Sustaining hope in patients is an important element of health care, allowing improvement in patient welfare and quality of life. However in the palliative care context, with patients who are terminally ill, it might seem that in order to maintain hope the palliative care practitioner would sometimes have to deceive the patient about the full nature or prospects of their condition by providing a ‘false hope’. This possibility creates an ethical tension in palliative practice, where the beneficent desire to improve (...) patient welfare through sustaining hope appears to be in conflict with an autonomy-based requirement not to deceive patients about their condition. In order to resolve this ethical tension, we provide an analysis of the concept of hope and argue that there is at least one conception – the ‘absolute’ conception of hope – which when properly understood allows practitioners to foster hope in terminally-ill patients while avoiding any need to deceive them about their condition. Practitioners therefore do not need to shy away from using the language of hope in the palliative setting, as on this understanding of hope it can be used in a way that both promotes patient welfare and respects patient autonomy. (shrink)

During the set-up phase of an international study of genetic influences on outcomes from sepsis, we aimed to characterise potential differences in ethics approval processes and outcomes in participating European countries. Between 2005 and 2007 of the FP6-funded international Genetics Of Sepsis and Septic Shock project, we asked national coordinators to complete a structured survey of research ethic committee approval structures and processes in their countries, and linked these data to outcomes. Survey findings were reconfirmed or modified in 2017. Eighteen (...) countries participated in the study, recruiting 2257 patients from 160 ICUs. National practices differed widely in terms of composition of RECs, procedures and duration of the ethics approval process. Eight countries used a single centralised process for approval, seven required approval by an ethics committee in each participating hospital, and three required both. Outcomes of the application process differed widely between countries because of differences in national legislation, and differed within countries because of interpretation of the ethics of conducting research in patients lacking capacity. The RECs in four countries had no lay representation. The median time from submission to final decision was 1.5 months; in nine approval was received within 1 month; six took over 6 months, and in one 24 months; had all countries been able to match the most efficient approvals processes, an additional 74 months of country or institution-level recruitment would have been available. In three countries, rejection of the application by some local RECs resulted in loss of centres; and one country rejected the application outright. The potential benefits of the single application portal offered by the European Clinical Trials Regulation will not be realised without harmonisation of research ethics committee practices as well as national legislation. (shrink)

ABSTRACT In an article in Encounter, Antony Flew usefully opens up the issue of what racism is by giving three ‘concepts’: (1) ‘unjustified discrimination’; (2) ‘heretical belief; and (3) ‘institutionalised racism’. He rejects senses (2) and (3) in favour of (1) and finds much ‘anti‐racism’in fact guilty of it. This article, while benefiting from Flew's account, argues that it basically misconceives and underestimates racism by ignoring its complex ideological (sense 2) and institutional (sense 3) character. In regard to (2) it (...) is argued that we need to distinguish scalar and statistical claims from the binary ‘us/them’essentialism characteristic of racism. In regard to (3) it is argued both that affirmative action is required by justice and that it entails ‘collateral injustice’as well as consequential uncertainties. (shrink)

But if you want to be free, you've got to be a prisoner. It's the condition of freedom—true freedom.‘True freedom!’ Anthony repeated in the parody of a clerical voice. ‘I always love that kind of argument. The contrary of a thing isn't the contrary; oh, dear me, no! It's the thing itself, but as it truly is. Ask any die-hard what conservatism is; he'll tell you it's true socialism. And the brewer's trade papers; they're full of articles about the (...) beauty of true temperance. Ordinary temperance is just gross refusal to drink; but true temperance, true temperance is something much more refined. True temperance is a bottle of claret with each meal and three double whiskies after dinner…. (shrink)

But if you want to be free, you've got to be a prisoner. It's the condition of freedom—true freedom.‘True freedom!’ Anthony repeated in the parody of a clerical voice. ‘I always love that kind of argument. The contrary of a thing isn't the contrary; oh, dear me, no! It's the thing itself, but as it truly is. Ask any die-hard what conservatism is; he'll tell you it's true socialism. And the brewer's trade papers; they're full of articles about the (...) beauty of true temperance. Ordinary temperance is just gross refusal to drink; but true temperance, true temperance is something much more refined. True temperance is a bottle of claret with each meal and three double whiskies after dinner…. (shrink)

In a recent paper Anthony Flew gives an argument which can be outlined as follows: 1. Any attempt to give a ‘free will defence’ must be based either on a compatibilist notion of free will or a libertarian, incompatibilist, notion of free will. 2. A free will defence based on a compatibilist notion of free will must fail, for on a compatibilist view of free will, God could make creatures who were free but never chose evil. 3. A free (...) will defence based on a libertarian notion of free will might have other difficulties, but on a libertarian view of free will God could not both leave men free and bring it about that they never chose evil. 4. But a free will defence based on an incompatibilist, libertarian notion of free will can be rejected, since: It is not clear that the ordinary use of such key terms as ‘action’ and ‘choice’ carry any implications of libertarian free will. If such terms did carry the implication of libertarian free will it becomes hard to see how anyone could be in a position to know that a choice had been made or an action performed. The possession of libertarian free will by created beings seems to be incompatible with the essential theistic doctrine that all created beings are always utterly dependent on God as their sustaining cause. 5. Therefore the free will defence fails. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:An Intervention into the Flew/Fogelin Debate Kenneth G. Ferguson Under an aggressive title, Robert FogeUn has recently undertaken to reveal "What Hume Actually Said About Miracles."1 He felt this necessary to correct whathe considers a serious misreading ofHume's essay "OfMiracles" (sec. 10 ofthe Enquiries2), a reading which infers that Hume did not argue thatmiracles are impossible a priori (Fogelin, 81). One writer at least regards this reading so common (...) that she has dubbed it the "traditional interpretation" of Hume's account of miracles.3 At any rate, it finds a strong advocate in Anthony Flew,4 against whom the majority ofFogelin's comments are directed. What I find fascinating about this debate is that both Flew and FogeUn appear to be right. On the one hand, Hume does have the textual resources to marshall a fully deductive argument against miracles, at least, once a strict definition of miracles is admitted. On the other hand, while exploiting these resources, Hume somewhat clumsily mingles in vestiges ofa not-fully consistent inductive argument against miracles which he bases on the balancing of probabilities. I will attempt to identify these two skeins ofargument, in the anticipation that this will help to temper the debate between Flew and Fogelin. Hume opens section 10by promisingan argument that will furnish "an everlasting check to all kinds of superstitious delusion" (E 110). Moreover, he claims that "there is here a direct and full proof... against the existence of any miracle" (E 115), a quote which Fogelin repeats seven times (toextractits full flavour). C. S. Peirce, wholate inlife took an interest in Hume's argument, conjectured that Hume hoped to provide a general disproof of all miracles that would not require "a minute analysis of each story"; such a procedure was in fact popular amongthe miracle debunkers ofHume's day, forexample, Rev. Thomas Woolston, whose books were extremely popular.5 Hume's boast of "a direct and full proof might be assumed, offhand, to augur an a priori argumentbased on the comparison ofideas; butitmust notbe forgotten that back in the Treatise (for which the essay "Of Miracles" was originally drafted6) Hume defines a "proof" as an argument "deriv'd from the relation of cause and effect."7 There he contrasts "proofs" explicitly with the type of assured knowledge that comes "from the comparison ofideas" (T 124). Still, Hume requires that proofs, despite their empirical origin, must nonetheless be "entirely free from doubt Volume XVII Number 2 105 KENNETH G. FERGUSON and uncertainty" (T 124); proofs, then, must be superior to ordinary causal arguments that are able to offer only a degree of probability (T 124). By his own examples, namely, that "the sun will rise to-morrow" and "all men must dye" (T 124), likewise from the essay "Of Miracles" itself, that "lead cannot, of itself, remain suspended in the air" and that "fire consumes wood" (E 114), Hume makes it clear that "proofs" are simply to be causal arguments uniformly confirmed by a great wealth of past experience: empirical conclusions so sound that any who deny them "wou'd appear ridiculous" (T 124). Taking Hume's definition of "proof" to heart, we might infer that his "direct and full proof against miracles is not then to be an a priori or deductive conclusion, but instead merely a fully convincing induction, along the Unes of"all men must dye." This,would appear to dispel Fogelin's hope to portray the argument as a priori; but the logic ofHume's special proofagainst miracles is somewhat complicated. As Hume's own selection of examples verify, a proof, at least ordinarily, issues in the confirmation of a law of nature. This contrasts with the special proof against miracles where the object is, of course, not to defend a law of nature, but rather to exploit reasoning about the formation of such laws to prove a result regarding the occurrence of miracles. The proof against miracles, consequently, concerns causes, but is not necessarily a causal argument in the ordinary sense. Indeed, it might be properly thought ofas a "meta-causal" argument, if such a term is allowed. And such an argument may potentially have, as Fogelin proposes, an a priori... (shrink)

Includes essays on parapsychology and life after death by J. B. Rhine, David Hume, George Price, Plato, Rene Descartes, Thomas Hobbes, and John Locke, among others.

Short Arguments: Some General Rules Arguments begin by marshaling reasons and organizing them in a clear and fair way. Chapter I offers general rules for ...

In a recent paper Edwards, Kirchin, and Huxtable have argued that research ethics committees (RECs) are often wrongfully paternalistic in their approach to medical research. They argue that it should be left to competent potential research subjects to make judgments about the acceptability of harms and benefits relating to research, and that this is not a legitimate role for any REC. They allow an exception to their overall antipaternalism, however, in that they think RECs should have the power to prohibit (...) the use of financial inducements to recruit research subjects into trials. In this paper it is argued that these claims are unjustified and implausible. A sketch is provided of an alternative model of the role of the REC as an expert body making judgments about the acceptability of research proposals through a consensual weighing of different moral considerations. (shrink)

What is logic? What were the most significant contributions of Kant, Plato and Descartes? What is the concept of yin and yang? The personalities, terminology, and definitions of philosophers and philosophical schools of thought are presented clearly in this unique A-to-Z reference guide.

The idea of passive euthanasia has recently been attacked in a particularly clear and explicit way by an “Ethics Task Force” established by the European Association of Palliative Care in February 2001. It claims that the expression “passive euthanasia” is a contradiction in terms and hence that there can be no such thing. This paper critically assesses the main arguments for the Task Force’s view. Three arguments are considered. Firstly, an argument based on the wrongness of euthanasia and the permissibility (...) of what is often called passive euthanasia. Secondly, the claim that passive euthanasia cannot really be euthanasia because it does not cause death. And finally, a consequence based argument which appeals to the bad consequences of accepting the category of passive euthanasia.We conclude that although healthcare professionals’ nervousness about the concept of passive euthanasia is understandable, there is really no reason to abandon the category provided that it is properly and narrowly understand and provided that “euthanasia reasons” for withdrawing or withholding life-prolonging treatment are carefully distinguished from other reasons. (shrink)

Taking a refreshingly hands-on approach to introductory ethics, A 21st Century Ethical Toolbox provides students with a set of tools to help them understand and make a constructive difference in real-life moral controversies. Thoroughly optimistic, it invites students to approach ethical issues with a reconstructive intent, making room for more and better options than the traditional "pro" and "con" positions that have grown up around tough problems like abortion and animal rights. Ideal for introductory and applied ethics courses, this unique (...) text does not treat ethics as a purely academic, historical, or theoretical subject, but as a wide-ranging and ongoing set of challenges that calls for multiple and interwoven kinds of intelligence. It covers the skills that are most vital to making real progress in ethics, including paying careful attention to the values at stake on all sides of an issue; looking for creative opportunities within difficult problems; critical-thinking skills such as defining key terms and making sure to judge similar cases alike; and learning how to engage in constructive dialogue. Instructors can readily use the experiential and applied activities inspired by this "toolbox" of practical skills to design an interactive and collaborative ethics course. Students can carry these essential skills directly from this book into such projects as campaigning for environmental awareness and staffing local homeless shelters. In addition to his own discussion, Weston includes gripping and provocative short selections from essayists, activists, and philosophers, and also cites his own students. Extensive "Exercises and Notes" sections end each chapter, and a detailed appendix offers instructors advice on how to use the Toolbox in the classroom. (shrink)

A Practical Companion to Ethics, Fourth Edition, is a concise and accessible introduction to the basic attitudes and skills that make ethics work, like thinking for oneself, creative and integrative problem-solving, and keeping an open mind. This unique volume illuminates the broad kinds of practical intelligence required in moral judgment, complementing the narrower theoretical considerations that often dominate ethics courses. The optimistic tone and brisk pace of the narrative provide an entertaining and intelligent guide to "everyday" morality. The fourth edition (...) features a new chapter on ethical theories; significantly revised and expanded chapters on conflicts of value and creative problem- solving in ethics; and a new concluding chapter on "Making a Difference, " which explains how students can incorporate ethical thinking and practice into their daily lives. (shrink)

This popular selection of Wittgenstein’s key writings has now been updated to include new material relevant to recent debates about the philosopher. Follows the evolution of Wittgenstein’s philosophical thought from the Tractatus Logico-Philosophicus through to the Philosophical Investigations. Excerpts are arranged by topic and introduce readers to all the central concerns of Wittgenstein’s philosophy. Now includes a new chapter on ‘Sense, Nonsense and Philosophy’ incorporating material relevant to recent debates about Wittgenstein.

In this brief but powerful book, acclaimed political philosopher C.B. Macpherson sets out in bold relief the essence of liberal democracy, both as it is currently conceived and as it might be reimagined. The Wynford edition includes a new Introduction by Frank Cunningham.

In lieu of an abstract, here is a brief excerpt of the content:Joseph de Maistre’s Civilization and its DiscontentsGraeme GarrardIn his study of Sigmund Freud’s social and political thought Paul Roazen claims that Freud was the first to depict the human psyche as torn between two fundamentally antithetical tendencies:The notion of a human nature in conflict with itself, disrupted by the opposition of social and asocial inclinations, the view that the social self develops from an asocial nucleus but that the (...) social trends are also dynamic and emotional in nature, and finally the conception that reason’s control can be extended by a detailed knowledge of the repressed asocial tendencies—all this was not known before Freud. 1Although Freud is undoubtedly the most famous modern exponent of this conception of human nature at war with itself, he was by no means its first, let alone only, proponent. Kant, for example, wrote of the “unsocial sociability of men” over a century earlier. 2 An even more unlikely precursor of this basic assumption of Freudian social psychology is the Catholic reactionary Joseph de Maistre (1753–1821). The social theory elaborated by this arch-paladin of throne and altar—who was, quite literally, plus royalist que le roi, plus catholique que le Pape—is strikingly similar to that expressed by Freud in his famous essay Civilization and Its Discontents (1929). 3 [End Page 429]Both conceived of the individual as “a being both social and evil,” 4 perpetually struggling to prevent the innate aggressiveness of the species from plunging society into a Hobbesian war of all against all. That is why Freud insisted that it “has to use its utmost efforts in order to set limits to man’s aggressive instincts,” 5 a view advanced over a century earlier by Maistre. Events in Europe after 1789 led many conservatives such as Maistre, as events after 1914 would lead Freud, to reject the common Enlightenment view of human beings as naturally sociable and of social life as a reflection of the spontaneous harmony of a natural world governed by laws established by God and discoverable by reason. In Maistre’s view, social and political life are better understood as the artificial and fundamentally precarious imposition of order on the violent flux of nature. Anticipating Freud, he asserts that individuals, if left to their own devices in society, would soon be plunged into a state of social warfare identical to that which Hobbes had attributed to the state of nature. His particular brand of extreme conservative thought derives its social and political authoritarianism from these deeply pessimistic social assumptions, which leave him with more in common (on this subject) with Freud than with either the Enlightenment or fellow conservatives such as Edmund Burke.Homo Homini LupusThe pessimistic, even tragic, argument of Civilization and Its Discontents is that human beings are driven by extremely powerful instincts, the full satisfaction of which is incompatible with social life. According to Freud, the “cultural frustration” that ensues from this incompatibility “dominates the large field of social relationships between human beings. As we already know, it is the cause of the hostility against which all civilizations has to struggle.” 6 Unhappiness, understood as the non-satisfaction of these basic libidinal urges, is therefore a necessary part of human association. “One feels inclined to say that the intention that man should be ‘happy,’” Freud writes pessimistically, “is not included in the plan of ‘Creation.’” 7Freud also argues that, in addition to these basically erotic instincts, there is a “constitutional inclination in human beings to be aggressive towards one another,” 8 which “constitutes the greatest impediment to civilization.” 9 [End Page 430] This ineliminable tendency accounts for Freud’s Hobbesian view of the precariousness of civilization: 10[M]en are not gentle creatures who want to be loved, and who at the most can defend themselves if they are attacked; they are, on the contrary, creatures among whose instinctual endowments is to be reckoned a powerful share of aggressiveness. As a result, their neighbour is for them not only a potential helper or sexual object, but also someone who tempts them to satisfy their aggressiveness on him, to exploit his capacity for work without compensation, to... (shrink)