Both living donor transplantation and human subjects research expose one set of individuals to clinical risks for the clinical benefits of others. In the Belmont Report, the National Commission for the Protection of Human Subjects of Biomedical and Behavior Research articulated three principles to serve as the basis for a research ethics framework: respect for persons, beneficence and justice. In contrast, living donor transplantation lacks a framework. In this manuscript, we adapt the three principles articulated in the Belmont Report to (...) serve as the foundation for an ethics framework for living donor transplantation which we supplement with the principles of vulnerability and responsibility. The National Commission supported additional protections for vulnerable groups of potential research participants. In 2001, Kenneth Kipnis effectively argued that the concept of vulnerable groups failed to explore in what ways particular groups of people were vulnerable, thereby risking unnecessary protections for some and inadequate protections for others. He proposed a taxonomy that explored different types of vulnerabilities that all research participants may experience to provide a more robust framework for human subjects protections, which we adapt to living donors. Robert Goodin claims that health professionals, who stand in special relationship with patients, are responsible for promoting and protecting their well-being. In living donor transplantation, the donor transplant team is responsible for empowering prospective donors to address their vulnerabilities and/or for protecting those who cannot by disqualifying them from donation. (shrink)

The traditional living donor was very healthy. However, as the supply-demand gap continues to expand, transplant programs have become more accepting of less healthy donors. This paper focuses on the other extreme, asking whether and when individuals who have life-limiting conditions should be considered for living organ donation. We discuss ethical issues raised by 1) donation by individuals with progressive severe debilitating disease for whom there is no ameliorative therapy; and 2) donation by individuals who are imminently dying or would (...) die by the donation process itself. (shrink)

Testa and colleagues argue that evaluation for suitability for living donor surgery is rooted in paternalism in contrast with the evaluation for most operative interventions which is rooted in the autonomy of patients. We examine two key ethical concepts that Testa and colleagues use: paternalism and autonomy, and two related ethical concepts, moral agency and shared decision making. We show that moving the conversation from paternalism, negative autonomy and informed consent to moral agency, relational autonomy and shared decision making, one (...) better understands why the arguments give by Testa and colleagues fail. (shrink)

Liver transplantation is the treatment of choice for many forms of liver disease. Unfortunately, the scarcity of cadaveric donor livers limits the availability of this technique. To improve the availability of liver transplantation, surgeons have developed the capability of removing a portion of liver from a live donor and transplanting it into a recipient. A few liver transplants using living donors have been performed worldwide.Our purpose was to analyze the ethics of liver transplants using living donors and to propose guidelines (...) for the procedure before it was introduced in the United States. We used a process of research ethics consultation that involves a collaboration between clinical investigators and clinical ethicists. We concluded that it was ethically appropriate to perform liver transplantation using living donors in a small series of patients on a trial basis, and we published our ethical guidelines in a medical journal before the procedure was introduced. We recommend this prospective, public approach for the introduction of other innovative therapies in medicine and surgery. (shrink)

_The Structures of the Life-World _is the final focus of twenty-seven years of Alfred Schutz's labor, encompassing the fruits of his work between 1932 and his death in 1959. This book represents Schutz's seminal attempt to achieve a comprehensive grasp of the nature of social reality. Here he integrates his theory of relevance with his analysis of social structures. Thomas Luckmann, a former student of Schutz's, completed the manuscript for publication after Schutz's untimely death.

Living out of silence, out of a fully functioning, lovingly attentive mind, and not just out of thought, out of a partially functioning mind, is requisite for depth or profundity in living or relating. A fully attentive, truly silent or meditative mind sees that there is real dualism of time and the timeless and that time and the timeless each has its own unique value. The timeless, or real silence, that which alone can make for depth in one's living and (...) relating, can be there only when, in one's awareness, time and all that is related to time, have come to an end. An examination of a wide variety of statements made by writers, both past and present, shows that these understandings are seldom there in contemporary writings, just as they were not there in writings that have come down to us from the past. 'Living beyond the One and the Many' invites readers to consider the possibility that what is presented in it can bring deep meaning to one's way of living in the world"--Publisher's description, back cover. (shrink)

In this paper we give a positive answer to Julia Robinson's question whether the definability of + and · from S and ∣ that she proved in the case of positive integers is extendible to arbitrary integers (cf. [JR, p. 102]).

This book presents a broad-ranging and fascinating examination of attitudes: how we form them; how we organize them towards others; and whether they are inherently human or could also be developed by computers. Professor Eiser suggests there are fundamental objections to the idea of a computer having a sense of self or a set of attitutdes.

By its alternative depiction of God's non-violent creative power at the start of the biblical canon, Gen 1 signals the Creator's original intent for shalom and blessing at the outset of human history, prior to the rise of human (or divine) violence. Gen 1 constitutes a normative framework by which we may judge all the violence that pervades the rest of the Bible.

Metaphysics and language: Quine, W. V. O. On the individuation of attributes. Körner, S. On some relations between logic and metaphysics. Marcus, R. B. Does the principle of substitutivity rest on a mistake? Van Fraassen, B. C. Platonism's pyrrhic victory. Martin, R. M. On some prepositional relations. Kearns, J. T. Sentences and propositions.--Basic and combinatorial logic: Orgass, R. J. Extended basic logic and ordinal numbers. Curry, H. B. Representation of Markov algorithms by combinators.--Implication and consistency: Anderson, A. R. Fitch on (...) consistency. Belnap, N. D., Jr. Grammatical propaedeutic. Thomason, R. H. Decidability in the logic of conditionals. Myhill, J. Levels of implication.--Deontic, epistemic, and erotetic logic: Bacon, J. Belief as relative knowledge. Wu, K. J. Believing and disbelieving. Kordig, C. R. Relativized deontic modalities. Harrah, D. A system for erotetic sentences. (shrink)

Let be a relational system whereby D is a nonempty set and P1 is an m1-ary relation on D. With we associate the (weak) monadic second-order theory consisting of the first-order predicate calculus with individual variables ranging over D; monadic predicate variables ranging over (finite) subsets of D; monadic predicate quantifiers; and constants corresponding to P1, P2, …. We will often use ambiguously to mean also the set of true sentences of.

If necessity is a generic notion, then, like any generic notion, it becomes specified not by a criterion as such but by a differentia. The differentia of logical necessity is that the denial of a logically necessary proposition is self-contradictory; one of our best criteria of logical necessity is that after careful consideration we see that the denial of the proposition is self-contradictory.