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.

“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)

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)

Anthropology of Consciousness, EarlyView.

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)

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)

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)

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)

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.

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)

Brauer (2022) has recently argued that if it is possible that there is nothing, then the correct modal logic for metaphysical modality cannot include D. Here, I argue that Brauer’s argument is unsuccessful; or at the very least significantly weaker than presented. First, I outline a simple argument for why it is not possible that there is nothing. I note that this argument has a well-known solution involving the distinction between truth in and truth at a possible world. However, I (...) then argue that once the semantics presupposed by Brauer’s argument is reformulated in terms of truth at a world, we have good reasons to think that a crucial semantic premise in Brauer’s argument should be rejected in favour of an alternative. Brauer’s argument is, however, no longer valid with this alternative premise. Thus, plausibly Brauer’s argument against D is only valid, if it is not sound. (shrink)

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)

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.

Robert Reilly’s America on Trial presents a lengthy defense of the principles of the American Founding against recent critiques, especially focusing on those written from a Catholic perspective. His book finds a place in a larger discussion of American Catholic political thought that has been going on for more than a century. I first situate Reilly’s book within that debate, and then argue that Reilly’s account is correct on most counts. Some loose ends remain, but they can be dealt with (...) by expanding some of the points that Reilly has already made. I think, though, that other points not even raised by Reilly’s critics will require further reflection by future American Catholic political thinkers. In 2020, the sensus communis in America has ceased to be “cool and deliberate,” a desideratum for the regime mentioned in Federalist 63; we need to figure out ways to make it cool again. (shrink)

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

Most interpreters of Aristotle claim that he either explicitly posited or at least implied a Grand End theory of practical reasoning as part of his ethical teachings. Sarah Broadie, in her 1991 book Ethics with Aristotle, denied this claim, which prompted Alasdair MacIntyre to respond in kind. After summarizing Broadie’s objection and MacIntyre’s rejoinder, I shall explore the deeper philosophical reasons that underpin MacIntyre’s conviction regarding this matter, establishing that the Grand End conception of practical reasoning is a supposition held (...) throughout MacIntyre’s mature body of writings. Then I shall argue for the main thesis of this paper, that MacIntyre’s conception of practical reasoning entails that he also maintains an inclusive end conception of the human good, which necessarily follows from his specific view of practical reasoning. Alasdair MacIntyre calls attention to what other scholars in some ways neglect: the conception of a Grand End is advantageous for the practical reasoning and virtuous living of even the average person. (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)

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)

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)

THE importance of understanding Aquinas’ metaphysical method before attempting a reconstruction of his metaphysical thought is evident. Unfortunately, however, his only clear statement of that method is found in his Commentary on the Metaphysics, a work whose nature has never been definitively established. Hence, prior to any discussion of the method employed in Thomist metaphysics, a few words are needed on the intentions which led Aquinas to compose his Commentary, and on the goal he wished to reach through that exposition.

Is Aquinas's Sententia libri Ethicorum an interpretation of Aristotle based on `principles of Christian ethics'? Or do we have in that work a presentation of the foundation of Aquinas's moral philosophy? Professor Doig answers these questions through an examination of the historical context within which the Sententia was composed. In Chapters 1-2, the work's role as a corrective of earlier commentaries is established. Chapter 3, by examining philosophy at Paris between 1215 and 1283, reveals that the proposal by Aquinas (...) of a moral philosophy would have been unexceptional. Chapter 4's investigation of the principles underlying the moral theory of the Sententia makes apparent that they were regarded by Aquinas as both philosophical and Aristotelian. The date to be assigned the composition of the Sententia is studied in Chapter 5, and the conclusion is drawn, that with some probability, the Sententia is its author's final proposal of moral doctrines. The closing Chapter offers a summary of that moral philosophy against the historical background brought out earlier. (shrink)

Thomas Aquinas' Commentary on the Metaphysics has long been con sidered by many as one of the most interesting, most rewarding of all his works. Yet strangely enough, there has been no extensive study of this work, at least none that has ever reached print. It is in the hope of partially filling this gap in medieval research that the present study of the metaphysical system of the Commentary was conceived. However, the discussion of the Commentary's metaphysics must simultaneously be (...) an investigation into the reasons which motivated Aquinas in the composition of his work. Did he wish to expose only the theories of Aristotle, or did he simultaneously intend to present his own metaphysical views? Obviously, we must learn the answer to this before we can proceed to disentangle the metaphysical system, or systems, operative in Aquinas' Commentary. Up to the present day this problem, the nature of Aquinas' exposition has not been answered in a manner acceptable to all. Generally speak ing, three theories have been advanced. A first one would see the 1 Commentary as an objective exposition of Aristotle. A second opinion views Aquinas' exposition as an attempt to express his own personal 2 theories on metaphysics. And finally, the third view divides within the Commentary paragraphs containing Aquinas' personal thought ... (shrink)

Philosophers have taken several approaches in attempting to silence this question once and for all. Some have started from the reality of ideas and attempted to trace them back to some basic sense datum which would contain its own justification. Others have sought to discover the basic components of the content of thought, contents basic in the sense of not needing epistemological underpinning. Yet neither approach has met with success or acceptance. Recently, a more promising suggestion has been advanced in (...) Professor A. Danto’s Analytical Philosophy of Knowledge. The proposal is made that we examine the representative content of thought while insisting on the lack of any logical connection between content and truth. On this basis, we would reject all hope of discovering any privileged content of thought, any sense datum intrinsically privileged in virtue of its basic character. If there be no logical connection between content and truth, then all thought and all sense data may be either true or false. Once we set out to answer the epistemological problem against such a background, the problem is displaced. If no content of thought is intrinsically true, the problem becomes one of discovering what "true" means in "true thought." I propose to examine this new approach to see whether it can indeed silence the ghost of Descartes. (shrink)

A study of the major philosophical theories of knowledge from Plato to Husserl intending to show the pivotal role of Descartes and the influence of his unjustified assumption of mental reality for ideas. On the basis of this study, the book suggests the need to return to the pre-Cartesian cognitive realism of the Greeks and Medievals.

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)