Background: Ethical frameworks for organ donation following circulatory death (DCD) were established >20 years ago. However, considerable variation exists among these, indicating consensus has not been reached on all issues. Additionally, advances such as cardiac DCD transplants and normothermic regional perfusion (NRP) may have reignited old debates.Methods: We reviewed the English-language literature addressing ethical issues in DCD from 1993 to 2022, examining changes in frequency with which ethical principles and their sub-themes identified within each, were addressed.Results: Non-maleficence was the most (...) frequently addressed principle (192 of 199 articles), as well as the most varied, with 9 subthemes (versus 2-4 within each of the other bioethical principles).Conclusions: There were several changes in the terminology used to refer to DCD over time, and substantial interest in cardiac DCD and NRP in recent publications, arising in 11 and 19 of the 30 publications from 2018 to 2022. (shrink)

In Metaphor and Film, Trevor Whittock demonstrates that feature films are permeated by metaphors that were consciously introduced by directors. An examination of cinematic metaphor forces us to reconsider the nature of metaphor itself, and the ways by which such visual imagery can be recognised and understood, as well as interpreted. Metaphor and Film identifies the principal forms of cinematic metaphor, and also provides an analysis of the mental operations that one must bring to it. Recent developments in cognitive (...) psychology, especially those relating to the nature and formation of categories, are called upon to explain these processes. Metaphor and Film ranges widely over film theory as it does over philosophical, literary, linguistic, and psychological accounts of metaphor. Particularly useful to those studying film, literature, and aesthetics, this study is also a provocative contribution to an important debate in which film theorists and philosophers are currently engaged. (shrink)

Religious-secular distinctions have been crucial to the way in which modern governments have rationalised their governance and marked out their sovereignty – as crucial as the territorial boundaries that they have drawn around nations. The authors of this volume provide a multi-dimensional picture of how the category of religion has served the ends of modern government. They draw on perspectives from history, anthropology, moral philosophy, theology and religious studies, as well as empirical analysis of India, Japan, Mexico, the United States, (...) Israel-Palestine, France and the United Kingdom. (shrink)

The field of bioethics is increasingly coming into contact with empirical research findings. In this article, we ask what role empirical research can play in the process of ethical clarification and decision-making. Ethical reflection almost always proceeds in three steps: the description of the moral question,the assessment of the moral question and the evaluation of the decision-making. Empirical research can contribute to each step of this process. In the description of the moral object, first of all, empirical research has a (...) role to play in the description of morally relevant facts. It plays a role in answering the “reality-revealing questions” (what, why,how, who, where and when), in assessing the consequences and in proposing alternative courses of action. Secondly, empirical research plays a role in assessing the moral question. It must be acknowledged that research possesses “the normative power of the factual,” which can also become normative by suppressing other norms. However, inductive normativity should always be balanced out by a deductive form of normativity. Thirdly, empirical research also has a role to play in evaluating the decision-making process. It can rule out certain moral choices by pointing out the occurrence of certain unexpected consequences or effects. It can also be useful, however, as a sociology of bioethics in which the discipline of bioethics itself becomes an object of research. (shrink)

Objectives: The objective of this research is to analyse the evolution and nature of published empirical research in the fields of medical ethics and bioethics.Design: Retrospective quantitative study of nine peer reviewed journals in the field of bioethics and medical ethics .Results: In total, 4029 articles published between 1990 and 2003 were retrieved from the journals studied. Over this period, 435 studies used an empirical design. The highest percentage of empirical research articles appeared in Nursing Ethics , followed by the (...) Journal of Medical Ethics and the Journal of Clinical Ethics . These three journals account for 84.1% of all empirical research in bioethics published in this period. The results of the χ2 test for two independent samples for the entire dataset indicate that the period 1997–2003 presented a higher number of empirical studies than did the period 1990–1996 . This increase is statistically significant . Most empirical studies employed a quantitative paradigm . The main topic of research was prolongation of life and euthanasia .Conclusions: We conclude that the proportion of empirical research in the nine journals increased steadily from 5.4% in 1990 to 15.4% in 2003. It is likely that the importance of empirical methods in medical ethics and bioethics will continue to increase. (shrink)

How can we apply philosophy to our everyday lives? Can philosophy affect the way we live? This book will show how philosophy can help to improve your thinking about everyday life. And how, by improving the quality of your thinking, you can improve the quality of your life. It will make you more aware of what you think and why, and how knowing this can help you can change the way you think about your life. Full of practical examples and (...) straightforward advice, and written by an expertin the field, this guide can help you become calmer and happier, and make better decisions. (shrink)

This paper first argues that we can bring out a tension between the following three popular doctrines: (i) the canonical reduction of metaphysical modality to essence, due to Fine, (ii) contingentism, which says that possibly something could have failed to be something, and (iii) the doctrine that metaphysical modality obeys the modal logic S5. After presenting two such arguments (one from the theorems of S4 and another from the theorems of B), I turn to exploring various conclusions we might draw (...) in light of these results, and argue that none comes cost free. In the course of laying out possible responses to my arguments, we'll have a chance to evaluate various doctrines about the interplay between contingency and essence, as well as develop some alternative reductions of metaphysical modality to essence. I don't decisively come down in favor of one response over the others, though I say some things that point towards the conclusion that essence has no role to play in reducing metaphysical modality. (shrink)

The consensus among spacetime substantivalists is to respond to Leibniz's classic shift arguments, and their contemporary incarnation in the form of the hole argument, by pruning the allegedly problematic metaphysical possibilities that generate these arguments. Some substantivalists do so by directly appealing to a modal doctrine akin to anti-haecceitism. Other substantivalists do so by appealing to an underlying hyperintensional doctrine that implies some such modal doctrine. My first aim in this paper is to pose a challenge for all extant forms (...) of this consensus position. My second aim is to show what form substantivalism must take in order to uphold the consensus while addressing this challenge. The result is a novel "plenitudinous" substantivalist view, which predicts that certain modal facts about spacetime are vague or indeterminate. I then argue against this view on independent grounds, concluding that substantivalists should reject the consensus position. The paper also discusses the way forward for substantivalists in light of this conclusion. (shrink)

Formal criteria of theoretical equivalence are mathematical mappings between specific sorts of mathematical objects, notably including those objects used in mathematical physics. Proponents of formal criteria claim that results involving these criteria have implications that extend beyond pure mathematics. For instance, they claim that formal criteria bear on the project of using our best mathematical physics as a guide to what the world is like, and also have deflationary implications for various debates in the metaphysics of physics. In this paper, (...) I investigate whether there is a defensible view according to which formal criteria have significant non-mathematical implications, of these sorts or any other, reaching a chiefly negative verdict. Along the way, I discuss various foundational issues concerning how we use mathematical objects to describe the world when doing physics, and how this practice should inform metaphysics. I diagnose the prominence of formal criteria as stemming from contentious views on these foundational issues, and endeavor to motivate some alternative views in their stead. (shrink)

The hole argument purports to show that all spacetime theories of a certain form are indeterministic, including the General Theory of Relativity. The argument has given rise to an industry of searching for a metaphysics of spacetime that delivers the right modal implications to rescue determinism. In this paper, I first argue that certain prominent extant replies to the hole argument—namely, those that appeal to an essentialist doctrine about spacetime—fail to deliver the requisite modal implications. As part of my argument, (...) I show that threats to determinism of the sort brought out by the hole argument are more general than has heretofore been recognized. I then use these results to propose a novel essentialist doctrine about spacetime that successfully rescues determinism, what I call sufficiency metric essentialism. However, I go on to argue that once we realize what an essentialist doctrine about spacetime must look like in order to address the hole argument, we should reject all such doctrines, because they can't fulfill their ambition of improving on standard modal replies to the argument. I close by suggesting some lessons for future work on spacetime and the metaphysics of physics more broadly, and also drawing some general morals for contemporary metaphysics, in particular about (i) whether essence can be used to articulate a precise structuralist doctrine, and (ii) the relationship between essence and modality. (shrink)

Approximately a quarter of a billion people around the world suffer from malaria each year. Most cases are located in sub-Saharan Africa where Anopheles gambiae mosquitoes are the principal vectors of this public health problem. With the use of CRISPR-based gene drives, the population of mosquitoes can be modified, eventually causing their extinction. First, we discuss the moral status of the organism and argue that using genetically modified mosquitoes to combat malaria should not be abandoned based on some moral value (...) of A. gambiae. Secondly, we argue that environmental impact studies should be performed to obtain an accurate account of the possible effects of a potential eradication of the organism. However, the risks from the purposeful extinction of A. gambiae should not overtake the benefits of eradicating malaria and risk assessments should be used to determine acceptable risks. Thirdly, we argue that the eventual release of the genetically modified mosquitoes will depend on transparency, community involvement, and cooperation between different nations. (shrink)

ABSTRACTSince its origin, bioethics has attracted the collaboration of few social scientists, and social scientific methods of gathering empirical data have remained unfamiliar to ethicists. Recently, however, the clouded relations between the empirical and normative perspectives on bioethics appear to be changing. Three reasons explain why there was no easy and consistent input of empirical evidence into bioethics. Firstly, interdisciplinary dialogue runs the risk of communication problems and divergent objectives. Secondly, the social sciences were absent partners since the beginning of (...) bioethics. Thirdly, the meta‐ethical distinction between ‘is’ and ‘ought’ created a ‘natural’ border between the disciplines. Now, bioethics tends to accommodate more empirical research. Three hypotheses explain this emergence. Firstly, dissatisfaction with a foundationalist interpretation of applied ethics created a stimulus to incorporate empirical research in bioethics. Secondly, clinical ethicists became engaged in empirical research due to their strong integration in the medical setting. Thirdly, the rise of the evidence‐based paradigm had an influence on the practice of bioethics. However, a problematic relationship cannot simply and easily evolve into a perfect interaction. A new and positive climate for empirical approaches has arisen, but the original difficulties have not disappeared. (shrink)

I demonstrate that a set of well-known objections defeat John Stuart Mill’s plural voting proposal, but do not defeat plural voting as such. I adopt the following as a working definition of political equality: a voting system is egalitarian if and only if departures from a baseline of equally weighted votes are normatively permissible. I develop an alternative proposal, called procedural plural voting, which allocates plural votes procedurally, via the free choices of the electorate, rather than according to a substantive (...) standard of competence. The alternative avoids standards objections to Mill’s proposal. Moreover, reflection on the alternative plural voting scheme disrupts our intuitions about what counts as an egalitarian voting system. Undue emphasis on Mill’s version of plural voting obscures three important reasons to reject plural voting in favor of strictly egalitarian voting systems: that certain choices that generate inequalities of political power are morally impermissible; that even... (shrink)

Philip James Jones, a Fellow of the British Academy, was one of the most distinguished, complex, and challenging of medieval historians. His works on the Italian city-states of the thirteenth to fifteenth centuries and on Italy's agrarian history are monuments built to last, benchmarks that defined the field for a generation. Jones was elected a Fellow of the British Academy in 1984 and was awarded the Serena Medal for Italian studies in 1988. He won a major open scholarship in Modern (...) History at Wadham College, University of Oxford. Jones took a First in Modern History in 1945 and was appointed to a research studentship at Magdalen College. He had also secured a temporary teaching post at Glasgow University. All Jones's previous works flowed into the 700 pages of his mammoth book Italian City-State: from Commune to Signoria. (shrink)

This article discusses the relation between empirical and normative approaches in bioethics. The issue of dwarf tossing, while admittedly unusual, is chosen as a point of departure because it challenges the reader to look with fresh eyes upon several central bioethical themes, including human dignity, autonomy, and the protection of vulnerable people. After an overview of current approaches to the integration of empirical and normative ethics, we consider five ways that the empirical and normative can be brought together to speak (...) to the problem of dwarf tossing: prescriptive applied ethics, theoretical ethics, critical applied ethics, particularist ethics and integrated empirical ethics. We defend a position of critical applied ethics that allows for a two-way relation between empirical and normative theories. Against efforts fully to integrate the normative and the empirical into one synthesis, we propose that the two should stand in tension and relation to one another. The approach we endorse acknowledges that a social practice can and should be judged both by the gathering of empirical data and by normative ethics. Critical applied ethics uses a five stage process that includes: (a) determination of the problem, (b) description of the problem, (c) empirical study of effects and alternatives, (d) normative weighing and (e) evaluation of the effects of a decision. In each stage, we explore the perspective from both the empirical (sociological) and the normative ethical point of view. We conclude by applying our five-stage critical applied ethics to the example of dwarf tossing. (shrink)

Background independence begins life as an informal property that a physical theory might have, often glossed as 'doesn't posit a fixed spacetime background'. Interest in trying to offer a precise account of background independence has been sparked by the pronouncements of several theorists working on quantum gravity that background independence embodies in some sense an essential discovery of the General Theory of Relativity, and a feature we should strive to carry forward to future physical theories. This paper has two goals. (...) The first is to investigate what a world must be like in order to be truly described by a background independent theory given extant accounts of background independence. The second is to argue that there are no non-empirical reasons to be more confident in theories that satisfy extant accounts of background independence than in theories that don't. The paper concludes by drawing a general moral about a way in which focussing primarily on mathematical formulations of our physical theories can adversely affect debates in the metaphysics of physics. (shrink)

This study examines the use of a modified form of the theory of planned behavior in understanding the decisions of undergraduate students in engineering and humanities to engage in cheating. We surveyed 527 randomly selected students from three academic institutions. Results supported the use of the model in predicting ethical decision-making regarding cheating. In particular, the model demonstrated how certain variables (gender, discipline, high school cheating, education level, international student status, participation in Greek organizations or other clubs) and moral constructs (...) related to intention to cheat, attitudes toward cheating, perceptions of norms with respect to cheating, and ultimately cheating behaviors. Further the relative importance of the theory of planned behavior constructs was consistent regardless of context, whereas the contributions of variables included in the study that were outside the theory varied by context. Of particular note were findings suggesting that the extent of cheating in high school was a strong predictor of cheating in college and that engineering students reported cheating more frequently than students in the humanities, even when controlling for the number of opportunities to do so. (shrink)

In this paper I seek to show how cultural niche construction theory offers the potential to extend the human evolutionary story beyond the Pleistocene, through the Neolithic, towards the kind of very large-scale societies in which we live today. The study of the human past has been compartmentalised, each compartment using different analytical vocabularies, so that their accounts are written in mutually incompatible languages. In recent years social, cognitive and cultural evolutionary theories, building on a growing body of archaeological evidence, (...) have made substantial sense of the social and cultural evolution of the genus Homo. However, specialists in this field of studies have found it difficult to extend their kind of analysis into the Holocene human world. Within southwest Asia the three or four millennia of the Neolithic period at the beginning of the Holocene represents a pivotal point, which saw the transformation of human society in the emergence of the first large-scale, permanent communities, the domestication of plants and animals, and the establishment of effective farming economies. Following the Neolithic, the pace of human social, economic and cultural evolution continued to increase. By 5000 years ago, in parts of southwest Asia and northeast Africa there were very large-scale urban societies, and the first large-scale states. An extension of cultural niche construction theory enables us to extend the evolutionary narrative of the Pleistocene into the Holocene, opening the way to developing a single, long-term, evolutionary account of human history. (shrink)

This paper will explore an epistemic aspect of hope, namely hope’s relationship to knowledge. It has been taken for granted that people do not hope for things to occur that they know will occur. I will be giving an argument that hope and knowledge are compatible, and I will defend that argument against one primary objection. More specifically, I will argue that there are instances when an agent knows that p and still hopes that p.

BackgroundCurrent preimplantation genetic testing (PGT) technologies enable embryo genotyping across the whole genome. This has led to the development of polygenic risk scoring of human embryos (PGT-P). Recent implementation of PGT-P, including screening for intelligence, has been extensively covered by media reports, raising major controversy. Considering the increasing demand for assisted reproduction, we evaluated how information about PGT-P is communicated in press media and explored the diversity of ethical themes present in the public debate.MethodsLexisNexis Academic database and Google News were (...) searched to identify articles about polygenic embryo screening. This led to 535 news articles. 59 original articles met the inclusion criteria. Inductive content analysis was used to analyse these articles.Results8.8% of articles gave embryo polygenic scoring a positive portrayal, while 36.8% expressed a negative attitude. 54.4% were neutral, mostly highlighting limited practical value of the technology in in vitro fertilization settings. We identified five main ethical themes that are also present in academic literature and the broader debate on reproductive technologies: a slippery slope towards designer babies, well-being of the child and parents, impact on society, deliberate choice and societal readiness.ConclusionsImplementation of embryo polygenic profiling engenders a need for specific recommendations. Current media analysis discloses important ethical themes to consider when creating future guidelines for PGT-P. (shrink)

Since its origin, bioethics has attracted the collaboration of few social scientists, and social scientific methods of gathering empirical data have remained unfamiliar to ethicists. Recently, however, the clouded relations between the empirical and normative perspectives on bioethics appear to be changing. Three reasons explain why there was no easy and consistent input of empirical evidence into bioethics. Firstly, interdisciplinary dialogue runs the risk of communication problems and divergent objectives. Secondly, the social sciences were absent partners since the beginning of (...) bioethics. Thirdly, the meta‐ethical distinction between ‘is’ and ‘ought’ created a ‘natural’ border between the disciplines. Now, bioethics tends to accommodate more empirical research. Three hypotheses explain this emergence. Firstly, dissatisfaction with a foundationalist interpretation of applied ethics created a stimulus to incorporate empirical research in bioethics. Secondly, clinical ethicists became engaged in empirical research due to their strong integration in the medical setting. Thirdly, the rise of the evidence‐based paradigm had an influence on the practice of bioethics. However, a problematic relationship cannot simply and easily evolve into a perfect interaction. A new and positive climate for empirical approaches has arisen, but the original difficulties have not disappeared. (shrink)

Scholarship on European imperialism in the Americas has become increasingly prominent in the historiography of early America after a long period when the subject was hardly discussed. Historians have come to see that local experience in the Americas needs to be placed in a wider, comparative Atlantic context. They have realised that what united most peoples’ experiences in the Americas was that they lived as colonial subjects within colonies that were part of imperial polities. This article examines recent writings on (...) European empires in the Americas, relating imperial history to related developments in fields such as Atlantic history. It suggests that renewed attention to imperialism allows historians to discuss in a fruitful fashion the relationship between power and authority in the formation of colonial societies and draws attention to the continuing importance of metropolitan influence in the articulation of colonial identities. (shrink)

This is a comprehensive and practical guide to the ethical issues raised by different kinds of medical research, and is the first such book to be written with the needs of the researcher in mind. Clearly structured and written in a plain and accessible style, the book covers every significant ethical issue likely to be faced by researchers and research ethics committees. The author outlines and clarifies official guidelines, gives practical advice on how to adhere to these, and suggests procedures (...) in areas where official recommendations are vague or absent. This invaluable handbook will help researchers identify and address the ethical issues at an early stage in the design of their studies, to avoid unnecessary delay and to safeguard the wellbeing of patients and healthy volunteers. It will also be extremely useful to members of research ethics committees. (shrink)

Participation in healthcare decision-making is considered to be an important right of minors, and is highlighted in both international legislation and public policies. However, despite the legal recognition of children’s rights to participation, and also the benefits that children experience by their involvement, there is evidence that legislation is not always translated into healthcare practice. There are a number of factors that may impact on the ability of the child to be involved in decisions regarding their medical care. Some of (...) these factors relate to the child, including their capacity to be actively involved in these decisions. Others relate to the family situation, sociocultural context, or the underlying beliefs and practices of the healthcare provider involved. In spite of these challenges to including children in decisions regarding their clinical care, we argue that it is an important factor in their treatment. The extent to which children should participate in this process should be determined on a case-by-case basis, taking all of the potential barriers into account. (shrink)

Environmental ethicists have not reached a consensus about whether or not individuals who contribute to climate change have a moral obligation to reduce their personal greenhouse gas emissions. In this paper, I side with those who think that such individuals do have such an obligation by appealing to the concept of integrity. I argue that adopting a political commitment to work toward a collective solution to climate change—a commitment we all ought to share—requires also adopting a personal commitment to reduce (...) one’s emissions. On these grounds, individuals who contribute to climate change have a prima facie moral duty to lower their personal greenhouse gas emissions. After presenting this argument and supporting each of its premises, I defend it from two major lines of objection: skepticism about integrity’s status as a virtue and concerns that the resulting moral duty would be too demanding to be morally required. I then consider the role that an appeal to integrity could play in galvanizing the American public to take personal and political action regarding climate change. (shrink)

Extracorporeal membrane oxygenation (ECMO) is typically viewed as a time-limited intervention—a bridge to recovery or transplant—not a destination therapy. However, some patients with decision-making capacity request continued ECMO support despite a poor prognosis for recovery and lack of viability as a transplant candidate. In response, critical care teams have asked for guidance regarding the ethical permissibility of unilateral withdrawal over the objections of a capacitated patient. In this article, we evaluate several ethical arguments that have been made in favor of (...) withdrawal, including distributive justice, quality of life, patients’ rights, professional integrity, and the Equivalence Thesis. We find that existing justifications for unilateral withdrawal of ECMO support in capacitated patients are problematic, which leads us to conclude that either: (1) additional ethical arguments are necessary to defend this approach or (2) the claim that it is not appropriate to use ECMO as a destination therapy should be questioned. (shrink)

This book considers how language can be appropriately theorized as both a natural and cultural phenomenon. In reaching his conclusion, Pateman draws on a wide range of work in linguistics, philosophy, and social theory, and argues in defense of Chomsky and against Wittgenstein, all within the framework of a realist philosophy of science and contemporary social theory.

BackgroundThe landscape of clinical research has evolved over the past decade. With technological advances, the practice of using electronic informed consent (eIC) has emerged. However, a number of challenges hinder the successful and widespread deployment of eIC in clinical research. Therefore, we aimed to investigate the views of various stakeholders on the potential advantages and challenges of eIC.MethodsSemi-structured interviews were conducted with 39 participants from 5 stakeholder groups from across 11 European countries. The stakeholder groups included physicians, patient organization representatives, (...) regulator representatives, ethics committee members, and pharmaceutical industry representatives, and all were involved in clinical research. Interviews were analyzed using the framework method.ResultsInterviewees identified that a powerful feature of eIC is its personalized approach as it may increase participant empowerment. However, they identified several ethical and practical challenges, such as ensuring research participants are not overloaded with information and offering the same options to research participants who would prefer a paper-based informed consent rather than eIC. According to the interviewees, eIC has the potential to establish efficient long-term interactions between the research participants and the research team in order to keep the participants informed during and after the study. Interviewees emphasized that a personal interaction with the research team is of utmost importance and this cannot be replaced by an electronic platform. In addition, interviewees across the stakeholder groups supported the idea of having a harmonized eIC approach across the European Member States.ConclusionsInterviewees reported a range of design and implementation challenges which needs to be overcome to foster innovation in informing research participants and obtaining their consent electronically. It was considered important that the implementation of eIC runs alongside the face-to-face contact between research participants and the research team. Moreover, interviewees expect that eIC could offer the opportunity to enable a personalized approach and to strengthen continuous communication over time. If successfully implemented, eIC may facilitate the engagement of research participants in clinical research. (shrink)