BackgroundPalliative sedation and analgesia are employed in patients with refractory and intractable symptoms at the end of life to reduce their suffering by lowering their level of consciousness. The doctrine of double effect, a philosophical principle that justifies doing a “good action” with a potentially “bad effect,” is frequently employed to provide an ethical justification for this practice. Main textWe argue that palliative sedation and analgesia do not fulfill the conditions required to apply the doctrine of double effect, and therefore (...) its use in this domain is inappropriate. Furthermore, we argue that the frequent application of the doctrine of double effect to palliative sedation and analgesia reflects physicians’ discomfort with the complex moral, intentional, and causal aspects of end-of-life care. ConclusionsWe are concerned that this misapplication of the doctrine of double effect can consequently impair physicians’ ethical reasoning and relationships with patients at the end of life. (shrink)

The model of parallel architecture for language presented by Jackendoff is a kind of stratificational model in the spirit of Sydney Lamb. It differs from the more usual stratificationalism most importantly in its clear commitment to nativism, though the variety of nativism is greatly modified from what is more usual among Chomskyans. The revised model presents a potential for fruitful discussion with proponents of stratificationalism, and the potential for enrichment via a relational implementation.

Drawing upon the disciplines of bioethics, anthropology and politics, Linda F Hogle examines the use of human body parts for transplantation and research in modern Germany. She focuses on German attitudes to organ transplantation and the fears expressed by doctors and the public regarding utilitarian justification of the use of body parts taken from the vulnerable to benefit others. In modern Germany, argues Hogle, organ transplantation and practices relating to the use of human body parts have developed under the shadow (...) of the history of medicine during National Socialism. This can be seen in the recent controversy over brain death, where the spectre of “lives not worth living” has been invoked in the context of decisions to declare death and authorise removal of body parts. Ethical tensions were …. (shrink)

l examine Singer’s analogy between human liberation movements and animal liberation movements. Two lines of criticism of animal liberation are rejected: (1) that animal-liberation is not as serious as human liberation since humans have interests which override those of animals; (2) that the concept of animal liberation blurs distinctions between what is appropriate for humans and what is appropriate foranimals. As an alternative I otfer a distinction between reform movements and liberation movements, arguing that while Singer meets the criterion for (...) the former, a higher degree of autonomy and communicative competence is necessary for the latter. In the final section, objections to the possibility of an autonomous animal liberation movement are met by rejecting assumptions concerning the illogicality of interspecies communication. (shrink)

Dramatic changes in medical technology challenge mankind’s traditional ways of diagnosing death. Death, Brain Death and Ethics examines the concept of death against the background of these changes, as well as ethical and philosophical issues arising from attempts to redefine the boundaries of life. In this book, David Lamb supports the use of brain-related criteria for the diagnosis of death, and proposes a new clinical definition of death based on both medical and philosophical principles. Death, Brain Death and Ethics (...) articulates the case for a brain death standard, while presenting an informed viewpoint on what constitutes the end points of human life. Although the book is written from a philosophical standpoint, it raises fundamental questions regarding the meaning of life and death, and will interest lay-persons, lawyers, and physicians. Death, Brain Death and Ethics is sure to prompt discussion and reflection on some of the philosophical beliefs which underlie clinical practice. (shrink)

A `slippery slope' argument in medical ethics is one that opposes itself to a new proposal on the grounds that it is not _per se_ intolerable but will lead to a situation that is. Lamb evaluates such arguments, demonstrating their centrality to the subject.

In this reply to David J Cole it is argued that the medical concept of death as an irreversible phenomenon is correct and that it does not conflict with ordinary concepts of death.

A `slippery slope' argument in medical ethics is one that opposes itself to a new proposal on the grounds that it is not per se intolerable but will lead to a situation that is. Lamb evaluates such arguments, demonstrating their centrality to the subject.

A `slippery slope' argument in medical ethics is one that opposes itself to a new proposal on the grounds that it is not _per se_ intolerable but will lead to a situation that is. Lamb evaluates such arguments, demonstrating their centrality to the subject.

This paper examines the development of the concept of brain death and of the criteria necessary for its recognition. Competing formulations of brain death are assessed and the case for a ‘brainstem’ concept of death is argued. Attention is finally drawn to some of the ethical issues raised by the use of neurological criteria in the diagnosis of human death.

Originally published in 1987, this volume reflects the diversity in Hegelianism and every branch of philosophy which he contributed to. It includes essays on his contribution to contemporary social philosophy, logic and the philosophy of religion. His work is examined in relation to Marx, Wittgenstein and his social philosophy discussed from a feminist standpoint.

Originally published in 1990, this study of the moral problems bound up with transplant therapy addresses a finely balanced distinction between ethical issues relating to its experimental nature on the one hand and those which arise when transplantation is routine on the other. Among the issues examined are proposals for routine cadaveric harvesting, criteria for organ and tissue procurement from living donors, foetuses, non-human animals and current ethical problems with artificial implants. Written as a contribution to practical philosophy, this book (...) will interest ethicists and health care professionals. (shrink)

In this commentary on the recommendations of the Danish Council of Ethics (DCE) concerning criteria for death it is argued that whilst the DCE is correct in stressing the cultural aspects of death, its adoption of cardiac-oriented criteria raises several problems. There are problems with its notion of a 'death process', which purportedly begins with brain death and ends with cessation of cardiac function, and there are serious problems regarding its commitment to a cardiac-oriented definition whilst permitting transplantation when the (...) heart is still beating. (shrink)

This stimulating collection is devoted to the life and work of the most flamboyant of twentieth-century philosophers, Paul Feyerabend. Feyerabend's radical epistemological claims, and his stunning argument that there is no such thing as scientific method, were highly influential during his life and have only gained attention since his death in 1994. The essays that make up this volume, written by some of today's most respected philosophers of science, many of whom knew Feyerabend as students and colleagues, cover the diverse (...) themes in his extensive body of work and present a personal account of this fascinating thinker. (shrink)

Is the Search for Extra Terrestrial Intelligence a genuine scientific research programme? David Lamb evaluates claims and counter-claims, and examines recent attempts to establish contact with other intelligent life forms. He considers the benefits and drawbacks of this communication, how we should communicate and whether we actually can. He also assesses competing theories on the origin of life on Earth, discoveries of former solar planets, proposals for space colonies and the consequent technical and ethical issues.

Drawing on ten years of research on the unpublished Wittgenstein papers, Stern investigates what motivated Wittgenstein's philosophical writing and casts new light on the Tractatus and Philosophical Investigations. The book is an exposition of Wittgenstein's early conception of the nature of representation and how his later revision and criticism of that work led to a radically different way of looking at mind and language. It also explains how the unpublished manuscripts and typescripts were put together and why they often provide (...) better evidence of the development of his ideas than can be found in his published writing. In doing so, the book traces the development of a number of central themes in Wittgenstein's philosophy, including his conception of philosophical method, the picture theory of meaning, the limits of language, the application of language to experience, his treatment of private language, and what he called the "flow of life." Arguing that Wittgenstein's views are often much more simple (and more radical) than we have been led to believe, Wittgenstein on Mind and Language provides an overview of the development of Wittgenstein's philosophy and brings to light aspects of his philosophy that have been almost universally neglected. (shrink)

In this commentary on the recommendations of the Danish Council of Ethics (DCE) concerning criteria for death it is argued that whilst the DCE is correct in stressing the cultural aspects of death, its adoption of cardiac-oriented criteria raises several problems. There are problems with its notion of a 'death process', which purportedly begins with brain death and ends with cessation of cardiac function, and there are serious problems regarding its commitment to a cardiac-oriented definition whilst permitting transplantation when the (...) heart is still beating. (shrink)

This paper is a reply to proposals to base priority health-care decisions on public opinion surveys. Whilst it is recognised that current practice is less than satisfactory, it is argued here that basing health-care priorities on societal attitudes in this way is not a solution and does not provide a satisfactory basis for bringing democracy to the health service.

Autonomous decision-making over therapy options is not reducible to the refusal of unwanted medical intervention. This is a myth that has been imported from questionable assumptions in political economy, and is of little benefit to medical practice and the sometimes agonizing decisions which have to be taken by patients and their relatives. An individual's right to therapy abatement can be protected from abuse only in the context of a full understanding of autonomous choice; not merely the right to refuse, but (...) the opportunity to receive assistance and consider alternatives. Limits are also required on the role of the surrogate in the refusal of therapy. Policies endorsing therapy abatement and exercise of the right to forego life-sustaining therapy should carry cast iron guarantees that they will not be disadvantageous to the poor and undereducated members of society. It should also be noted that fears of unlimited life-prolongation have been greatly exaggerated. In an atmosphere of governmental indifference to the plight of the sick, with the notion of welfare tuned to market forces, there is a danger that self-determination can have a restricted meaning; the option of death in the context of an underfunded health service. This may not be the time to campaign for the right to refuse therapy, but rather the time to campaign for improvements to existing therapy. (shrink)

This reply to P Whitaker's `Resource allocation: a plea for a touch of realism' acknowledges that health-care ethics should be relevant to events in the real world, but questions the extent to which philosophical inquiry should be confined to parameters determined by existing sociopolitical forces. The reading of the daily paper is the morning prayer of the realist.

l examine Singer’s analogy between human liberation movements and animal liberation movements. Two lines of criticism of animal liberation are rejected: (1) that animal-liberation is not as serious as human liberation since humans have interests which override those of animals; (2) that the concept of animal liberation blurs distinctions between what is appropriate for humans and what is appropriate foranimals. As an alternative I otfer a distinction between reform movements and liberation movements, arguing that while Singer meets the criterion for (...) the former, a higher degree of autonomy and communicative competence is necessary for the latter. In the final section, objections to the possibility of an autonomous animal liberation movement are met by rejecting assumptions concerning the illogicality of interspecies communication. (shrink)

Introducing Applied Ethics Edited by Brenda Almond, Blackwell, 1995. Pp. 375. ISBN 0-631-19389-8. 45.00 (hbk), 14.99 (pbk). Environmental Ethics Edited by Robert Elliot, Oxford University Press, 1995. Pp. 255. ISBN 9-19-875144-3. 9.95 (pbk) Medicine and Moral Reasoning Edited by K.W.M. Fulford, Grant Gillett and Janet Martin Soskice Cambridge University Press, 1994. Pp. 207. ISBN 0-521-45325-9 37.50 (hbk), 12.95 (pbk). Enlightenment and Religion. Rational Dissent in Eighteenth-century Britain Edited by Knud Haakonssen, Cambridge University Press, 1996. Pp. xii + 348. ISBN 0-521-56060-8. (...) 40.00. Dialettica, Arte e Societ : Saggio su Theodor W. Adorno By Giacomo Rinaldi, Quattroventi, Urbino, 1994. Pp. 205. L. 30,000. Relevance: Communication and Cognition, new revised edition, By Dan Sperber and Deirdre Wilson, Blackwell, 1995. Pp. 326. ISBN 0-631-19878-4. 15.99. Autobiographical Reflections By Eric Voegelin (Edited, with Introduction, by Ellis Sandoz), Louisiana State University Press, 1996. Pp. 131. ISBN 0807120766 $10.95. (shrink)

This paper examines the development of the concept of brain death and of the criteria necessary for its recognition. Competing formulations of brain death are assessed and the case for a ‘brainstem’ concept of death is argued. Attention is finally drawn to some of the ethical issues raised by the use of neurological criteria in the diagnosis of human death.

In this new introduction to a classic philosophical text, David Stern examines Wittgenstein's Philosophical Investigations. He gives particular attention to both the arguments of the Investigations and the way in which the work is written, and especially to the role of dialogue in the book. While he concentrates on helping the reader to arrive at his or her own interpretation of the primary text, he also provides guidance to the unusually wide range of existing interpretations, and to the reasons (...) why the Investigations have inspired such a diversity of readings. Following closely the text of the Investigations and meant to be read alongside it, this survey is accessible to readers with no previous background in philosophy. It is well-suited to university-level courses on Wittgenstein, but can also be read with profit by students in other disciplines. (shrink)

Is the Search for Extra Terrestrial Intelligence a genuine scientific research programme? David Lamb evaluates claims and counter-claims, and examines recent attempts to establish contact with other intelligent life forms. He considers the benefits and drawbacks of this communication, how we should communicate and whether we actually can. He also assesses competing theories on the origin of life on Earth, discoveries of former solar planets, proposals for space colonies and the consequent technical and ethical issues.

Although the importance of spirituality is increasingly recognized in clinical medicine, spirituality is rarely mentioned in the practice, literature, or training programs of global health. To understand the role of spirituality in global health practice and identify factors that influence and limit its expression, I initiated conversations and informal interviews with more than 300 global health leaders, students, and practitioners during 2010-2014. Four spiritual themes or challenges emerged: compassion at a distance; dichotomous thinking; conspiracy of silence; and compulsion to save (...) the world. Practitioners expressed strong interest in bringing spirituality more fully into global health discourse, which could help the field realize its potential. (shrink)

This is a two-volume study of the work of 18th-century German philosopher Georg Hegel. When studying Hegel's work it is notoriously difficult to find a starting point. Volume I begins with his views on moral issues and progresses through political and legal theory and property and punishment. Volume II explores Hegel's ideas of logic, freedom and recognition, science, aesthetics, religion and feminism in the 20th century.

Papers delivered at the joint meeting of the Hegel Society of America and the Hegel Society of Great Britain held at Merton College, Oxford, Sept. 1-4, 1981, to mark the 150th anniversary of Hegel's death. Includes bibliographical references and index.

Well-known social psychologist David G. Myers addresses why Americans can have so many social problems--reflecting a deep spiritual poverty--at a time when material wealth is at record levels. 32 illustrations.