In New Zealand an advance directive can be either an oral statement or a written document. Such directives give individuals the opportunity to make choices about future medical treatment in the event they are cognitively impaired or otherwise unable to make their preferences known. All consumers of health care have the right to make an advance directive in accordance with the common law. When we consider New Zealand's rapidly ageing population, the fact that more people now live with and die (...) of chronic rather than acute conditions, the importance given to respecting autonomous decision-making, increasing numbers of individuals who require long-term residential care, and financial pressures in the allocation of medical resources, there would seem to be a number of compelling reasons to encourage individuals to write or verbalise an advance directive. Indeed the promotion of advance directives is encouraged. However, caution should be exercised in promoting advance directives to older people, especially in light of several factors: ageist attitudes and stereotypes towards them, challenges in the primary healthcare setting, and the way in which advance directives are currently focused and formulated. This paper considers some of the specific challenges that need to be addressed if the promotion of advance directives are to improve outcomes of patient treatment and care near the end of life. (shrink)

This case concerns aspects of the treatment of a post-surgical patient in a major public hospital in New Zealand during the author's experiences as a fourth year medical student. This case is used to consider the interlinked ethical issues of sympathy, moral virtue, dignity and how the medical environment can realign these values.

One of the key learning objectives in any health professional course is to develop ethical and judicious practice. Therefore, it is important to address how medical and pharmacy students respond to, and deal with, ethical dilemmas in their clinical environments. In this paper, we examined how students communicated their resolution of ethical dilemmas and the alignment between these communications and the four principles developed by Beauchamp and Childress. Three hundred and fifty-seven pharmacy and medical students (overall response rate=63%) completed a (...) questionnaire containing four clinical case scenarios with an ethical dilemma. Data were analysed using multiple methods. The findings revealed that 73% of the qualitative responses could be exclusively coded to one of the ‘four principles’ determined by the Beauchamp and Childress' framework. Additionally, 14% of responses overlapped between the four principles (multiple codes) and 13% of responses could not be coded using the framework. The subsequent subgroup analysis revealed different response patterns depending on the case being reviewed. The findings showed that when students are faced with challenging ethical dilemmas their responses can be aligned with the Beauchamp and Childress framework, although more contentious dilemmas involving issues of law are less easily categorised. The differences between year and discipline groups show students are developing ethical frames of reference that may be linked with their teaching environments and their levels of understanding. Analysis of these response patterns provides insight into the way students will likely respond in ‘real’ settings and this information may help educators prepare students for these clinical ethical dilemmas. (shrink)

This paper presents students’ views about honest and dishonest actions within the pharmacy and medical learning environments. Students also offered their views on solutions to ameliorating dishonest action. Three research questions were posed in this paper: (1) what reasons would students articulate in reference to engaging in dishonest behaviours? (2) What reasons would students articulate in reference to maintaining high levels of integrity? (3) What strategies would students suggest to decrease engagement in dishonest behaviours and/or promote honest behaviours? The design (...) of the study incorporated an initial descriptive analysis to interpret students’ responses to an 18-item questionnaire about justifications for dishonest action. This was followed by a qualitative analysis of students’ commentaries in reference to why students would engage in either honest or dishonest action. Finally a qualitative analysis was conducted on students’ views regarding solutions to dishonest action. The quantitative results showed that students were more likely to use time management and seriousness justifications for dishonest actions. The qualitative findings found that students’ actions (honest or dishonest) were guided by family and friends, the need to do well, issues of morality and institutional guidelines. Students suggested that dishonest action could be ameliorated by external agencies and polarised views between punitive and rewards-based mechanisms were offered. These results suggest that these students engaged in dishonest action for various reasons and solutions addressing dishonest action need to consider diverse mechanisms that likely extend beyond the educational institution. (shrink)

The rise of literary theory spawned the rise of anti-aestheticism, so that even for cultural theorists, discussions concerning aesthetics were often carried out in a critical shorthand that failed to engage with the particularity of the work of art, much less the specificities of aesthetic experience. This book introduces the notion of a new aestheticism--"new" insofar as it identifies a turn taken by a number of important contemporary thinkers towards the idea that focussing on the specifically aesthetic impact of a (...) work of art or literature has the potential to open radically different ways of thinking about identity, politics and culture. (shrink)

During an initial palliative care assessment, a dying man discloses that he had killed several people whilst a young man. The junior doctor, to whom he revealed his story, consulted with senior palliative care colleagues. It was agreed that legal advice would be sought on the issue of breaching the man’s confidentiality. Two legal opinions conflicted with each other. A decision was made by the clinical team not to inform the police.In this article the junior doctor, the palliative medicine specialist, (...) a medical ethicist, and a lawyer consider the case from their various perspectives. (shrink)

One of the central arguments given to resist testing currently healthy, asymptomatic children for adult-onset diseases is that they may be psychologically harmed by the knowledge gained from such tests. In this discussion I examine two of the most serious arguments: children who are tested may face limited futures, and that testing may result in damage to the child’s self esteem . I claim that these arguments do not stand up to critical evaluation. In conclusion, whilst I do not suggest (...) that all at-risk children should be tested for adult-onset diseases we ought to listen carefully to some parental requests for such testing because the putative psychological harms may not be as significant or likely as initially thought. This is because parents generally have the best interests of their children at heart and if they are properly supported and educated about predictive genetic testing and the possible consequences, then the risk of psychological harms occurring may be ameliorated. (shrink)

:This article describes the well-developed and long-standing medical ethics teaching programs in both of New Zealand’s medical schools at the University of Otago and the University of Auckland. The programs reflect the awareness that has been increasing as to the important role that ethics education plays in contributing to the “professionalism” and “professional development” in medical curricula.

Review of J.E. Malpas, *Donald Davidson and the Mirror of Meaning* (CUP).

This paper first considers why it is important to give children genetic information about hereditary conditions in the family, which will go on to affect their lives in a salient way. If it is important to inform children that they are at risk for an adult-onset disease that exists in the family, why should they not also grow up knowing whether they actually carry the genetic mutation? Central to this discussion is the importance of the process of disclosure and the (...) environment in which genetic information is divulged. It is concluded that the reasons given for defending disclosure of genetic conditions in the family to children are also important reasons to cautiously defend predictive genetic testing of children for adult-onset diseases. (shrink)

In a recent number of this journal there appeared an article by Niall Shanks and John King-Farlow on the theory of radical interpretation as developed by Donald Davidson. In that paper Davidson was presented as an opponent of “metaphysical openness in general [and] … idealism in particular” and as a philosopher who has “sought to silence all philosophically challenging talk both about the ordinary speaker’s systematic errors and about the claims of revisionary metaphysicians such as phenomenalists or absolute idealists.” I (...) suspect that Davidson would be somewhat surprised by this description of himself. He might also wonder just what it means to be an “opponent of metaphysical openness in general.” Like any other philosopher, Davidson has his own views on matters philosophical; and, like other philosophers, he criticizes what he sees as false or mistaken in the views of others. One cannot help but suspect that what Davidson’s opposition to “metaphysical openness” really comes down to is his criticism of views associated with idealism. (shrink)

SummaryIn Davidson's Theory of radical interpretation the principle of charity plays a crucial role. However the principle is the subject of widespread misunderstanding. The author attempts to provide an overall account of the principle and in doing so details some aspects of the holism which characterises the Davidsonian approach to interpretation. Charity is shown as inseparable from that holism. Two aspects of the principle are distinguished and some objections to the principle are also considered.

A wide-ranging collection of philosophical essays in honor of Hans-Georg Gadamer.

The publication of Heidegger's Black Notebooks has provoked a storm of controversy. Much of this has centred on the pro-Nazi and anti-Semitic comments the volumes contain. But these aspects of the Notebooks are perhaps the least surprising and important. This essay offers a summary overview of the issues to which the Notebooks give rise, at the same time as it also aims to provide a preliminary assessment of their overall significance, especially in relation to what they show about the nature (...) and development of Heidegger's thinking from the early 1930s to the late 1940s. (shrink)

(2001). Comparing topographies: Across paths/around place: A reply to Casey. Philosophy & Geography: Vol. 4, No. 2, pp. 231-238.

According to Quine the inscrutability of reference leads to ontological relativity, or, as Donald Davidson calls it, relativity of reference. Davidson accepts both inscrutability and the indeterminacy of translation which it grounds, but rejects any explicit relativity of reference or ontology. The reasons behind this rejection are set out and explained. Explicit relativization is shown to be at odds with indeterminacy. Some notion of the relativity of reference (or, more generally, interpretation) is nevertheless shown to be both possible and necessary. (...) It is, however, a relativity which is compatible with commensurability — the idea of absolute incommeasurability is ruled out along with the realist ideal of universal commensuration — as well as with indeterminacy. The indeterminacy thesis itself undergoes some slight elaboration, particularly in respect of the notion of empirical equivalence. In general the resulting account is one which retains both the absolute character of truth and some sense of the relativity of ontology against the background of Davidsonian holism. (shrink)

. Book Reviews. International Journal of Philosophical Studies: Vol. 8, No. 2, pp. 253-269.

A major voice in late twentieth-century philosophy, Alan Donagan is distinguished for his theories on the history of philosophy and the nature of morality. The Philosophical Papers of Alan Donagan, volumes 1 and 2, collect 28 of Donagan's most important and best-known essays on historical understanding and ethics from 1957 to 1991. Volume 1 includes essays on Spinoza, Descartes, Bradley, Collingwood, Russell, Moore, and Popper, as well as two previously unpublished papers on the history of philosophy as a discipline, and (...) on Ryle and Wittgenstein's nature of philosophy. Linked by Donagan's commitment to the central importance of history for philosophy and his interest in problems of historical understanding, these essays represent the remarkable scope of Donagan's thought. (shrink)

A major voice in late twentieth-century philosophy, Alan Donagan is distinguished for his theories on the history of philosophy and the nature of morality. The Philosophical Papers of Alan Donagan, volumes 1 and 2, collect 28 of Donagan's most important and best-known essays on historical understanding and ethics from 1957 to 1991. Volume 2 addresses issues in the philosophy of action and moral theory. With papers on Kant, von Wright, Sellars, and Chisholm, this volume also covers a range of questions (...) in applied ethics—from the morality of Truman's decision to drop atomic bombs on Hiroshima and Nagasaki to ethical questions in medicine and law. (shrink)

Within the medical, legal and bioethical literature, there has been an increasing concern that the information derived from genetic tests may be used to unfairly discriminate against individuals seeking various kinds of insurance; particularly health and life insurance. Consumer groups, the general public and those with genetic conditions have also expressed these concerns, specifically in the context of life insurance. While it is true that all insurance companies may have an interest in the information obtained from genetic tests, life insurers (...) potentially have a very strong incentive to (want to) use genetic information to rate applicants, as individuals generally purchase their own cover and may want to take out very large policies. This paper critically focuses on genetic information in the context of life insurance. We consider whether genetic information differs in any relevant way from other kinds of non-genetic information required by and disclosed to life insurance companies by potential clients. We will argue that genetic information should not be treated any differently from other types of health information already collected from those wishing to purchase life insurance cover. (shrink)

In January 2010, fifth year medical students in the medical programme at the University of Auckland were asked to write a 1200-word report as part of their ethics assessment. The purpose of the report was to get students to reflect critically on the ethical dimension of a clinical case or situation they had been involved in during the past 2 years. Students were required to identify and discuss the salient ethical issues that arose as they saw them, and consider what (...) they had personally learnt from the situation. The purpose of the following discussion is twofold: first, to outline some of the ethical issues raised by year five medical students in their ethics reports; and second, to reflect on what we, as educators and health professionals can learn from their experiences and insights. (shrink)

In a recent number of this journal there appeared an article by Niall Shanks and John King-Farlow on the theory of radical interpretation as developed by Donald Davidson. In that paper Davidson was presented as an opponent of “metaphysical openness in general [and] … idealism in particular” and as a philosopher who has “sought to silence all philosophically challenging talk both about the ordinary speaker’s systematic errors and about the claims of revisionary metaphysicians such as phenomenalists or absolute idealists.” I (...) suspect that Davidson would be somewhat surprised by this description of himself. He might also wonder just what it means to be an “opponent of metaphysical openness in general.” Like any other philosopher, Davidson has his own views on matters philosophical; and, like other philosophers, he criticizes what he sees as false or mistaken in the views of others. One cannot help but suspect that what Davidson’s opposition to “metaphysical openness” really comes down to is his criticism of views associated with idealism. (shrink)

(2001). Comparing topographies: Across paths/around place: A reply to Casey. Philosophy & Geography: Vol. 4, No. 2, pp. 231-238.

According to Quine the inscrutability of reference leads to ontological relativity, or, as Donald Davidson calls it, relativity of reference. Davidson accepts both inscrutability and the indeterminacy of translation which it grounds, but rejects any explicit relativity of reference or ontology. The reasons behind this rejection are set out and explained. Explicit relativization is shown to be at odds with indeterminacy. Some notion of the relativity of reference (or, more generally, interpretation) is nevertheless shown to be both possible and necessary. (...) It is, however, a relativity which is compatible with commensurability — the idea of absolute incommeasurability is ruled out along with the realist ideal of universal commensuration — as well as with indeterminacy. The indeterminacy thesis itself undergoes some slight elaboration, particularly in respect of the notion of empirical equivalence. In general the resulting account is one which retains both the absolute character of truth and some sense of the relativity of ontology against the background of Davidsonian holism. (shrink)

There has been a strong tendency in recent years, in countries such as Australia and the United States, for governmental and corporate spokespersons to present advice and information that comes from independent scientific sources as if it were no better grounded than that from any other source. Such a leveling out of all advice and information into mere “opinion” has been a key strategy in the assertion of corporate and governmental control over public debate and policy. In this paper, we (...) aim to explore some of the factors that diminish the credibility and reliability of information within organizational structures, effectively undermining the value of that information; we argue for the importance of processes like those of peer review in maintaining the credibility and reliability of information that is so important to effective action and decision; and we also provide an analysis of the rationale that underpins such processes. One of our conclusions will be that processes like those of peer review succeed largely because of the way in which they depend upon, but also support, the dispersal of information and authority within an organizational structure so as to ensure both that information is accessible within the structure and also remains open to challenge and scrutiny. (shrink)

J. E. Malpas discusses and develops the ideas of Donald Davidson, influential in contemporary thinking on the nature of understanding and meaning, and of truth and knowledge. He provides an account of Davidson's holistic and hermeneutical conception of linguistic interpretation, and, more generally, of the mind. Outlining its Quinean origins and the elements basic to Davidson's Radical Interpretation, J. E. Malpas' book goes on to elaborate this holism and to examine the indeterminacy of interpretation and the principle of (...) charity. The metaphysical and epistemological consequences of Davidson's approach are considered, particularly in relation to scepticism and relativism, the realist/anti-realist debate, and the problem of truth. Parallels are drawn between the Davidsonian emphasis on the centrality of the notion of truth and Heidegger's notion of truth as aletheia, as the book looks to structuralist, hermeneutical and phenomenological sources to illuminate Davidson's position. (shrink)

(2001). J.E. Malpas's Place and Experience: A Philosophical Topography (Cambridge University Press, 1999) Converging and diverging in/on place. Philosophy & Geography: Vol. 4, No. 2, pp. 225-230.

(2001). J.E. Malpas's Place and Experience: A Philosophical Topography (Cambridge University Press, 1999) Converging and diverging in/on place. Philosophy & Geography: Vol. 4, No. 2, pp. 225-230. doi: 10.1080/10903770123141.