This paper provides a series of reflections on making the case to senior leaders for the introduction of clinical ethics support services within a UK hospital Trust at a time when clinical ethics committees are dwindling in the UK. The paper provides key considerations for those building a case for clinical ethics support within hospitals by drawing upon published academic literature, and key reports from governmental and professional bodies. We also include extracts from documents relating to, and annual reports of, (...) existing clinical ethics support within UK hospitals, as well as extracts from our own proposal submitted to the Trust Board. We aim for this paper to support other ethicists and/or health care staff contemplating introducing clinical ethics support into hospitals, to facilitate the process of making the case for clinical ethics support, and to contribute to the key debates in the literature around clinical ethics support. We conclude that there is a real need for investment in clinical ethics in the UK in order to build the evidence base required to support the wider introduction of clinical ethics support into UK hospitals. Furthermore, our perceptions of the purpose of, and perceived needs met through, clinical ethics support needs to shift to one of hospitals investing in their staff. Finally, we raise concerns over the optional nature of clinical ethics support available to practitioners within UK hospitals. (shrink)

This article explores egg freezing experiences of women in Turkey. Since 2014, it has been legal in Turkey to use egg freezing technology for ageing women, while it was previously allowed only for disease-related purposes. In cooperation with a private fertility clinic in Istanbul, the authors conducted 21 interviews with older, single women who held either professional or managerial positions and who were undergoing or had undergone the procedure. Drawing on a qualitative analysis of these interviews, the authors explore the (...) social context in which women postpone motherhood and decide to freeze their eggs. The study also looks at the women’s emotional responses to ageing that were triggered by the experience of egg freezing and their narratives of empowerment as a result of the procedure. (shrink)

In any society influenced by a plurality of cultures, there will be widespread, systematic differences about at least some important values, including moral values. Many of these differences look like deep disagreements, difficult to resolve objectively if that is possible at all. One common response to the suspicion that these disagreements are unsettleable has always been moral relativism. In the flurry of sympathetic treatments of this doctrine in the last two decades, attention has understandably focused on the simpler case in (...) which one fairly self-contained and culturally homogeneous society confronts, at least in thought, the values of another; but most have taken relativism to have implications within a single pluralistic society as well. I am not among the sympathizers. That is partly because I am more optimistic than many about how many moral disagreements can be settled, but I shall say little about that here. For, even on the assumption that many disputes are unsettleable, I continue to find relativism a theoretically puzzling reaction to the problem of moral disagreement, and a troubling one in practice, especially when the practice involves regular interaction among those who disagree. This essay attempts to explain why. (shrink)

Purpose. Based on the study of philosophical anthropological concepts, to highlight the project of personality in different historical periods, to reveal the meaning of humanistic issues in the postmodern epoch, to identify the essential features of the image of human of the second half of the XX the beginning of the XXI century. Theoretical basis. The methodological basis of the article is the principles of historicism, integrity, objectivity regarding the mastery of the issue of person’s image in postmodernism. The research (...) applied comparative-historical, culturological, analytical, axiological approaches to reveal the problem of individuality in the second half of the XX the beginning of the XXI century. The theoretical basis of the article consists of scientific works in the field of philosophical anthropology, history, cultural studies, and aesthetics. Originality. The author revealed the peculiarities of transformation of the personality model from antiquity to postmodernism, specified the image of man of the second half of the XX the beginning of the XXI century. Conclusions. The analysis of anthropological ideas of Western philosophy of different ages shows the variety of views about understanding the nature of the person, its complexity and ambiguity. In the epoch of postmodernism humanistic issues are of particular relevance, which is connected with social and political uncertainty, domination of mass consciousness, loss of national and cultural identity. The image of a person of this period is deprived of a solid foundation, it is blurred and relative. The destruction of faith in the absolute in the context of the second half of the twentieth century contributed to the formation of confidence in the interdependence of all things, raised the problem of the personality image to a new ontological level. Orientation in the achievements of European civilization, perception of its anthropological experience, intercultural dialogue contribute to the productive use of the achievements of mankind in order to understand the modern person and to form its adequate image. In its essence, postmodernism does not set the goal to realize a retrospection of subject type. However, separating from the cultural memory the excerpts of ideas about a person, by certain styles and directions, it builds on their formations its own eclectic image of the individual. (shrink)

Disorders of Consciousness (DoCs) raise difficult and complex questions about the value of life for persons with impaired consciousness, the rights of persons unable to make medical decisions, and our social, medical, and ethical obligations to patients whose personhood has frequently been challenged and neglected. Recent neuroscientific discoveries have led to enhanced understanding of the heterogeneity of these disorders, and focused renewed attention on the medical and ethical problem of misdiagnosis. -/- This book examines the entanglement of epistemic and ethical (...) uncertainty in DoCs and other medical contexts, and how they interact to create both epistemic and ethical risks. Philosopher and bioethicist L. Syd M Johnson pulls together multiple threads in this work: the ontological mysteries of consciousness, medical uncertainty about unconsciousness, ableist bias, withdrawal of treatment in neurointensive care, and the rarely questioned view that consciousness is essential to personhood and moral status. Johnson challenges longstanding bioethical dogmas about DoC patients, and argues for an ethics of uncertainty for contexts where there is a need for decisive action in the presence of unavoidable uncertainty. The ethics of uncertainty refocuses ethical inquiry concerning persons with DoCs, placing less emphasis on their contested personhood, and more on inductive risk and uncertainty, on respect for autonomy, and especially on epistemic justice. With applications to various decisional contexts where uncertainty and ethical risk interact, this ethical approach enables surrogate decision makers facing fraught and risky choices to fulfill their obligations as moral and epistemic agents. (shrink)

Où en sommes-nous dans l'étude des rapports entre femmes et mouvement ouvrier en France? A faire le bilan on remarque d'abord que ce travail a surtout porté sur la période de l'avant Première Guerre mondiale, et ce pour de bonnes raisons. Le XIXe siècle est bel et bien la période de l'essor du capitalisme industriel en France et aussi de la prolétarisation pour de nombreux ouvriers et ouvrières. C'est aussi l'âge héroïque du commencement de la revendication ouvrière, du socialisme et...

A weak form of intuitionistic set theory WST lacking the axiom of extensionality is introduced. While WST is too weak to support the derivation of the law of excluded middle from the axiom of choice, we show that beefing up WST with moderate extensionality principles or quotient sets enables the derivation to go through.

Ever since medical assistance in dying (MAID) became legal in Canada in 2016, controversy has enveloped the refusal by many faith‐based institutions to allow this service on their premises. In a recent article in this journal, Philip and Joshua Shadd have proposed ‘changing the conversation’ on this issue, reframing it as an exercise not of conscience but of an institutional right of self‐governance. This reframing, they claim, will serve to show how health‐care institutions may be justified in refusing to provide (...) MAID on moral or religious grounds. I argue that it will not make it easier to justify institutional refusal, and is likely to make it harder. (shrink)

The interconnections, common interests, and other linkages between the Jewish and Islamic traditions have long been a matter of interest to academics. Today the need to understand these relationships, and to emphasize commonalities rather than conflicts, is of the greatest public interest. The present volume of studies, likely the first such collection in the scholarly literature, explores the full range of interconnections between Jews and Muslims in all fields (intellectual history, religion, philosophy, social history, etc.) and in all periods, from (...) the Middle Ages till today. The essays have been written by some twenty distinguished scholars from North America, Europe, and Israel. The volume is dedicated to our esteemed colleague Joel L. Kraemer, John Barrows Professor Emeritus in the Divinity School and on the Committee on Social Thought of the University of Chicago. In the course of his distinguished career Professor Kraemer has made major contributions to our understanding of the intellectual and cultural history of the Jews in the Arabic world, Islamic and Jewish philosophy and their sources in ancient philosophy, the humanistic renaissance in Islam (on which he published two seminal monographs), and Maimonides (on which he has published many important papers and is completing a biography and a translation of Maimonides' letters, to appear in the Yale Judaica Series). (shrink)

L. Nandi Theunissen offers an original and provocative account of the value of humanity. Human beings have value just as anything of value has value: because we are capable of being of value to someone--in the first place, to ourselves. And this explains the key forms of ethical responsiveness that we owe to one another.

The soul has played many different roles in philosophy and religion. Two of the primary functions of the soul are the bearer of personal identity and the foundation of immortality. In this paper I shall consider different interpretations of what the soul has been taken to be and argue that however we interpret the soul we cannot consistently maintain the soul is both what we are and what continues after our bodily death.

I argue that environmental ignorance is a group-based form of substantive ignorance that is analogous to race-based ignorance, showing that they are structurally and functionally similar and sometimes overlap. While race theorists offer promising solutions toward eliminating race-based ignorance, I argue that something far more is needed in the environmental case. I turn to panpsychism as a possible solution. Though I conclude that it is too radical for most Americans to willingly embrace, I incorporate a notion of “encounter” to argue (...) that an expanded conception of home helps with the conceptual overhaul needed to overcome environmental ignorance. (shrink)

A standard objection to act utilitarian theories is that they are not helpful in deciding what it is morally permissible for us to do when we actually have to make a choice between alternatives. That is, such theories are worthless as decision procedures. A standard reply to this objection is that act utilitarian theories can be evaluated solely as theories about right-making characteristics and, when so evaluated, their inadequacy as decision procedures is irrelevant. Even if somewhat unappealing, this is an (...) effective reply to the standard objection. (shrink)

This article is about Gilles Deleuze's book Le Pli. Leibniz et le Baroque from 1988. It shows how Deleuze's notion of folding captures some basic intuitions in Leibniz and how they relate to each other. To this purpose, I propose five figures, all referring to the same basic fold, all illustrating how the consideration of such figures allows developing central elements of Leibniz's monadology. These figures can help, I hope, alleviate some of the fundamental difficulties in understanding Deleuze's approach to (...) the Monadology from the non-Deleuzian perspective of contemporary Leibniz scholarship and give a sense of the synthetic, explanatory force that Deleuze's notion of folding has in relation to Leibniz's monadological metaphysics. (shrink)

Bioethicists have recently expressed concern over a lack of quality control within the field. This apprehension focuses on bioethics expanding in ways that obscure its distinctive ethical remit and the specialist reasoning skills it requires. This thesis about the quality and conduct of bioethics may have particular relevance for clinical ethics. As one of the youngest offshoots of bioethics, the field focuses on the ethical issues that arise specifically in a clinical context. However, non-ethics specialists are increasingly involved in this (...) field. This means that clinical ethics could be especially vulnerable to the quality control concerns articulated within bioethics. The growing public profile of clinical ethics means that concerns over quality in this area warrant specific attention by those concerned with declining standards in bioethics and those working in clinical ethics. (shrink)

The question that I address in this paper is whether there is a right to privacy. It is not the question whether in the United States there is a legal right to privacy or, more particularly, a constitutional right to privacy. There are any number of ordinary legal rights and specific constitutional rights that might be so described, and the U.S. Supreme Court has referred also to a generic “right to privacy” that is implicit in the U.S. Constitution. Nor is (...) the question that I address whether persons have a moral claim to privacy that others ought to respect. I assume that in many circumstances, respecting a person's claim to privacy is productive of the good and, if so, that the claim ought to be respected. Rather, my question is whether persons have a right to privacy not dependent on positive law, such that it ought ordinarily to be respected without regard to the consequences, good or bad, simply because it is right. (shrink)

Jerry L. Walls argues that the doctrine of heaven is ripe for serious reconsideration. He contends not only that the orthodox view of heaven can be defended from objections commonly raised against it, but also that heaven is a powerful resource for addressing persistent philosophical problems, not the least of which concern the ground of morality and the meaning of life. Walls shows how heaven is integrally related to central Christian doctrines, particularly those related to salvation, and tackles the difficult (...) problem of why faith in Christ is necessary to save us from our sins. In addition, heaven is shown to illumine thorny problems of personal identity and to be an essential component of a satisfactory theodicy. Walls goes on to examine data from near-death experiences from the standpoint of some important recent work in epistemology and argues that they offer positive evidence for heaven. He concludes that we profoundly need to recover the hope of heaven in order to recover our very humanity. (shrink)

SETTING: Previous health policies in South Africa neglected the teaching of ethics and human rights to health professionals. In April 1995, a pilot course was run at the University of Cape Town in which the ethical dimensions of human rights issues in South Africa were explored. OBJECTIVES: To compare knowledge and attitudes of participating students with a group of control students. DESIGN: Retrospective cohort study. SUBJECTS: Seventeen fourth-year medical students who participated in the course and 13 control students from the (...) same class, matched for gender. INTERVENTIONS: Students participated in a one-week module on ethics and human rights. Five months after the course had been run, students completed a semi-structured questionnaire exploring their knowledge and attitudes with regards to ethics and human rights issues. MAIN OUTCOME MEASURES: Knowledge scores, attitude scores and various individual indicators of attitude. RESULTS: Clear benefits for overall knowledge score, for four out of five individual knowledge questions and for one of the attitude questions, were demonstrated. Participating students also appeared to be more convinced of the need for teaching on the ethical dimensions of human rights at postgraduate level and that such teaching should also be integrated in the curriculum. The low response rate amongst controls may have selected students who were more socially conscious, thereby leading to an underestimate of the true impact of the course. CONCLUSION: The evaluation indicates clear benefits of the course for undergraduate students, and supports arguments for the inclusion of such courses in the training of health professionals. This is particularly important given the challenges posed by the Truth and Reconciliation Commission to the health professions to address past complicity in human rights abuses through reorientation of medical training in South Africa. (shrink)