This paper examines what it is for a condition to be a disease. It falls into two sections. In the first I examine the best existing account of disease (as proposed by Christopher Boorse) and argue that it must be rejected. In the second I outline a more acceptable account of disease. According to this account, by disease we mean a condition that it is a bad thing to have, that is such that we consider the afflicted person to have (...) been unlucky, and that can potentially be medically treated. All three criteria must be fulfilled for a condition to be a disease. The criterion that for a condition to be a disease it must be a bad thing is required to distinguish the biologically different from the diseased. The claim that the sufferer must be unlucky is needed to distinguish diseases from conditions that are unpleasant but normal, for example teething. Finally, the claim that for a condition to be a disease it must be potentially medically treatable is needed to distinguish diseases from other types of misfortune, for example economic problems and legal problems. (shrink)

This discussion emphasises the diversity, philosophical seriousness and methodological distinctiveness of sophistic thought. Particular attention is given to their views on language, ethics, and the social construction of various norms, as well as to their varied, often undogmatic dialectical methods. The assumption that the sophists must have shared common doctrines (not merely overlapping interests and professional practices) is called into question.

Can we feel emotions about abstract objects, assuming that abstract objects exist? I argue that at least some emotions can have abstract objects as their intentional objects and discuss why this conclusion is not just trivially true. Through critical engagement with the work of Dacher Keltner and Jonathan Haidt, I devote special attention to awe, an emotion that is particularly well suited to show that some emotions can be about either concrete or abstract objects. In responding to a possible objection, (...) according to which we can only feel emotions about things that we take to matter to our flourishing, and thus cannot feel emotions about causally inefficacious abstract objects, I explore how abstract objects can be relevant to human flourishing and discuss someemotions other than awe that can be about abstract objects. I finish by explaining somereasons why my conclusion matters, including the fact that it presents a challenge to perceptual theories of emotion and causal theories of intentionality. (shrink)

Identity Economics provides an important and compelling new way to understand human behavior, revealing how our identities--and not just economic incentives--influence our decisions. In 1995, economist Rachel Kranton wrote future Nobel Prize-winner George Akerlof a letter insisting that his most recent paper was wrong. Identity, she argued, was the missing element that would help to explain why people--facing the same economic circumstances--would make different choices. This was the beginning of a fourteen-year collaboration--and of Identity Economics. The authors explain how (...) our conception of who we are and who we want to be may shape our economic lives more than any other factor, affecting how hard we work, and how we learn, spend, and save. Identity economics is a new way to understand people's decisions--at work, at school, and at home. With it, we can better appreciate why incentives like stock options work or don't; why some schools succeed and others don't; why some cities and towns don't invest in their futures--and much, much more. Identity Economics bridges a critical gap in the social sciences. It brings identity and norms to economics. People's notions of what is proper, and what is forbidden, and for whom, are fundamental to how hard they work, and how they learn, spend, and save. Thus people's identity--their conception of who they are, and of who they choose to be--may be the most important factor affecting their economic lives. And the limits placed by society on people's identity can also be crucial determinants of their economic well-being. (shrink)

Pyrrhonian sceptics claim, notoriously, to assent to the appearances without making claims about how things are. To see whether this is coherent we need to consider the philosophical history of ‘appearance’(phainesthai)-talk, and the closely related concept of an impression (phantasia). This history suggests that the sceptics resemble Plato in lacking the ‘non-epistemic’ or ‘non-doxastic’ conception of appearance developed by Aristotle and the Stoics. What is distinctive about the Pyrrhonian sceptic is simply that the degree of doxastic commitment involved in his (...) assent to an impression is asymptotally low. (shrink)

A new reading of Plato's account of conventionalism about names in the Cratylus. It argues that Hermogenes' position, according to which a name is whatever anybody 'sets down' as one, does not have the counterintuitive consequences usually claimed. At the same time, Plato's treatment of conventionalism needs to be related to his treatment of formally similar positions in ethics and politics. Plato is committed to standards of objective natural correctness in all such areas, despite the problematic consequences which, as he (...) himself shows, arise in the case of language. (shrink)

This article discusses recent theories of the meaning of generics. The discussion is centred on how the theories differ in their approach to addressing the primary difficulty in providing a theory of generic meaning: The notoriously complex ways in which the truth conditions of generics seem to vary. In addition, the article summarizes considerations for and against each theory.

Hume's position in ethics, which is based on his empiricist theory of the mind, is best known for asserting four theses: (1) Reason alone cannot be a motive to the will, but rather is the slave of the passions (see Section 3) (2) Moral distinctions are not derived from reason (see Section 4). (3) Moral distinctions are derived from the moral sentiments: feelings of approval (esteem, praise) and disapproval (blame) felt by spectators who contemplate a character trait or action (see (...) Section 7). (4) While some virtues and vices are natural (see Section 13), others, including justice, are artificial (see Section 9). There is heated debate about what Hume intends by each of these theses and how he argues for them. He articulates and defends them within the broader context of his metaethics and his ethic of virtue and vice. Hume's main ethical writings are Book 3 of his Treatise of Human Nature, Of Morals (which builds on Book 2, Of the Passions), his Enquiry concerning the Principles of Morals, and some of his Essays. In part the moral Enquiry simply recasts central ideas from the moral part of the Treatise in a more accessible style; but there are important differences. The ethical positions and arguments of the Treatise are set out below, noting where the moral Enquiry agrees; differences between the Enquiry and the Treatise are discussed afterwards. (shrink)

A generally ignored feature of Plato’s celebrated image of the cave in Republic VII is that the ascent from the cave is, in its initial stages, said to be brought about by force. What kind of ‘force’ is this, and why is it necessary? This paper considers three possible interpretations, and argues that each may have a role to play.

Identity Economics provides an important and compelling new way to understand human behavior, revealing how our identities--and not just economic incentives--influence our decisions. In 1995, economist Rachel Kranton wrote future Nobel Prize-winner George Akerlof a letter insisting that his most recent paper was wrong. Identity, she argued, was the missing element that would help to explain why people--facing the same economic circumstances--would make different choices. This was the beginning of a fourteen-year collaboration--and of Identity Economics. The authors explain how (...) our conception of who we are and who we want to be may shape our economic lives more than any other factor, affecting how hard we work, and how we learn, spend, and save. Identity economics is a new way to understand people's decisions--at work, at school, and at home. With it, we can better appreciate why incentives like stock options work or don't; why some schools succeed and others don't; why some cities and towns don't invest in their futures--and much, much more. Identity Economics bridges a critical gap in the social sciences. It brings identity and norms to economics. People's notions of what is proper, and what is forbidden, and for whom, are fundamental to how hard they work, and how they learn, spend, and save. Thus people's identity--their conception of who they are, and of who they choose to be--may be the most important factor affecting their economic lives. And the limits placed by society on people's identity can also be crucial determinants of their economic well-being. (shrink)

The standard view amongst philosophers of language and linguists is that the logical form of generics is quantificational and contains a covert, unpronounced quantifier expression Gen. Recently, some theorists have begun to question the standard view and rekindle the competing proposal, that generics are a species of kind-predication. These theorists offer some forceful objections to the standard view, and new strategies for dealing with the abundance of linguistic evidence in favour of the standard view. I respond to these objections and (...) show that their strategies fail. I offer a novel argument in favour of the standard view that I call the binder argument. The upshot of this argument is that if one rejects the existence of Gen, then one is committed to rejecting the existence of covert structure in general. (shrink)

This study examines the public's and physicians' willingness to support deception of insurance companies in order to obtain necessary healthcare services and how this support varies based on perceptions of physicians' time pressures. Based on surveys of 700 prospective jurors and 1617 physicians, the public was more than twice as likely as physicians to sanction deception (26% versus 11%) and half as likely to believe that physicians have adequate time to appeal coverage decisions (22% versus 59%). The odds of public (...) support for deception compared to that of physicians rose from 2.48 to 4.64 after controlling for differences in time perception. These findings highlight the ethical challenge facing physicians and patients in balancing patient advocacy with honesty in the setting of limited societal resources. (shrink)

Among Aristotle’s criticisms of the Form of the Good is his claim that the knowledge of such a Good could be of no practical relevance to everyday rational agency, e.g. on the part of craftspeople. This critique turns out to hinge ultimately on the deeply different assumptions made by Plato and Aristotle about the relation of ‘good’ and ‘good for’. Plato insists on the conceptual priority of the former; and Plato wins the argument.

Plato’s depiction of the first city in the Republic (Book II), the so-called ‘city of pigs’, is often read as expressing nostalgia for an earlier, simpler era in which moral norms were secure. This goes naturally with readings of other Platonic texts (including Republic I and the Gorgias) as expressing a sense of moral decline or crisis in Plato’s own time. This image of Plato as a spokesman for ‘moral nostalgia’ is here traced in various nineteenth- and twentieth-century interpretations, and (...) rejected. Plato’s pessimism about human nature in fact precludes any easy assumption that things, or people, were better in the old days. (shrink)

This book derives from Annas’s 1997 Townsend Lectures at Cornell University, and it retains the invigorating clarity and fast pace of a first-rate lecture series. In it Annas discusses assorted topics in Plato’s ethics and their ancient interpretation: her unifying theme is that we have much to learn from ancient readings of Plato, and those of the Middle Platonists in particular.

Bioethics has entered a new era: as many commentators have noted, the familiar mantra of autonomy, beneficence, nonmaleficence, and justice has proven to be an overly simplistic framework for understanding problems that arise in modern medicine, particularly at the intersection of public policy and individual preferences. A tradition of liberal pluralism grounds respect for individual preferences and affirmation of competing conceptions of the good. But we struggle to maintain (or at times explicitly reject) this tradition in the face of individual (...) preferences that we find distasteful, suspect, or even repugnant, especially where the broader social good or respect for equality is at stake. Directed donation presents us with such a dilemma: can we uphold the right of self-determination through respect of individual preferences regarding disposition of transplantable organs while at the same time maintaining an allocation system that reflects values of equity and justice claimed to underlie the socially negotiated practice of transplantation? Or are some preferences simply to be deemed unethical and not respected, even if that leads to a reduction in the number of transplantable organs available and to an apparent disregard for the autonomous decisions of the recently deceased? (shrink)

A major goal of this work is to specify some steps of the process by which participants maintain coherency in their conversations.The underlying element of the analysis is a construct called a “context space.” Roughly, a group of utterances that refers to a single issue or episode forms the basis for a context space. Superficially, a conversation is a sequence of utterances; at a deeper level it is a structured entity whose utterances can be parsed into hierarchically related context spaces.As (...) a conversation proceeds, each conversant builds a discourse model that includes the conversation's context space structure, a notion of the present discourse topic, and a list of items being focused upon. Conversational coherency depends upon a lack of conflict between the respective models of the participants. Conflicts are prevented by speakers following high level syntactic and semantic relational rules that enable listeners to identify their discourse models. These rules, given in the study, are highly integrated with the view of conversation presented here—a hierarchy of related context spaces. (shrink)

It is very difficult to get a clear picture of how the Stoic is supposed to deliberate. This paper considers a number of possible pictures, which cover such a wide range of options that some look Kantian and others utilitarian. Each has some textual support but is also unworkable in certain ways: there seem to be genuine and unresolved conflicts at the heart of Stoic ethics. And these are apparently due not to developmental changes within the school, but to the (...) Stoics’ having adopted implicitly incompatible solutions in response to different philosophical challenges. (shrink)

The DSM is the main classification of mental disorders used by psychiatrists in the United States and, increasingly, around the world. Although widely used, the DSM has come in for fierce criticism, with many commentators believing it to be conceptually flawed in a variety of ways. This paper assesses some of these philosophical worries. The first half of the paper asks whether the project of constructing a classification of mental disorders that ‘cuts nature at the joints’ makes sense. What is (...) mental disorder? Are types of mental disorder natural kinds (that is, are the distinctions between them objective and of fundamental theoretical importance, as are, say, the distinctions between the chemical elements)? The second half of the paper addresses epistemic worries. Even if types of mental disorder are natural kinds there may be reason to doubt that the DSM will come to reflect their natural structure. In particular, I examine the extent to which the DSM is theory-laden, and look at how it has been shaped by social and financial factors. Ultimately, I conclude that although the DSM is of immense practical importance it is not likely to become the best possible classification of mental disorders. (shrink)

Are the long, wildly inventive etymologies in Plato’s Cratylus just some kind of joke, or does Plato himself accept them? This standard question misses the most important feature of the etymologies: they are a competitive performance, an agôn by Socrates in which he shows that he can play the game of etymologists like Cratylus better than they can themselves. Such show-off performances are a recurrent feature of Platonic dialogue: they include Socrates’ speeches on eros in the Phaedrus, his rhetorical discourse (...) in the Menexenus, and his literary interpretation in the Protagoras. The paper compares these cases to work out the ground rules, purposes and implications of the Platonic agôn, and the Cratylus etymologies in particular. (shrink)

In this article, I compare and evaluate R. D. Laing and A. Esterson’s account of schizophrenia as developed in Sanity, Madness and the Family, social models of disability, and accounts of extended mental disorder. These accounts claim that some putative disorders should not be thought of as reflecting biological or psychological dysfunction within the afflicted individual, but instead as external problems. In this article, I consider the grounds on which such claims might be supported. I argue that problems should not (...) be located within an individual putative patient in cases where there is some acceptable test environment in which there is no problem. A number of cases where such an argument can show that there is no internal disorder are discussed. I argue, however, that Laing and Esterson’s argument—that schizophrenia is not within diagnosed patients—does not work. The problem with their argument is that they fail to show that the diagnosed women in their study function adequately in any environment. (shrink)

This article describes a new prenatal genetic test that is painless, early, and increasingly available. State legislatures have reacted by prohibiting abortion for reason of fetal sex or of fetal diagnosis and managing genetic counseling. This article explores these legislative responses and considers how physicians and genetic counselors currently communicate post-testing options. The article then examines the challenges ahead for genetic counseling, particularly in light of the troubling grip of abortion politics on conversations about prenatal diagnosis.

It is widely held by commentators that in the Protagoras, Socrates attempts to explain the experience of mental conflict and weakness of the will without positing the existence of irrational desires, or desires that arise independently of, and so can conflict with, our reasoned conception of the good. In this essay, I challenge this commonly held line of thought. I argue that Socrates has a unique conception of an irrational desire, one which allows him to explain the experience of mental (...) conflict and weakness of the will, while still holding the Socratic thesis that we always do what we think is good. The resulting picture is both psychologically plausible and philosophically distinctive. (shrink)

Increasingly, Deaf activists claim that it can be good to be Deaf. Still, much of the hearing world remains unconvinced, and continues to think of deafness in negative terms. I examine this debate and argue that to determine whether it can be good to be deaf it is necessary to examine each claimed advantage or disadvantage of being deaf, and then to make an overall judgment regarding the net cost or benefit. On the basis of such a survey I conclude (...) that being deaf may plausibly be a good thing for some deaf people but not for others. (shrink)

Paradigmatically, natural kinds are the kinds of thing or stuff that are classified by the natural sciences. The periodic table provides perhaps the best example of the potential importance of natural kinds for science. In the philosophy of psychiatry, debates over whether mental disorders can be natural kinds emerge because kinds of mental disorder are manifestly different from chemical kinds in various ways. While chemical kinds are precise, psychiatric kinds are fuzzy. While chemical kinds are objective, the identification of psychiatric (...) kinds is value-laden. Psychiatric classification involves classifying people, and unlike chemical elements, those people can respond to being classified in various ways. This chapter goes through these differences, one-by-one, and argues that despite them, mental disorders may be natural kinds. (shrink)

Truth, the pragmatist claims, is something we make, not something which corresponds to reality. If this view of truth is accepted, Rorty notes, two problems arise: the pragmatist will have little to say to those who abuse others, because he or she will not be able to point to some universal standards that the abusers are vio lating ; and the torturers may be able to quote pragmatic principles in their own defence. Rorty argues that the pragmatist can reduce cruelty (...) by splitting himself or herself into public and private parts. I examine this problem and Rorty's solution. I argue that his solution fails for two reasons: first, keeping our public and private selves apart is unlikely to reduce cruelty; and, second, he cannot maintain the public/private split. Consequently, Rorty is unable to deal with the anti-pragmatic criticism that his theory of truth could lead to an increase in cruelty. Key Words: democracy • liberalism • political theory • pragmatism • Richard Rorty. (shrink)

Summary Traditional accounts of seventeenth-century English republicanism have usually presented it as inherently anti-monarchical and anti-democratic. This article seeks to challenge and complicate this picture by exploring James Harrington's views on royalism, republicanism and democracy. Building on recent assertions about Harrington's distinctiveness as a republican thinker, the article suggests that the focus on Harrington's republicanism has served to obscure the subtlety and complexity of his moral and political philosophy. Focusing on the year 1659, and the pamphlet war that Harrington and (...) his supporters waged against their fellow republicans, it seeks to re-emphasise important but neglected elements of Harrington's thought. It suggests that the depth and extent of Harrington's sympathy with royalists and royalism has been underplayed, while too little attention has been paid to the fundamental differences between his ideas and those adopted by other republican thinkers at the time. In addition it brings to light, for the first time, Harrington's innovative endorsement of both the term and the concept of ?democracy? and draws attention to his intellectual and personal affinities with the Levellers. Finally it outlines some implications of these findings for understandings of English republicanism and the republican tradition more generally. (shrink)

Simplicius’ project of harmonizing previous philosophers deserves to be taken seriously as both a philosophical and an interpretive project. Simplicius follows Aristotle himself in developing charitable interpretations of his predecessors: his distinctive project, in the Neoplatonic context, is the rehabilitation of the Presocratics (especially Parmenides, Anaxagoras and Empedocles) from a Platonic-Aristotelian perspective. Simplicius’ harmonizations involve hermeneutic techniques which are recognisably those of the serious historian of philosophy; and harmonization itself has a distinguished history as a constructive philosophical method.

What would my life have been like if I had been born more intelligent? Or taller? Or a member of the opposite sex? Or a non-biological being? It is plausible that some of these questions make sense, while others stretch the limits of sense making. In addressing questions of how I might have been, genetic essentialism is popular, but this article argues that genetic essentialism, and other versions of origin essentialism for organisms, must be rejected. It considers the prospects for (...) counterpart theory and shows how counterpart theory can be used to illuminate volitional accounts of identity as proposed by Harry Frankfurt. This enables one to make sense of claims that, say, being gay, or Deaf, or Black, can be essential to someone's identity. The discussion is then extended to show how it can be made applicable to the transworld identity theorist who denies that individuals possess essential properties. (shrink)

Friesen et al. (2023) describe barriers to research in patient populations that have been historically labeled as vulnerable and, as a result, are under-represented in research due to the Instituti...

An assortment of different points of view on conspiracy thinking and conspiracy theories, pro and con.

Cultural forces such as film create and reinforce rigidly-defined images of a doctor's identity for both the public and for medical students. The authoritarian and hierarchical institution of medical school also encourages students to adopt rigidly-defined professional identities. This restrictive identity helps to perpetuate the power of the patriarchy, limits uniqueness, squelches inquisitiveness, and damages one's self-confidence. This paper explores the construction of a physician's identity using cultural theorists' psychoanalytic analyses of gender and race as a framework of analysis. Cultural (...) theorists' politically-motivated work provides an excellent point of departure for destabilizing parts of the authoritarian medical hierarchy that can damage a student's professional development. Drawing on such discourse, this paper examines the processes by which a doctor's identity becomes rigidly defined and fixed by daily training. It finally proposes a way for a medical student to extrapolate himself from the current definitions of this identity and create a broader, more malleable concept of professional identity by defining himself from outside of, rather than through, difference. (shrink)

Because organic certification standards institutionalized a product-based rather than process-based definition, certified organic produce can be grown on large-scale industrial monocrop farms. Besides toxicity of inputs, these farms operate in much the same way as conventional production. Scholars emphasize the fact that labor rights have been left out of certification criteria, and because of that, organic farms reproduce the same labor relations as conventional. Empirical studies of organic farm labor, however, rely primarily on the perspective of farmers. In this study, (...) I ask the farmworkers themselves how harvesting on organic farms compares to conventional, and found that working in organic negatively impacts farmworker livelihoods. Qualitative interviews with 36 strawberry harvesters in Oxnard, California reveal that farmworkers make more money in conventional strawberry production because of the interaction between wage structure and size of the berry. Conventional strawberries are larger and therefore fewer of them fill up a box. Farmworkers routinely pick more boxes in conventional than in organic, thus earning more, since under the piece rate system, farmworkers are paid per box. With short-term economic survival rather than long-term occupational health concerns in mind, strawberry harvesters would rather work on conventional farms because “la fresa orgánica es más chiquita”. (shrink)

The food sovereignty movement calls for a reversal of the neoliberal globalization of food, toward an alternative development model that supports peasant production for local consumption. The movement holds an ambiguous stance on peasant production for export markets, and clearly prioritizes localized trade. Food sovereignty discourse often simplifies and romanticizes the peasantry—overlooking agrarian class categories and ignoring the interests of export-oriented peasants. Drawing on 8 months of participant observation in the Andean countryside and 85 interviews with indigenous peasant farmers, this (...) paper finds that export markets are viewed as more fair than local markets. The indigenous peasants in this study prefer export trade because it offers a more stable and viable livelihood. Feeding the national population through local market intermediaries, by contrast, is perceived as unfair because of oversupply and low, fluctuating prices. This perspective, from the ground, offers important insight to movement actors and scholars who risk oversimplifying peasant values, interests, and actions. (shrink)

To better understand the influence of religiosity and spirituality on moral reasoning, 1,037 college students completed a survey including demographic questions, a religiosity measure, a spirituality measure, and Forsyth's Ethical Position Questionnaire. Religiosity and spirituality positively correlated with moral idealism, whereas spirituality negatively correlated with moral relativism. However, religiosity and spirituality accounted for a very little variability in moral reasoning, suggesting that they do not directly influence moral reasoning. In addition, female participants reported higher spirituality, but there were no gender (...) differences on a spirituality measure. Future research is needed to examine other factors that may influence moral reasoning. (shrink)

This paper suggests that a basic distinction between philosophical counselling and psychotherapy is to be found in the conception of ‘the person’that is inherent in each of the fields. Understanding this distinction allows not only for a more profound recognition of what is unique to philosophical counselling but also for a better view of possibilities of interchange between the fields. [1].

Enzymes that degrade nucleic acids are emerging as important players in the pathogenesis of inflammatory disease. This is exemplified by the recent identification of four genes that cause the childhood inflammatory disorder, Aicardi‐Goutières syndrome (AGS). This is an autosomal recessive neurological condition whose clinical and immunological features parallel those of congenital viral infection. The four AGS genes encode two nucleases: TREX1 and the hetero‐trimeric Ribonuclease H2 (RNase H2) complex. The biochemical activity of these enzymes was initially characterised 30 years ago (...) but a role in neurological inflammation was entirely unanticipated until they were found to be mutated in AGS. This has led to a hypothesis that accumulation of intracellular nucleic acids occurs as a consequence of mutation in these enzymes and triggers an inflammatory response through activation of innate immune pattern recognition receptors. ©2007 Wiley Periodicals, Inc BioEssays 30:833–842, 2008. © 2008 Wiley Periodicals, Inc. (shrink)

I present and analyze J.G. Herder’s aesthetics of sculpture, as an art form directed toward and appreciated by the sense of touch. I argue that Herder is unsuccessful in his attempt so to define sculpture, but his account is nonetheless fruitful, both in making salient and explaining signal aspects of sculptural appreciation and criticism and, more broadly and quite innovatively, in proposing an aesthetics of touch, even an embodied aesthetics.

Motivation has been the subject of much research in the sport psychology literature, whereas athlete mental health has received limited attention. Motivational complexities in elite sport are somewhat reflected in the mental health literature, where there is evidence for both protective and risk factors for athletes. Notably, few studies have linked motivation to mental health. Therefore, the key objective of this study was to test four mental health outcomes in the motivational sequence posited by the Hierarchical Model of Intrinsic and (...) Extrinsic Motivation: motivational climate  basic psychological needs  motivation  mental health outcomes. Elite team-sport athletes (140 females, 75 males) completed seven psychometric inventories of motivation-related and mental health variables. Overall, the athletes reported positive motivational patterns, with autonomous motivation and task climate being more prevalent than their less adaptive counterparts. Elevated depressive symptoms and poor sleep quality affected nearly half of the cohort. Structural equation modelling supported pathways between motivational climate, basic needs, motivation, and mood, depressive symptoms, sleep quality, and trait anxiety. Specifically, a task climate was positively associated with the three basic psychological needs, and an ego climate was positively associated with competence. Autonomy and relatedness had positive and negative associations with autonomous and controlled forms of motivation, respectively. Controlled motivation regulations were positively associated with the four mental health outcomes. Integrated regulation had a negative association with anxiety, and intrinsic regulation had a positive association with depressive symptoms. These findings highlight the complexities of and interrelations between motivation and mental health among athletes, and support the importance of considering mental health as an outcome of motivation. (shrink)

The 1981 Uniform Determination of Death Act (UDDA) established the validity of both cardio-respiratory and neurological criteria of death. However, many religious traditions including most forms of Haredi Judaism (ultra-orthodox) and many varieties of Buddhism strongly disagree with death by neurological criteria (DNC). Only one state in the U.S., New Jersey, allows for both religious exemptions to DNC and provides continuation of health insurance coverage when an exception is invoked in its 1991 Declaration of Death Act (NJDDA). There is yet (...) no quantitative or qualitative data on the frequencies of religious exemptions in New Jersey. This study gathered information about the frequency of religious exemptions and policy in New Jersey that was created out of respect for religious beliefs. Literature and internet searches on topics related to religious objections to DNC were conducted. Fifty-three chaplains and heads of bioethics committees in New Jersey hospitals were contacted by phone or email requesting a research interview. Respondents answered a set of questions about religious exemptions to DNC at the hospital where they worked that explored the frequency of such religious exemptions in the past five years, the religious tradition indicated, and whether any request for a religious exemption had been denied. This study was approved by the Northeastern University Institutional Review Board (IRB #: 16–03-15). Eighteen chaplains and bioethics committee members participated in a full research interview. Of these, five reported instances of religious exemptions to DNC occurring at the hospital at which they worked for a total of approximately 30–36 known exemptions in the past five years. Families sought religious exemptions because of faith in an Orthodox Judaism tradition and nonreligious reasons. No failed attempts to obtain an exemption were reported. Religious exemptions to DNC in New Jersey do occur, although very infrequently. Prior to this study, there was no information on their frequency. Considering religious exemptions do occur, there is a need for national or state policies that addresses both religious objections to DNC and hospital resources. More information is needed to better understand the impact of granting religious exemptions before new policy can be established. (shrink)