. (shrink)