There have been few empirical studies into what non-medical factors influence physicians and nurses when deciding about admission and discharge of ICU patients. Information about the attitudes of healthcare professionals about this process can be used to improve decision-making about resource allocation in intensive care. To provide insight into ethical problems that influence the ICU admission and discharge process, we aimed to identify and explore ethical dilemmas healthcare professionals are faced with.

While Gabriel Watts and Ainsley Newson argue that diagnostic laboratories do not have a general duty to routinely reinterpret genomic variant classifications, they do formulate several restricted duties to actively reinterpret specific types of classifications.1 They place these duties with laboratories, acknowledging that they are setting aside any responsibilities that might arise for clinicians. Here, we will discuss the implications of this obligation for clinicians and the moral tension it may confront them with. We focus in particular on the consequences (...) of the proposed moral obligation to actively reinterpret variant classifications that carry a higher risk of being false positives. Such reclassification is likely to result in ‘downgrades’: previously pathogenic variants (pathogenic/likely pathogenic, P/LP) reclassified to benign (likely benign/benign, LB/B) or uncertain variants (variant of uncertain significance, VUS). Any laboratory policy to actively reinterpret (specific sets of) classifications will confront the clinician with the question whether the person tested should be recontacted on a reinterpretation of previously reported results. As others have pointed out, recontacting in general comes with challenges, since patients may not want to be recontacted or have forgotten about their genetic test.2 3 Recontacting in case of a downgrade, however, is particularly impactful. Previous studies on the psychosocial impact of reclassification on patients …. (shrink)

Newborn screening involves a complex logistical process, which depends on the close cooperation of many professionals, such as midwives, laboratory technicians, general practitioners and pediatricians. These professionals may encounter moral problems in the process, which have not been systematically studied before. This study fills this gap. We conducted interviews with 36 professionals involved in NBS in the Netherlands and made an inventory of the moral problems they encounter, as well as of the ways in which they tend to respond to (...) them. The moral problems professionals encounter stem from interpersonal conflicts and intrapersonal conflicts. Given the complexity of the work of NBS professionals, the study suggests that the moral problems that occur on the work floor cannot easily be solved by means of offering better or more stringent policy guidelines. Rather, it should be appreciated that professionals contribute significantly to shaping the morality of NBS with the help of their daily choices, and they should be supported in carrying out this task—for example with the help of a moral training or regular multidisciplinary moral deliberation, facilitated by an ethicist. (shrink)

In their 2007 paper, Swierstra and Rip identify characteristic tropes and patterns of moral argumentation in the debate about the ethics of new and emerging science and technologies (or “NEST-ethics”). Taking their NEST-ethics structure as a starting point, we considered the debate about tissue engineering (TE), and argue what aspects we think ought to be a part of a rich and high-quality debate of TE. The debate surrounding TE seems to be predominantly a debate among experts. When considering the NEST-ethics (...) arguments that deal directly with technology, we can generally conclude that consequentialist arguments are by far the most prominently featured in discussions of TE. In addition, many papers discuss principles, rights and duties relevant to aspects of TE, both in a positive and in a critical sense. Justice arguments are only sporadically made, some “good life” arguments are used, others less so (such as the explicit articulation of perceived limits, or the technology as a technological fix for a social problem). Missing topics in the discussion, at least from the perspective of NEST-ethics, are second “level” arguments—those referring to techno-moral change connected to tissue engineering. Currently, the discussion about tissue engineering mostly focuses on its so-called “hard impacts”—quantifiable risks and benefits of the technology. Its “soft impacts”—effects that cannot easily be quantified, such as changes to experience, habits and perceptions, should receive more attention. (shrink)

In their 2007 paper, Swierstra and Rip identify characteristic tropes and patterns of moral argumentation in the debate about the ethics of new and emerging science and technologies (or “NEST-ethics”). Taking their NEST-ethics structure as a starting point, we considered the debate about tissue engineering (TE), and argue what aspects we think ought to be a part of a rich and high-quality debate of TE. The debate surrounding TE seems to be predominantly a debate among experts. When considering the NEST-ethics (...) arguments that deal directly with technology, we can generally conclude that consequentialist arguments are by far the most prominently featured in discussions of TE. In addition, many papers discuss principles, rights and duties relevant to aspects of TE, both in a positive and in a critical sense. Justice arguments are only sporadically made, some “good life” arguments are used, others less so (such as the explicit articulation of perceived limits, or the technology as a technological fix for a social problem). Missing topics in the discussion, at least from the perspective of NEST-ethics, are second “level” arguments—those referring to techno-moral change connected to tissue engineering. Currently, the discussion about tissue engineering mostly focuses on its so-called “hard impacts”—quantifiable risks and benefits of the technology. Its “soft impacts”—effects that cannot easily be quantified, such as changes to experience, habits and perceptions, should receive more attention. (shrink)

The Dutch system of obstetric care is often recommended for midwife-attended births, the high number of home deliveries, and the low rate of intervention during pregnancy and labour. In this contribution, the question is addressed whether processes of medicalization can be demonstrated in the Dutch midwife practice. Medicalization of pregnancy and childbirth is often criticized because it creates dependency on the medical system and infringement of the autonomy of pregnant women. It is concluded that medicalization is present in the practice (...) of Dutch independent midwives, however it is less clear and outspoken than in hospital policies. (shrink)

Erich Fromm was a political activist, psychologist, psychoanalyst, philosopher, and one of the most important intellectuals of the twentieth century. Known for his theories of personality and political insight, Fromm dissected the sadomasochistic appeal of brutal dictators while also eloquently championing love--which, he insisted, was nothing if it did not involve joyful contact with others and humanity at large. Admired all over the world, Fromm continues to inspire with his message of universal brotherhood and quest for lasting peace. The first (...) systematic study of Fromm's influences and achievements, this biography revisits the thinker's most important works, especially _Escape from Freedom_ and _The Art of Loving_, which conveyed important and complex ideas to millions of readers. The volume recounts Fromm's political activism as a founder and major funder of Amnesty International, the National Committee for a Sane Nuclear Policy, and other peace groups. Consulting rare archival materials across the globe, Lawrence J. Friedman reveals Fromm's support for anti-Stalinist democratic movements in Central and Eastern Europe and his efforts to revitalize American democracy. For the first time, readers learn about Fromm's direct contact with high officials in the American government on matters of war and peace while accessing a deeper understanding of his conceptual differences with Freud, his rapport with Neo-Freudians like Karen Horney and Harry Stack Sullivan, and his association with innovative artists, public intellectuals, and world leaders. Friedman elucidates Fromm's key intellectual contributions, especially his innovative concept of "social character," in which social institutions and practices shape the inner psyche, and he clarifies Fromm's conception of love as an acquired skill. Taking full stock of the thinker's historical and global accomplishments, Friedman portrays a man of immense authenticity and spirituality who made life in the twentieth century more humane than it might have been. (shrink)

The Constitution of the Athenians ascribed to Xenophon the orator.--The Politeia of the Spartans by Xenophon.--The Boeotian Constitution from the Oxyrhynchus historian.--The Constitution of Athens by Aristotle.

With the passing of S. A. Janovskaja, contemporary Soviet philosophy has lost one of its leading experts in logic and in combining creativity with survival.

Until now, adult crying has received relatively little interest from investigators, whereas in the popular media there are many strong claims about crying (e.g., crying brings relief) of which the scientific basis is not clear. In this review, we provide an overview of the current state of the scientific literature with respect to crying. We identify gaps in knowledge and propose questions for future research. The following topics receive special attention: Ontogenetic development, antecedents, individual and gender differences, and the intra- (...) and interindividual effects of crying. We conclude that the study of crying may help us obtain better insight into human nature, that is, not only our emotional, but also social, and moral functioning. (shrink)

Outstanding translations by leading contemporary scholars--many commissioned especially for this volume--are presented here in the first single edition to include the entire surviving corpus of works attributed to Plato in antiquity. In his introductory essay, John Cooper explains the presentation of these works, discusses questions concerning the chronology of their composition, comments on the dialogue form in which Plato wrote, and offers guidance on approaching the reading and study of Plato's works. Also included are concise introductions by Cooper and Hutchinson (...) to each translation, meticulous annotation designed to serve both scholar and general reader, and a comprehensive index. This handsome volume offers fine paper and a high-quality Smyth-sewn cloth binding in a sturdy, elegant edition. (shrink)

In this 1974 book a practising scientist and gifted expositor sets forth an exciting point of view on the nature of science and how it works.

BLWith new text and full apparatus criticus The Eudemian Ethics was one of two ethical treatises which Aristotle wrote on the subject of ethica or `matters to do with character'. Although the two works cover much the same ground, the Nicomachean Ethics is better known; the poor manuscript tradition of the Eudemian Ethics has made correct translation and interpretation of the text extremely difficult. The subject of the work is the choice of a certain means of conduct, made by a (...) `man of practical wisdom', between two extremes of behaviour: asceticism and yielding to uncontrolled impulses. Aristotle also stresses the notion of moral intention and the importance of virtue of character. This new Oxford Classical Text of the Eudemian Ethics is the result of many years of work. After Sir David Ross's death, his original text was substantially reworked and revised by his friend and colleague R. R. Walzer, who was aided in the revision by his former pupil Mrs Jean Mingay, who continued his work after his death in 1974. Mrs Mingay was fortunate in being able to make use of previously unpublished contributions from D. J. Allan after his death in the late seventies, and more recently has been helped in her work by the suggestions of Professor D. A. Russell, David Robinson, and Christopher Rowe. (shrink)

CONSCIOUSNESS AND THE BRAIN SELF-REGULATION PARADOX The relationship of consciousness to biology has intrigued mankind thoroughout recorded history. However, little progress has been made not only in understanding these issues but also in raising fundamental questions central to the problem. As Davidson and Davidson note in their introduction, William James suggested, almost a century ago in his Principles of Psychology, that the brain was the organ of mind and be havior. James went so far as to suggest that the remainder (...) of the Principles was but a "footnote" to this central thesis. This volume brings together diverse biobehavioral scientists who are addressing the various aspects of the mindlbrainlbodylbehavior issue. Although some of the authors have previously published together in other volumes, by and large the particular combination of authors and topics selected by the editors makes this volume unique and timely. Unlike the Consciousness and Self-Regulation series (Schwartz & Shapiro, 1976, 1978), also published by Plenum, this volume is devoted entirely to a psychobiological approach to consciousness. Although readers will differ in their interest in specific chapters, the well-rounded investigator who is concerned with the psychobiology of consciousness will want to become intimately acquainted with all the views presented in this volume. As noted by the individual contributors, the topic of this volume stimulates fundamental questions which, on the surface, may appear trivial, yet, on further reflection, turn out to have deep significance. (shrink)

Theodor W. Adorno is best known for his contributions to aesthetics and social theory. Critics have always complained about the lack of a practical, political or ethical dimension to Adorno's philosophy. In this highly original contribution to the literature on Adorno, J. M. Bernstein offers the first attempt in any language to provide an account of the ethical theory latent in Adorno's writings. Bernstein relates Adorno's ethics to major trends in contemporary moral philosophy. He analyses the full range of Adorno's (...) major works, with a special focus on Dialectic of Enlightenment, Minima Moralia and Negative Dialectics. In developing his account Bernstein lays particular stress on Adorno's contention that the event of Auschwitz demands a new categorical imperative. This book will be widely acknowledged as the standard work on Adorno's ethics and as such will interest professionals and students of philosophy, political theory, sociology, history of ideas, art history and music. (shrink)