In this short article, we articulate a position that organ recovery from uncontrolled DCD — primarily patients who have suffered a cardiac arrest — is unlikely to result in a significant number of organs, and this small gain must be balanced against significant risk of unduly influencing resuscitation provider decision-making, and jeopardizing public trust in the propriety of organ donation and transplantation.

Serious actualism is the view that it is metaphysically impossible for an entity to have a property, or stand in a relation, and not exist. Fine (1985) and Pollock (1985) influentially argue that this view is false. In short, there are properties like the property of nonexistence, and it is metaphysically possible that some entity both exemplifies such a property and does not exist. I argue that such arguments are indeed successful against the standard formulation of serious actualism. However, I (...) also argue that we should distinguish a weaker formulation of serious actualism using the actualist distinction between truth in, and truth at, a possible world. This weaker formulation is then shown to be consistent with the existence and possible exemplification of properties like the property of nonexistence. I end with a novel argument for the truth of the weaker formulation. (shrink)

Body integrity identity disorder (BIID), previously called apotemnophilia, is an extremely rare condition where sufferers desire the amputation of a healthy limb because of distress associated with its presence. This paper reviews the medical and philosophical literature on BIID. It proposes an evidenced based and ethically informed approach to its management. Amputation of a healthy limb is an ethically defensible treatment option in BIID and should be offered in some circumstances, but only after clarification of the diagnosis and consideration of (...) other treatment options. (shrink)

“I think there’s a big strong belief in [...] the community … and maybe it’s in the world at large that somehow the doctors are more concerned about harvesting the organs than what’s best for the patient.”1 In the past 45 years, organ and tissue recovery and transplantation have moved from the occasional and experimental to a standard of care for end-stage organ failure; receiving an organ transplant is for many the only opportunity for increased quantity and/or quality of life. (...) The increasing prevalence of diseases such as viral hepatitis, diabetes, and hypertension has significantly increased the incidence of end-organ failure. Additionally, surgical advances have permitted less stringent qualification criteria, so that people of advanced age or patients who may be in a physiologically fragile state are now eligible to be organ recipients. These changes have created a significant demand for organs. (shrink)

Engineering the Climate: The Ethics of Solar Radiation Management is a wide-ranging and expert analysis of the ethics of the intentional management of solar radiation. This book will be a useful tool for policy-makers, a provocation for ethicists, and an eye-opening analysis for both the scientist and the general reader with interest in climate change.

Propositional contingentism is the view that what propositions there are is a contingent matter—certain propositions ontologically depend on objects which themselves only contingently exist. Possible worlds are, loosely, complete ways the world could have been. That is to say, the ways in which everything in its totality could have been. Propositional contingentists make use of possible worlds frequently. However, a neglected, but important, question concerns whether there are any notions of worlds which are both theoretically adequate and consistent with propositional (...) contingentism. Some notion of a possible world is adequate if the systematic connection between, at least, possibility and truth at some possible world holds. Here, I argue that no adequate notion of a possible world is available to at least those who subscribe to one natural formulation of propositional contingentism. I also show that this result contrasts with a simple and adequate definition of a possible world available to the necessitist—those who hold that necessarily everything necessarily exists. (shrink)

Let serious propositional contingentism (SPC) be the package of views which consists in (i) the thesis that propositions expressed by sentences featuring terms depend, for their existence, on the existence of the referents of those terms, (ii) serious actualism—the view that it is impossible for an object to exemplify a property and not exist—and (iii) contingentism—the view that it is at least possible that some thing might not have been something. SPC is popular and compelling. But what should we say (...) about possible worlds, if we accept SPC? Here, I first show that a natural view of possible worlds, well-represented in the literature, in conjunction with SPC is inadequate. Though I note various alternative ways of thinking about possible worlds in response to the first problem, I then outline a second more general problem—a master argument—which generally shows that any account of possible worlds meeting very minimal requirements will be inconsistent with compelling claims about mere possibilia which the serious propositional contingentist should accept. (shrink)

Serious actualists take it that all properties are existence entailing. I present a simple puzzle about sentence tokens which seems to show that serious actualism is false. I then consider the most promising response to the puzzle. This is the idea that the serious actualist should take ordinary property-talk to contain an implicit existential presupposition. I argue that this approach does not work: it fails to generalise appropriately to all sentence types and tokens. In particular, it fails to capture the (...) right distinctions we ought to make between what I call _typographical sentence types_—an interesting and previously undiscussed class of fine-grained sentence types which are partially individuated by their typography, or how they look when written out. (shrink)

Increasingly, voices in the growing neurodiversity movement are alleging that individuals who are neurologically divergent, such as those with conditions related to bipolar disorder, autism, schizophrenia, and depression, must struggle for their civil rights. This movement therefore raises questions of interest to scholars in the humanities and social sciences, as well as to concerned members of the general public. These questions have to do with such matters as the accessibility of knowledge about mental health; autonomy and community within the realm (...) of the mentally ill; and accommodation in civil society and its institutions. The contributors to Ethics and Neurodiversity explore these questions, and the traditional philosophical questions related to them. The authors pay special attention to the need to examine the policies and practices of institutions, such as higher education, social support, and healthcare. (shrink)

Anthropology of Consciousness, EarlyView.

The architectural photographer Julius Shulman (1910-2009) is one of the few image makers to have documented, as well as witnessed, nearly an entire century of Los Angeles history.

Name der Zeitschrift: Klio Jahrgang: 99 Heft: 1 Seiten: 342-349.

sirIn a scholarly and thought-provoking paper, Clarke sets out to debunk the concept of “rational suicide” as nonsensical.1 His motivation in this is to undermine any support that the notion of rational suicide might give to a “categorical right to suicide”. If his enterprise were successful, however, it would go far beyond the “rights issue” and would have a profound impact on all arguments raised in support of euthanasia or physician-assisted suicide.Clarke's major thrust might be termed the argument from posthumous (...) ignorance. He begins with a claim that the process of making a rational decision involves the process of “gaining all possible facts and `imagining' all possible consequences”. He goes on to say that making a rational decision “in the consideration of life or death . . . would seem to be impossible”. It is “impossible” …. (shrink)

In this paper we shall consider whether John Rawls’s treatment of Ignatius of Loyola is a fair one. Rawls claims in A Theory of Justice that Catholic theology (and Ignatius’s theology in particular) aims at a “dominant end” of serving God that overrides other moral considerations. Rawls argues that dominant end views lead to a disfigured self and a disregard for justice. We do not question Rawls on the normative issue of whether dominant end conceptions are untenable, but rather on (...) his factual claim that Ignatian spirituality and Catholic theology in general presupposes a dominant end view as he defines it. The Loyola whom Rawls attacks in Theory of Justice is a straw-man. Ignatian spirituality and Catholic theology in general embraces something closer to an inclusive end view, since it argues that several different ways of virtuous living can lead to happiness. (shrink)

In this paper we shall consider whether John Rawls’s treatment of Ignatius of Loyola is a fair one. Rawls claims in A Theory of Justice that Catholic theology aims at a “dominant end” of serving God that overrides other moral considerations. Rawls argues that dominant end views lead to a disfigured self and a disregard for justice. We do not question Rawls on the normative issue of whether dominant end conceptions are untenable, but rather on his factual claim that Ignatian (...) spirituality and Catholic theology in general presupposes a dominant end view as he defines it. The Loyola whom Rawls attacks in Theory of Justice is a straw-man. Ignatian spirituality and Catholic theology in general embraces something closer to an inclusive end view, since it argues that several different ways of virtuous living can lead to happiness. (shrink)

Calls into question the 'bedrock' reality of spacetime, examines the idea of alternative realities founded on different sorts of consciousness, and explores concepts of being and non-being in religious traditions.

Many of the world’s mental health acts, including all Australian legislation, allow for the coercive detention and treatment of people with mental illnesses if they are deemed likely to harm themselves or others. Numerous authors have argued that legislated powers to impose coercive treatment in psychiatric illness should pivot on the presence or absence of capacity not likely harm, but no Australian act uses this criterion. In this paper, I add a novel element to these arguments by comparing the use (...) of the harm to others justification for coercive treatment in mental illness with its use in illness due to infectious disease, and suggest a double standard applies. People with mental illness are subjected to coercive treatments at levels of risk to others far, far lower than would precipitate coercive treatment in people with influenza. In effect, this element of mental health legislation represents an example of sanism—state-sanctioned discrimination against people with mental illnesses. (shrink)

Background: Compassion fatigue is recognized as impacting the health and effectiveness of healthcare providers, and consequently, patient care. Compassion fatigue is distinct from “burnout.” Reliable measurement tools, such as the Professional Quality of Life scale, have been developed to measure the prevalence, and predict risk of compassion fatigue. This study reviews the prevalence of compassion fatigue among healthcare practitioners, and relationships to demographic variables. Methods: A systematic review was conducted using key words in MEDLINE, PubMed, and Ovid databases. Data were (...) extracted from a total of 71 articles meeting inclusion criteria, from studies measuring compassion fatigue in healthcare providers using a validated instrument. Quantitative and qualitative data were extracted and compiled by three independent reviewers into an evidence table that included basic study characteristics, study strength and quality determination, measurements of compassion fatigue, and general findings. Meta-analysis, where data allowed, was stratified by Professional Quality of Life version, heterogeneity was quantified, and pooled means were reported with 95% confidence interval. A table of major study characteristics and results was created. Ethical consideration: This paper contains no primary data obtained directly from research participants. Data obtained from previously published resources have been acknowledged within references. Psychological distress, particularly compassion fatigue, can be insidious, no health profession is immune, and may significantly impact the ability to provide care. Results: A total of 71 studies were included. Compassion fatigue was reported across all practitioner groups studied. Relationships to most demographic variables such as years of experience and specialty were either not statistically significant or unclear. Variability in reporting of Professional Quality of Life results was found. Interpretation: Compassion fatigue exists across diverse practitioner groups. Prevalence is highly variable, and its relationship with demographic, personal, and/or professional variables is inconsistent. Questions are raised about how to mitigate compassion fatigue. (shrink)

This article addresses the general ethical issues of accessing online personal data for research purposes. The authors discuss the practical aspects of online research with a specific case study that illustrates the ethical challenges encountered when accessing data from Kooth, an online youth web-counselling service. This paper firstly highlights the relevance of a process-based approach to ethics when accessing highly sensitive data and then discusses the ethical considerations and potential challenges regarding the accessing of public data from Digital Mental Health (...) services. It presents solutions that aim to protect young DMH service users as well as the DMH providers and researchers mining such data. Special consideration is given to service users’ expectations of what their data might be used for, as well as their perceptions of whether the data they post is public, private or open. We provide recommendations for planning and designing online research that includes vulnerable young people as research participants in an ethical manner. We emphasise the distinction between public, private and open data, which is crucial to comprehend the ethical challenges in accessing DMH data. Among our key recommendations, we foreground the need to consider a collaborative approach with the DMH providers while respecting service users’ control over personal data, and we propose the implementation of digital solutions embedded within the platform for explicit opt-out/opt-in recruitment strategies and ‘read more’ options. (shrink)

This article addresses the general ethical issues of accessing online personal data for research purposes. The authors discuss the practical aspects of online research with a specific case study that illustrates the ethical challenges encountered when accessing data from Kooth, an online youth web-counselling service. This paper firstly highlights the relevance of a process-based approach to ethics when accessing highly sensitive data and then discusses the ethical considerations and potential challenges regarding the accessing of public data from Digital Mental Health (...) services. It presents solutions that aim to protect young DMH service users as well as the DMH providers and researchers mining such data. Special consideration is given to service users’ expectations of what their data might be used for, as well as their perceptions of whether the data they post is public, private or open. We provide recommendations for planning and designing online research in an ethical manner that includes vulnerable young people as research participants. We emphasise the distinction between public, private and open data, which is crucial to comprehend the ethical challenges in accessing DMH data. Among our key recommendations, we foreground the need to consider a collaborative approach with the DMH providers while respecting service users’ control over personal data, and we propose the implementation of digital solutions embedded within the platform for explicit opt-out/opt-in recruitment strategies and ‘read more’ options. (shrink)

Interactions between an intelligent software agent and a human user are ubiquitous in everyday situations such as access to information, entertainment, and purchases. In such interactions, the ISA mediates the user’s access to the content, or controls some other aspect of the user experience, and is not designed to be neutral about outcomes of user choices. Like human users, ISAs are driven by goals, make autonomous decisions, and can learn from experience. Using ideas from bounded rationality, we frame these interactions (...) as instances of an ISA whose reward depends on actions performed by the user. Such agents benefit by steering the user’s behaviour towards outcomes that maximise the ISA’s utility, which may or may not be aligned with that of the user. Video games, news recommendation aggregation engines, and fitness trackers can all be instances of this general case. Our analysis facilitates distinguishing various subcases of interaction, as well as second-order effects that might include the possibility for adaptive interfaces to induce behavioural addiction, and/or change in user belief. We present these types of interaction within a conceptual framework, and review current examples of persuasive technologies and the issues that arise from their use. We argue that the nature of the feedback commonly used by learning agents to update their models and subsequent decisions could steer the behaviour of human users away from what benefits them, and in a direction that can undermine autonomy and cause further disparity between actions and goals as exemplified by addictive and compulsive behaviour. We discuss some of the ethical, social and legal implications of this technology and argue that it can sometimes exploit and reinforce weaknesses in human beings. (shrink)

This festschrift collects a number of insightful essays by a group of accomplished Christian scholars, all of who have either worked with or studied under Hendrik Hart during his 35-year tenure as Senior Member in Systematic Philosophy at the Institute for Christian Studies, Toronto, Canada.

In 2012, a U.S. Institute of Medicine report called for a different approach to health care: “Left unchanged, health care will continue to underperform; cause unnecessary harm; and strain national, state, and family budgets.” The answer, they suggested, would be a “continuously learning” health system. Ethicists and researchers urged the creation of “learning health organizations” that would integrate knowledge from patient‐care data to continuously improve the quality of care. Our experience with an ongoing research study on atrial fibrillation—a trial known (...) as IMPACT‐AFib—gave us some insight into one of the challenges that will have to be dealt with in creating these organizations. Although the proposed educational intervention study placed no restrictions on what providers and health plans could do, the oversight team argued that the ethical principle of beneficence did not allow the researchers to be “bystanders” in relation to a control group receiving suboptimal care. In response, the researchers designed a “workaround” that allowed the project to go forward. We believe the experience suggests that what we call “bystander ethics” will create challenges for the kinds of quality improvement research that LHOs are designed to do. (shrink)

This chapter explores the idea that phylogenetic diversity plays a unique role in underpinning conservation endeavour. The conservation of biodiversity is suffering from a rapid, unguided proliferation of metrics. Confusion is caused by the wide variety of contexts in which we make use of the idea of biodiversity. Characterisations of biodiversity range from all-variety-at-all-levels down to variety with respect to single variables relevant to very specific conservation contexts. Accepting biodiversity as the sum of a large number of individual measures results (...) in an empirically intractable framework. However, large-scale decisions cannot be based on biodiversity variables inferred from local conservation imperatives because the variables relevant to the many systems being compared would be incommensurate with one another. We therefore need some general conception of biodiversity that would make tractable such large-scale environmental decision-marking. We categorise the large array of strategies for the measurement of biodiversity into four broad groups for consideration as general measures of biodiversity. We compare common moral justifications for the conservation of biodiversity and conclude that some form of instrumental value is the most plausible justification for biodiversity conservation. Although this is often interpreted as a reliance on option value, we opt for a broadly consequentialist characterisation of biodiversity conservation. We conclude that the best justified general measure of biodiversity will be some form of phylogenetic diversity. (shrink)

T. H. Huxley (1825-1895) was not only an active protagonist in the religious and scientific upheaval that followed the publication of Darwin's theory of evolution but also a harbinger of the sociobiological debates about the implications of evolution that are now going on. His seminal lecture Evolution and Ethics, reprinted here with its introductory Prolegomena, argues that the human psyche is at war with itself, that humans are alienated in a cosmos that has no special reference to their needs, and (...) that moral societies are of necessity in conflict with the natural conditions of their existence. Seen in the light of current understanding of the mechanisms of evolution, these claims remain as controversial today as they were when Huxley proposed them. In this volume George Williams, one of the best-known evolutionary biologists of our time, asserts that recent biological ideas and data justify a more extreme condemnation of the "cosmic process" than Huxley advocated and more extreme denial that the forces that got us here are capable of maintaining a viable world. James Paradis, an expert in Victorian studies, has written an introduction that sets the celebrated lecture in the context of cultural history, revealing it to be an impressive synthesis of Victorian thinking, as well as a challenge to eighteenth-century assumptions about the harmony of of nature. With Huxley's lecture as a focal point, the three parts of this book unite philosophy and science in a shared quest that recalls their common origins as systems of knowledge. Originally published in 1989. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)