The controversy over the equivalence of continuous sedation until death (CSD) and physician-assisted suicide/euthanasia (PAS/E) provides an opportunity to focus on a significant extended use of CSD. This extension, suggested by the equivalence of PAS/E and CSD, is designed to promote additional patient autonomy at the end-of-life. Samuel LiPuma, in his article, “Continuous Sedation Until Death as Physician-Assisted Suicide/Euthanasia: A Conceptual Analysis” claims equivalence between CSD and death; his paper is seminal in the equivalency debate. Critics contend that sedation (...) follows proportionality protocols for which LiPuma’s thesis does not adequately account. Furthermore, sedation may not eliminate consciousness, and as such LiPuma’s contention that CSD is equivalent to neocortical death is suspect. We not only defend the equivalence thesis, but also expand it to include additional moral considerations. First, we explain the equivalence thesis. This is followed by a defense of the thesis against five criticisms. The third section critiques the current use of CSD. Finally, we offer two proposals that, if adopted, would broaden the use of PAS/E and CSD and thereby expand options at the end-of-life. (shrink)

According to Aristotle, the medical art aims at health, which is a virtue of the body, and does so in an unlimited way. Consequently, medicine does not determine the extent to which health should be pursued, and “mental health” falls under medicine only via pros hen predication. Because medicine is inherently oriented to its end, it produces health in accordance with its nature and disease contrary to its nature—even when disease is good for the patient. Aristotle’s politician understands that this (...) inherent orientation can be systematically distorted, and so would see the need for something like the Hippocratic Oath. (shrink)

Scholars have often thought that a monistic reading of Aristotle’s definition of the human good – in particular, one on which “best and most teleios virtue” refers to theoretical wisdom – cannot follow from the premises of the ergon argument. I explain how a monistic reading can follow from the premises, and I argue that this interpretation gives the correct rationale for Aristotle’s definition. I then explain that even though the best and most teleios virtue must be a single virtue, (...) that virtue could in principle be a whole virtue that arises from the combination of all the others. I also clarify that the definition of the human good aims at capturing the nature of human eudaimonia only in its primary case. (shrink)

In Nicomachean Ethics 1. 7, Aristotle gives a definition of the human good, and he does so by means of the “ ergon argument.” I clear the way for a new interpretation of this argument by arguing that Aristotle does not think that the ergon of something is always the proper activity of that thing. Though he has a single concept of an ergon, Aristotle identifies the ergon of an X as an activity in some cases but a product in (...) others, depending on the sort of thing the X is—for while the ergon of the eye is seeing, the ergon of a sculptor is a sculpture. This alternative interpretation of Aristotle’s concept of an ergon allows the key explanatory middle term of the ergon argument to be what, I argue, it ought to be: “the best achievement of a human.”. (shrink)

We can clarify a certain difficulty with regard to the phrase ‘the best and most perfect virtue’ in Aristotle’s definition of the human good in Nicomachean Ethics I 7 if we make use of two related distinctions: Donnellan’s attributive–referential distinction and Kripke’s distinction between speaker’s reference and semantic reference. I suggest that Aristotle is using the phrase ‘the best and most perfect virtue’ attributively, not referentially, and further that even though the phrase may refer to a specific virtue (semantic reference), (...) Aristotle is not using the phrase to refer to a specific virtue (speaker’s reference). (shrink)

We have good reason to believe that Nicomachean Ethics VI. 2 is a Nicomachean revision of an originally Eudemian text. Aristotle seems to have inserted lines 1139a31-b11 by means of a marginal note, which the first editor then mistakenly added in the wrong place, and I propose that we move these lines so that they follow the word κοινωνεῖν at 1139a20. The suggested note appears to be Nicomachean for several reasons but most importantly because it contains a desire-based account of (...) the practical intellect as teleologically oriented to action. The NE articulates consequences of this account regarding practical philosophy’s methodology and teleological orientation to action. The EE does not articulate such consequences, and instead seems to assume an object-based account of the practical intellect. Consequently, it would seem that, between the EE and the NE, Aristotle revised his conception of the practical intellect and consequently his conception of practical philosophy. (shrink)

What is a human body? Some reasons are given for thinking that, in the primary case, it is a body that is both of and suitable to a rational animal.

This book is a collection of introspective essays bringing together the experience of the biographical process of biographers. It illustrates which type of psychoanalytic response is likely to catalyze a process that will increase the biographer's self-awareness as it pertains to his creativity.

For the last fifty years, the United States healthcare system has done an extremely poor job of delivering healthcare in a just and fair manner. The United States holds the dubious distinction of being the only industrialized nation in the world lacking provisions to ensure universal coverage. We attempt to provide some of the reasons this dysfunctional system has persisted and show that healthcare should not be a commodity. We begin with a brief historical overview of healthcare delivery in the (...) United States since WWII. This is followed by a critical analysis of the for-profit model including reasons to support the view that healthcare should not be a free market commodity. We also demonstrate how special interest groups have been able to win support for their practices based on propaganda rather than fact. A brief analysis of the Affordable Care Act is offered along with critical comments regarding its ineffectiveness. We conclude with a brief overview of international approaches that have resulted in universal coverage and suggest the United States ought to adopt an approach similar to those outlined so that it no longer stands as the only industrialized nation to ignore the glaring problems that exist. (shrink)

Pragmatism is a distinctive approach to clinical research ethics that can guide bioethicists and members of institutional review boards (IRBs) as they struggle to balance the competing values of promoting medical research and protecting human subjects participating in it. After defining our understanding of pragmatism in the setting of clinical research ethics, we show how a pragmatic approach can provide guidance not only for the day-to-day functioning of the IRB, but also for evaluation of policy standards, such as the one (...) that addresses acceptable risks for healthy children in clinical research trials. We also show how pragmatic considerations might influence the debate about the use of deception in clinical research. Finally, we show how a pragmatic approach, by regarding the promotion of human research and the protection of human subjects as equally important values, helps to break down the false dichotomy between science and ethics in clinical research. (shrink)

The American Journal of Bioethics, Volume 11, Issue 6, Page 48-49, June 2011.

Concerns have been raised in Africa to address women’s construction health and safety needs adequately. These concerns include less participation of women in the sector, low income and less benefits being given to women, lack of adequate protective construction clothing suited for women, unfavourable employment conditions for women, and lack of construction site security and other facilities for women. This research article provides an overview of the suggested solutions to address the concerns raised. In addition, practical interventions being implemented by (...) the Durban University of Technology and Makerere University research collaboration project team to address women’s needs in construction health and safety through women empowerment and involvement in construction research, education and practice in Africa are outlined. The main approaches applied in this research study are as follows: use of relevant publications on women’s construction health and safety needs in Africa and analysis of data obtained from reliable construction professional bodies in South Africa and Uganda to demonstrate gender imbalances.Contribution: The main contribution of this study was to emphasise the significance of including and involving women in construction research, education and practice as a major solution to address women’s health and safety needs in Africa in the future as women are in a much better position to understand their own needs than men. (shrink)

The HIV/AIDS epidemic is increasingly a diseaseof the disadvantaged, a destroyer of nations,and a threat to global security and well-being.But this need not be so: the world has thescientific knowledge, technologicalinnovations, and financial resources tosignificantly reduce the spread and sufferingcaused by the disease. This paper argues thatthe wealthy nations of the world, led by theUnited States, have a moral obligation to offermuch greater assistance to developing countrieswhere the epidemic is most severe. UsingZimbabwe as a case study, this essay examinesthe immediate (...) and underlying factors behind theepidemic in order to make realistic andaffordable policy recommendations that includenew investments in global health care, debtrelief, and long-term economic development. Bydemonstrating our ability to dramaticallyaffect the future course and consequences ofthis unprecedented epidemic, the paperconcludes that greater action is not only inthe interest of public health, but is also amoral imperative. By investing the necessaryresources to improve public health and toreduce global poverty, we promote and extendthe fundamental rights and values that weprofess to hold dear. (shrink)

This book examines when it is morally appropriate for medical intervention to hasten the dying process. The authors’ overriding goal is to humanize the dying process by expanding patient centered autonomous control.

As currently practiced, the use of continuous sedation until death (CSD) is controlled by clinicians in a way that may deny patients a key choice in controlling their dying process. Ethical guidelines from the American Medical Association and the American Academy of Pain Medicine describe CSD as a “last resort,” and a position statement from the American Academy of Hospice and Palliative Medicine describe it as “an intervention reserved for extreme situations.” Accordingly, patients must progress to unremitting pain and suffering (...) and reach a last-resort stage before the option to pursue CSD is considered. Alternatively, we present and defend a new guideline in which decisionally capable, terminally ill patients who have a life expectancy of less than six months may request CSD before being subjected to the refractory suffering of a treatment of “last resort.”. (shrink)

While deductive validity provides the limiting upper bound for evaluating the strength and quality of inferences, by itself it is an inadequate tool for evaluating arguments, arguing, and argumentation. Similar remarks can be made about rhetorical success and dialectical closure. Then what would count as ideal argumentation? In this paper we introduce the concept of cognitive compathy to point in the direction of one way to answer that question. It is a feature of our argumentation rather than my argument or (...) your argument. In that respect, compathy is like the harmonies achieved by an accomplished choir, the spontaneous coordination of athletic teamwork, or the experience of improvising jazz musicians when they are all in the flow together. It is a characteristic of arguments, not a virtue that can be attributed to individual arguers. It makes argumentation more than just the sum of its individual parts. The concept of cognitive compathy is brought into focus by locating it at the confluence of two lines of thought. First, we work up to the concept of compathy by contrasting it with empathy and sympathy in the context of emotions, which is then transplanted into epistemic, cognitive, and argumentative soil. Second, the concept is analytically linked to ideal argumentation by way of authenticity in communication. In the final section, we explore the extent to which argumentative virtues are conducive to producing compathetic argumentation, but reach the unhappy conclusion that the extra value of compathetic argumentation also transcends the evaluative reach of virtue argumentation theory. (shrink)