Many real-world agents recognise that they impose harms by choosing to emit carbon, e.g., by flying. Yet many do so anyway, and then attempt to make things right by offsetting those harms. Such offsetters typically believe that, by offsetting, they change the deontic status of their behaviour, making an otherwise impermissible action permissible. Do they succeed in practice? Some philosophers have argued that they do, since their offsets appear to reverse the adverse effects of their emissions. But we show that (...) they do not. In practice, standard carbon offsetting does not reverse the harms of the original action, nor does it even benefit the same group as was harmed. Standard moral theories hence deny that such offsetting succeeds. Indeed, we show that any moral theory that allows offsetting in this setting faces a dilemma between allowing any wrong to be offset, no matter how grievous, and recognising an implausibly sharp discontinuity between offsettable actions and non-offsettable actions. The most plausible response is to accept that carbon offsetting fails to right our climate wrongs. (shrink)

Despite advances in palliative care, some patients still suffer significantly at the end of life. Terminal Sedation (TS) refers to the use of sedatives in dying patients until the point of death. The following limits are commonly applied: (1) symptoms should be refractory, (2) sedatives should be administered proportionally to symptoms and (3) the patient should be imminently dying. The term ‘Expanded TS’ (ETS) can be used to describe the use of sedation at the end of life outside one or (...) more of these limits.In this paper, we explore and defend ETS, focusing on jurisdictions where assisted dying is lawful. We argue that ETS is morally permissible: (1) in cases of non-refractory suffering where earlier treatments are likely to fail, (2) where gradual sedation is likely to be ineffective or where unconsciousness is a clinically desirable outcome, (3) where the patient meets all criteria for assisted dying or (4) where the patient has greater than 2 weeks to live, is suffering intolerably, and sedation is considered to be the next best treatment option for their suffering.While remaining two distinct practices, there is scope for some convergence between the criteria for assisted dying and the criteria for ETS. Dying patients who are currently ineligible for TS, or even assisted dying, should not be left to suffer. ETS provides one means to bridge this gap. (shrink)

In many forms of severe acute brain injury there is an early phase when prognosis is uncertain, followed later by physiological recovery and the possibility of more certain predictions of future impairment. There may be a window of opportunity for withdrawal of life support early, but if decisions are delayed there is the risk that the patient will survive with severe impairment. In this paper I focus on the example of neonatal encephalopathy and the question of the timing of prognostic (...) tests and decisions to continue or to withdraw life-sustaining treatment. Should testing be performed early or later; and how should parents decide what to do given the conflicting values at stake? I apply decision theory to the problem, using sensitivity analysis to assess how different features of the tests or different values would affect a decision to perform early or late prognostic testing. I draw some general conclusions from this model for decisions about the timing of testing in neonatal encephalopathy. Finally I consider possible solutions to the problem posed by the window of opportunity. Decision theory highlights the costs of uncertainty. This may prompt further research into improving prognostic tests. But it may also prompt us to reconsider our current attitudes towards the palliative care of newborn infants predicted to be severely impaired. (shrink)

Identifying a range of key concerns related to representation and difference, Representing the Other offers a provocative agenda for the future development of feminist theory and practice. The book's contributors, including many key international researchers in women's studies, draw on personal experiences of speaking "for" and "about" others in their research, professional practice, academic writing, or political activism. They highlight problems of representing the Other with an ethnic or cultural background different from one's own and extend discussions of "Othering" to (...) representations of children, prostitutes, infertile women, fat women, gay men with HIV/AIDS, and people with disabilities. The reader, which includes articles and discussions from four issues of the journal Feminism & Psychology, also features new pieces and an extensive editorial introduction. Representing the Other will be integral reading for students and academics in women's studies, gender studies, and feminist theory across a range of social science disciplines, including social psychology, sociology, anthropology, sociolinguistics, social policy, and political science. (shrink)

Do people who cause themselves to be ill (e.g. by smoking) forfeit some of their rights to healthcare? This paper examines one argument for the view that they do, the restoration argument. It goes as follows. Smokers need more health‐resources than non‐smokers. Given limited budgets, we must choose between treating everyone equally (according to need) or reducing smokers' entitlements. If we choose the former, non‐smokers will be harmed by others' smoking, because there will be less resources available for them than (...) if no‐one smoked. This is unfair: why should non‐smokers suffer because of others' unhealthy lifestyle choices? We should therefore choose the latter and reduce smokers' entitlements. This paper criticises the restoration argument on the following grounds. In order to avoid generating unpalatable conclusions elsewhere, it must be combined with a principle according to which activities which are sufficiently ‘socially valuable’ (e.g. parenting) are immune from restoration claims. This however means that what was supposed to be one of the argument's most attractive features, its compatibility with ‘liberal neutrality’ with respect to the value of different lifestyles, doesn't really exist. Hence, the restoration argument is nowhere near as attractive as it at first appears to be. (shrink)

According to much modern social psychology, behavioural economics and common sense, people's actions and beliefs are frequently the result of rapid intuitive thought rather than careful deliberation. Richard Thaler and Cass Sunstein, in their influential book, Nudge, synthesised the literature and used it as the basis for numerous policy ideas.1 Not least, they gave the word ‘nudge’ as a handy term to apply to all sorts of ways of taking advantage of people's psychological quirks without coercing or bribing them. But (...) while Nudge was long on ideas and enthusiasm, it was short on conceptual clarity. The idea of a nudge was inconsistent with some of the policies Thaler and Sunstein endorsed and their account of nudging's relation to freedom and paternalism was flawed.In Salvaging the concept of nudge, Yashar Saghai acts as a friendly critic who thinks nudging has plenty to offer the policy world but sees that it needs both conceptual clarity and ethical defence.2 He wants to show how some of ways of taking advantage of people's psychology could leave them as free as before and he is especially concerned with what I would describe as a question of manipulation: …. (shrink)

This issue of the Journal of Medical Ethics features a special symposium on ‘elective ventilation’ . EV ) was originally described in the 1990s by doctors working in Exeter in the UK.1 At that time there was concern about the large shortfall in organs for transplantation. Patients could become organ donors if they were diagnosed as being brain dead, but this only ever occurred in patients on breathing machines in intensive care who developed signs of brainstem failure. Doctors wondered if (...) there were patients dying outside intensive care who, if they were ventilated, could become brain dead and hence eligible to donate their organs. They embarked on a process of identifying patients who were dying who would not normally be taken to intensive care because their prognosis was judged to be too poor, and then ‘electing’ to insert breathing tubes when they stopped breathing.1 With the consent of family members the patients were supported in intensive care until they were diagnosed as having signs of brain death, or until the family and doctors together judged that this was unlikely to occur.1 The Exeter team saw a 50% increase in their numbers of organs for transplantation.Box 1 Definition of elective ventilation Elective ventilation is the provision to a patient of intensive medical treatment with the sole purpose of facilitating organ donation, in the absence of an expected medical benefit.EV was a controversial practice at the time. There were a number of papers written from points of view defending2 ,3 and criticising it.4 A Department of Health guideline in 1994 concluded that EV was not in the best interests of patients and was therefore unlawful5; subsequently, the practice effectively ceased.2 However, debate about EV has not …. (shrink)

Are there some newborn infants whose short- and long-term care costs are so great that treatment should not be provided and they should be allowed to die? Public discourse and academic debate about the ethics of newborn intensive care has often shied away from this question. There has been enough ink spilt over whether or when for the infant's sake it might be better not to provide life-saving treatment. The further question of not saving infants because of inadequate resources has (...) seemed too difficult, too controversial, or perhaps too outrageous to even consider. However, Roman Catholic ethicist Charles Camosy has recently challenged this, arguing that costs should be a primary consideration in decision-making in neonatal intensive care. In the first part of this paper I will outline and critique Camosy's central argument, which he calls the ‘social quality of life (sQOL)’ model. Although there are some conceptual problems with the way the argument is presented, even those who do not share Camosy's Catholic background have good reason to accept his key point that resources should be considered in intensive care treatment decisions for all patients. In the second part of the paper, I explore the ways in which we might identify which infants are too expensive to treat. I argue that both traditional personal ‘quality of life’ and Camosy's ‘sQOL’ should factor into these decisions, and I outline two practical proposals. (shrink)

The Theory Theory (TT) versus Simulation Theory (ST) debate is primarily concerned with how we understand others’ mental states. Theory theorists claim we do this using rules that are akin to theoretical laws, whereas simulation theorists claim we use our own minds to imagine ourselves in another’s position. Theorists from both camps suggest a consideration of individuals with autism spectrum disorders (ASD) can help resolve the TT/ST debate (e.g., Baron-Cohen 1995; Carruthers 1996a; Goldman 2006). We present a three-part argument that (...) such research has so far been inconclusive and that the prospects for studies of ASD to resolve the debate in the near future remain uncertain. First, we discuss evidence indicating that some individuals with ASD can perform effectively on tests of mental state understanding, which questions what ASD can tell us regarding theorising or simulation. Second, we claim that there is compelling evidence that domain-general mechanisms are implicated in mental state reasoning, which undermines how ASD might inform the TT/ST debate given that both theories appeal to domain-specific mindreading mechanisms. Third, we suggest that neuroscientific evidence for an assumed role of the mirror neuron system in autism also fails to arbitrate between TT and ST. We suggest that while the study of ASD may eventually provide a resolution to the TT/ST debate, it is also vital for researchers to examine the issues through other avenues, for example, by examining people’s everyday counterfactual reasoning with mental state scenarios. (shrink)

I question the place of psychoanalysis and psychoanalytically oriented psychotherapy in the National Health Service (NHS), with reference to published material; and, particularly, in relation to primary care, health economics and medical ethics. I argue that there are pressing clinical, research, economic, and ethical reasons in support of the contention that an urgent review of the extent and impact of psychoanalytic practices in the health service is called for.

: It has recently become known that, in Liverpool and elsewhere, parts of children's bodies were taken postmortem and used for research without the parents being told. But should parental consent be sought before using children's corpses for medical purposes? This paper presents the view that parental consent is overrated. Arguments are rejected for consent from dead children's interests, property rights, family autonomy, and religious freedom. The only direct reason to get parental consent is to avoid distressing the parents, which (...) carries implications for the consent process, secret harvesting of body parts, and the weight to be given to parental feelings. (shrink)

The elements which every schoolboy learns on beginning Latin Verse Composition include a number of rules which seem arbitrarily designed to make the game harder. In hexameters, he is told, he must have a masculine caesura either in the third foot or in the second and fourth, and end normally with a disyllabic or a trisyllable; in pentameters he must end with a disyllabic; and in neither line may a single monosyllable stand at the end. Rarely, in my experience, is (...) any reason given him by way of redress, and he will search for one in vain in most of the school text-books, in introductions like Postgate's to Tibullus and Propertius, and in histories of Latin literature like Wight Duff's and Mackail's. This reticence may be due to the dissensions of experts on this subject and on the subject of Latin accentuation in general, but the theory that predominates in England, among those who hold a theory at all, explains so many of the phenomena that it deserves to be more widely and precisely known. The most detailed exposition of it is by E. H. Sturtevant, who summed up his analyses in a pair of articles in the Transactions of the American Philological Association in 1923–4. While his careful work is invaluable as marshalling the statistics and evidence, it errs on the side of excessive minuteness, and leaves room not merely for some additions, but for a different kind of treatment concerned less with bare statistics and more with poetic principles and historical development. Since Latin Verse Composition plays such an important part in English higher classical education, it seems desirable that a less technical and more accessible account should be available for English readers. Such an account I attempt to give here, keeping separate as far as possible the exposition and the consideration of the criticisms and rival theories that have been advanced. (shrink)

As in literature poetry precedes prose, so in poetry a special and ‘heightened’ diction seems to precede everyday language. Mr.T.S.Eliot has put it thus: ‘Every revolution in poetry is apt to be, and sometimes to announce itself as, a return to common speech.’ How does this apply to Greek and Latin ? There are objections to considering words in isolation from this point of view, since neutral ones are apt to go now grey, now purple, according to their company; but (...) if we do not do so, we deny ourselves the only considerable method of investigation that is still open to us. Again, we must recognize that most poems are composed largely of ordinary words, though these are often used in a way that is not ordinary. (shrink)

In his précis, James Stacey Taylor sets out his full-blooded Epicureanism, which concludes that “death is not a harm to the person who dies and that persons can neither be harmed nor wronged by events that occur after their deaths.”1 He then considers various topics in bioethics in the light of his Epicureanism, one of which I consider here: presumed consent in the procurement of organs for transplantation. Although I do not accept Taylor's Epicureanism and although his examination of presumed (...) consent is flawed in various ways, I think we can learn something important from him.Taylor couches the problem in terms of what we are supposed to presume about people's consent or dissent and he thinks that the USA and UK have a system of ‘presumed refusal’ “whereby it is presumed that a person would refuse to have her transplantable organs removed from her postmortem unless she had explicitly indicated otherwise” . Taylor makes a common mistake. The USA and UK have never had such a presumption. In these countries, people who explicitly refuse may not have their organs taken, whereas people who do not explicitly consent may have their organs taken if, roughly speaking, their families consent. Thus non-consenters are not presumed to be refusers.Leaving aside the mistake about the status quo, …. (shrink)

Cladistic analyses are based on the distinction between primitive and derived character states (hypotheses of the polarity of evolutionary transformations) and a complete reliance on only derived character state distributions as bona fide evidence of holophyletic assemblages of taxa. The cladistic premise that only derived character state distributions provide evidence of holophyly is reconsidered and shown to be both unjustified and inconsistent with the desire or methodological prescription of using all the available evidence. Cladistic techniques are here viewed primarily as (...) methods for the ordering of character states so that they may be differentially weighted. The problem of assigning realistic differential weight to primitive and derived character state distributions is briefly discussed. One possible use of primitive character state distributions as evidence of holophyly that is largely free of the problem of weight is proposed. This application is illustrated with an example from the caecilian amphibians (Amphibia: Gymnophiona). (shrink)

Huang and colleagues provide some intriguing insights into the attitudes about end of life care of practising Taiwanese neonatal doctors and nurses.1 There are some similarities with surveys from other parts of the world. Most Taiwanese neonatologists and nurses agreed that it was potentially appropriate to withhold or limit treatment for infants who were dying. A very high proportion was opposed to active euthanasia of such infants. But there were also some striking differences. Only 21% of Taiwanese doctors ‘agreed’ with (...) withdrawal of mechanical ventilation for dying newborn infants. This proportion is lower than reported in any European country.2 More than 90% of neonatologists surveyed in the UK, the USA, The Netherlands and Sweden found withdrawal of mechanical ventilation acceptable.2 ,3 Taiwanese doctors also seemed reluctant to give analgesia or sedatives to such infants, with almost 60% disagreeing with their use in dying infants where there was a risk of hastening death.1 In contrast, two-thirds or more of European neonatologists thought this was acceptable .2The results of the survey of Huang et al highlight three beliefs about end-of-life care that are widespread, but all of which are seriously mistaken1. None are new, but …. (shrink)

This paper develops a normative evaluation of the minimum wage in the light of recent evidence and theory about its effects. It argues that the minimum wage should be evaluated using a consequentialist criterion that gives priority to the jobs and incomes of the worst off. This criterion would be accepted by many different types of consequentialism, especially given the two major views about what the minimum wage does. One is that the minimum wage harms the jobs and incomes of (...) the worst off and the other is that it does neither much harm nor much good. The paper then argues at length that there are no important considerations besides jobs and incomes relevant to the assessment of the minimum wage. It criticizes exploitation arguments for the minimum wage. It is not clear that the minimum wage would reduce exploitation and the paper doubts that, if it did, it would do so in a morally significant way. The paper then criticizes freedom arguments against the minimum wage by rejecting appeals to self-ownership and freedom of contract and by arguing that no freedom of significance is lost by the minimum wage that is not already taken account of in the main consequentialist criterion. The conclusion is that, at worst, the minimum wage is a mistake and, at best, something to be half-hearted about. Footnotes1 My thanks to Paul Brown and Jerry Cohen for their written and verbal help, Andrew Williams for long discussions of this paper, two anonymous referees and the editors, and audiences at the Universities of Auckland, Newcastle, and Reading. (shrink)

The Mental Capacity Act will come into force in 2007. It sets out guidelines for the ethical review of research involving incompetent adults which will have an impact on the REC process. This paper attempts to explain the Act's requirements in a way that will give research ethics committees some clarity about what must be considered when reviewing applications. Potential difficulties have been highlighted with guidance as to how these might be resolved.

This work offers an evaluation of Plato’s portrayal of “Socrates” in relation to models of the ancient Greek “agon”, oral poetic performance, and the practices of “xenia”. The author reinterprets the values of the oral tradition and xenia as non-agonistic, and shows how these values can illuminate the dramatic and philosophical import of Plato’s Socrates in ways potentially relevant to current thinking about “demokratia”.

An attempt is made in this paper to analyze the purely formal nature of information-theoretic concepts. The suggestion follows that such concepts, used to supplement the logical and mathematical structure of the language of science, represent an addition to this language of such a sort as to allow the use of a unitary language for the description of phenomena. (The alternative to this approach must be certain multi-linguistic and mutually untranslatable descriptions of related phenomena, as with the various versions of (...) Complementarity). This conception is tested for the specific case of Heisenberg's Uncertainty Principle, in order to show that, with the assumption of a suitable and intuitively satisfactory definition of the quantity of information contained in a measurement, the Heisenberg Principle becomes an informational restriction arising from the formal properties of the symbols of a given language rather than as a "law" of nature. (shrink)

This paper examines issues of legitimacy surrounding feminist research in psychology, in relation to its current and future impact on the mainstream of the discipline. It argues that its relatively limited impact to date is due, in part, to the nature of feminist psychology, and, in part, to its interaction with the social institutions of psychology as a discipline. Further, the paper contends that the influence of the field may well remain relatively minor, however convincingly its potential benefits are argued, (...) if it fails both to analyse and to utilize the social processes by which legitimacy is conferred. (shrink)

La concepción de Marcus sobre las creencias se aplica al debate centrado en la cuestión: "¿Son creencias los delirios?" Dos consecuencias que se siguen de ello son: i) que la cuestión "¿Son creencias los delirios?" necesita reformularse, y ii) que la respuesta es: "No, algunos pacientes que sufren delirios no creen lo que, "prima facie", parecen creer".

Dating from around 300BC, Tao Te Ching is the first great classic of the Chinese school of philosophy called Taoism. Within its pages is summed up a complete view of the cosmos and how human beings should respond to it. A profound mystical insight into the nature of things forms the basis for a humane morality and vision of political utopia. The ideas in this work constitute one of the main shaping forces behind Chinese spirituality, art and science, so much (...) so that no understanding of Chinese civilisation is possible without a grasp of Taoism. This edition presents the authoritative translation by Arthur Waley, with a new Introduction reflecting recent developments in the interpretation of the work. (shrink)