The issue of prenatal testing and selective abortion has never received open public appraisal. This is somewhat regrettable. The interest in this area, however, is rapidly growing. In part this is a result of concerns about the rate of development in genetic knowledge and questions as to its application. For instance, there will be a huge increase in the scope of conditions or features for which we will be able to screen, some of which could hardly be described as significant. (...) Further, for some time now, people with disabilities have had concerns about the practice of prenatal testing and selective abortion. This article looks at the relationship between reproductive autonomy, prenatal testing and associated practices, and the interests of people with disabilities. It asks whether such practices negatively affect the interests of such individuals, and if so, how. This is an important question for the formulation of public policy in this area. Although some groups have studied this issue in detail, policy bodies do not necessarily fully engage with their analyses. This may be a reflection of public confusion about this issue. To some degree, fear of causing offense may also inhibit both expression of public opinion and, in turn, policy analysis. This is unfortunate and needs to be acknowledged. a. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Visions of Damietta:St. Francis, Robert Grosseteste, and the Crusades, 1219–1253Rosamund M. Gammie (bio)A peculiar and under-explored event in Robert Grosseteste's (d. 1253) life is that of his supposed dream-vision in 1249, reported posthumously and in only one source, the Lanercost chronicle.1 The vision foreshadows the loss of Damietta in Egypt the following year, during the Seventh Crusade (1249–54) under the leadership of Louis IX. The parallels to St. Francis's (...) vision at Damietta in 1219 during the Fifth Crusade (1215–21) are immediately noticeable yet the vision has remained largely dismissed as an afterthought in the scholarship of Grosseteste. Considering that Grosseteste wrote, in 1236, what has been described by Michael Lower as "surely the best defence of the cross petition a crusader ever had," in addition to his association with the Franciscans and his relationship with Richard, earl of Cornwall, brother of Henry III and nephew of celebrated crusader Richard I and a (if not the) principal leader of the Baron's Crusade, it is surprising that there is no fuller account of his support for the movement; rather there are piecemeal references to certain acts of interference such as that noted by Lower.2 This paper seeks to establish Grosseteste's position on the crusades, in light of a thoroughly Franciscan influence, beginning with Damietta. [End Page 141]Robert Grosseteste and the FranciscansMuch has been written about the relationship between Robert Grosseteste and the early Franciscan movement in England.3 As Giles Gasper writes in a recent study of Grosseteste and the Franciscan school at Oxford, "Robert Grosseteste is well-known for his support for the Franciscan order, and his warm relations with many brothers of the English province."4 James McEvoy concludes in his examination of Grosseteste's affinity with the nascent movement that "there can be no doubt that Grosseteste was well acquainted with the personality and ideals of St. Francis, the circumstance of the Franciscans' foundation, and the nature of their vocation."5 Grosseteste's Letters are full of admiration for the Franciscans and involvement in their affairs, so much so that a clear and uncompromisingly affectionate relationship can be traced during the bishop's lifetime. Indeed, Grosseteste, in Letter 41, ca. 13 March, 1236, declares to Elias of Cortona, third minister of the Franciscan Order, that "there are no assistants I know of … so effective as your friars."6 The Friars themselves reciprocated their love for Grosseteste; the same letter states, "your sons, the Friars Minor in England, out of kindness in a special way embrace me tightly with arms of love." A letter from 1238 (Letter 58) to Pope Gregory IX asks for help in preserving the reputation of the Brothers, who "illuminate our whole land with the brilliant light of their preaching and teaching" with the warning that "the glory of such an important religious order will vanish and the masses will be scandalized in them."7 [End Page 142]The Dominican Brother Hubert perhaps best expresses the affection between the religious orders and Grosseteste, writing the celebratory Life of Grosseteste shortly after the bishop's death in 1253.8 According to Brother Hubert, Grosseteste was the "father and guardian" of both orders, whose presence "pleased him, as did their / Arrival, their multitude, and frequent conversation," and that just "as a mother to her new-born, he fostered, loved / Protected, fed, and valued them."9 Gasper continues, "English Franciscan historiography leaves no doubt as to the high esteem in which the order held Grosseteste from the mid-13th century onwards, honored in particular for his teaching and learning."10 Chosen personally by Agnellus of Pisa to teach the first Franciscans at Oxford, his influence cannot be underestimated. Indeed, there were Franciscan (and Dominican) contributions to the ultimately unsuccessful attempt to canonize the bishop; a ten-lined letter from Nicholas, guardian of the Greyfriars at Lincoln, penned on 26 June, 1289, extolls the exemplary actions of the bishop.11The relationship between Grosseteste and this first generation of Franciscans was one of mutual respect and love. What is harder to trace is Grosseteste's appreciation of St. Francis himself. When Servus Gieben asks... (shrink)

Presenting twelve breakthrough practices for bringing creativity into all human endeavors, The Art of Possibility is the dynamic product of an extraordinary partnership. The Art of Possibility combines Benjamin Zander's experience as conductor of the Boston Philharmonic and his talent as a teacher and communicator with psychotherapist Rosamund Stone Zander's genius for designing innovative paradigms for personal and professional fulfillment. The authors' harmoniously interwoven perspectives provide a deep sense of the powerful role that the notion of possibility can play (...) in every aspect of life. Through uplifting stories, parables, and personal anecdotes, the Zanders invite us to become passionate communicators, leaders, and performers whose lives radiate possibility into the world. (shrink)

Although a pregnant woman can now refuse any medical treatment needed by the fetus, the Court of Appeal has acknowledged that ethical dilemmas remain, adverting to the inappropriateness of legal compulsion of presumed moral duties in this context. This leaves the impression of an uncomfortable split between the ethics and the law. The notion of a pregnant woman refusing medical treatment needed by the fetus is troubling and it helps little simply to assert that she has a legal right to (...) do so. At the same time, the idea that a pregnant woman fails in her moral duty unless she accepts any recommended treatment or surgery—however great the burdens—is also not without difficulty. This article seeks to find a way between these two somewhat polarized positions by arguing that, instead of being a question primarily about whether legally to enforce moral obligations, the «maternal—fetal conflict» begins with previously unrecognized difficulties in determining when a woman's prima facie moral rights invoked in the treatment context should «give way» to the interests of the fetus. This difficulty is mirrored within the law. Thus, how can we tell when a pregnant woman has the moral or legal duty to submit to a caesarean section? Seen in this way, the conflict is a problem which lies at the interface between moral and legal rights and duties, showing that there are important conceptual links between the ethics and the law. Against this background, this article explores the limits of a pregnant woman's right to bodily integrity by focusing upon the idea of her moral duty to aid the fetus through her body. Here we find difficulties in determining the existence and extent of this somewhat extraordinary duty. Such a duty is contrasted with both negative and positive duties toward others in the course of «general conduct». Attention to the social context of pregnancy and the refusal of treatment within this is also instructive. Overall, the purpose is to foster understanding and acceptance of the current legal position. (shrink)

The Human Fertilisation and Embryology Authority’s recent restrictive recommendations on sex selection have highlighted the need for consideration of the plausibility of ethical arguments against sex selection. In this paper, the author suggests a parental virtues approach to some questions of reproductive ethics as a superior alternative to an exclusively harm focused approach such as the procreative liberty framework. The author formulates a virtue ethics argument against sex selection based on the idea that acceptance is a character trait of the (...) good parent. It is concluded that, because the argument presented posits a wrong in the sex selecting agent’s action that is not a harm, the argument could not function as a justification of the HFEA’s restrictive position in light of their explicit commitment to procreative liberty; it does, however, suggest that ethical approaches focused exclusively on harm fail to capture all the relevant moral considerations and thus that we should look beyond such approaches. (shrink)

This article critically appraises the current legal scope of the principal applications of preimplantation genetic diagnosis (PGD). This relatively new technique, which is available to some parents undergoing in vitro fertilization (IVF) treatment, aims to ensure that a child is not born with a seemingly undesirable genetic condition. The question addressed here is whether there should be serious reasons to test for genetic conditions in embryos in order to be able to select between them. The Human Fertilisation and Embryology Authority (...) and the Human Genetics Commission have decided that there should be such reasons by broadly aligning the criteria for PGD with those for selective abortion. This stance is critically explored, as are its implications for the possible use of PGD to select either against or for marginal features or for significant traits. The government is currently reviewing the legal scope and regulation of PGD. (shrink)

To what extent should parents be able to choose the kind of child they have? The unfortunate phrase 'designer baby' has become familiar in debates surrounding reproduction. As a reference to current possibilities the term is misleading, but the phrase may indicate a societal concern of some kind about control and choice in the course of reproduction. Typically, people can choose whether to have a child. They may also have an interest in choosing, to some extent, the conditions under which (...) they do so, such as whether they have a child with a serious disability or disease. The purpose of this book is to explore the difficult and controversial question of the appropriate ethical and legal extent of reproductive autonomy in this context. The book examines ethical, legal and public policy issues in prenatal screening, prenatal diagnosis (PND), selective abortion and preimplantation genetic diagnosis (PGD). It explores the ethics of these selection practices and the ability of current ethical guidelines and legal mechanisms, including the law on selective abortion and wrongful birth, to deal with advances in genetic and other knowledge in these areas. Unlike in the United States, in England the relevant law is not inherently rights-based, but the impact of the Human Rights Act 1998 inevitably raises questions about the proper scope of reproductive autonomy in this context. The implications of the analysis are considered for the development of relevant law, public policy and ethical guidelines and will be of interest to academics in medical law and ethics, health professionals, lawyers, those working on public policy and students with an interest in these issues. (shrink)

When I think about America, I think about a great diversity of types of people, from different backgrounds, national origins, races, religions, classes and points of view. The US is made up of descendants of African slaves and recent African immigrants; mid-western farmers and Asian Americans whose families come from nearly every Asian nation; Jewish families from Eastern Europe and Native Americans who have owned our land for centuries before any others. These are only a few of the stories that (...) make up the rich diversity of American society. Diversity is our greatest asset. (shrink)

This Paper identifies seven positive elements of an _ethics system_, or framework, for public officials - namely, (1) the culture and values prevailing in a country; (2) codes and laws and their enforcement; (3) new institutions to uphold ethics in public life; (4) audit, public accountability and openness; (5) guiding principles and motivation to encourage good conduct; (6) external and internal education and training for public life; and (7) the views of the public in regard to their call for greater (...) trust, honesty, and integrity in public life. The Paper next discusses in detail each of these seven elements of an _ethics system_ in the context of British Central Government. However, these seven elements are deemed appropriate for the Public Service of any country seeking to strengthen its standards of conduct and uphold its ethical responsibilities. Finally, this Paper concludes with a reference to business companies and the relevance to them of an _ethics system_. For example, there is a defence in the new UK Bribery Act of 2010 (to be implemented on 1st July 2011 and applicable also to foreign corporations doing business in the UK) that, if a business company has procedures in place to prevent corruption (that is, an _ethics system_), it will be treated more leniently. (shrink)

This paper argues that the professional situation of junior doctors is unique in ethically important ways and thus that ethics work focusing on junior doctors specifically is necessary. Unlike the medical student or the more senior doctor, the doctor in his or her early postgraduate years is simultaneously a responsible health professional, a subjugate learner and a human resource. These multiple roles generate the set of ethical issues faced by junior doctors, a set that has some overlaps with that faced (...) by medical students and with that faced by more experienced doctors but is far from completely continuous with either. Further, the multiple roles that junior doctors play affect their options for negotiating the ethical challenges that they face. Their position determines not only the content of the set of ethical issues that they encounter, but also the kinds of actions they can take in the face of these challenges. Thus considering junior doctors only in combination with medical students or more senior doctors fails on two fronts. Firstly, only a very incomplete set of the ethical issues faced by junior doctors will be addressed, and, secondly, the constraints associated with the specific professional situation of junior doctors will not be adequately considered, limiting the practical applicability for these agents of any such analyses. (shrink)

The claim that human reproductive cloning constitutes an affront to human dignity became a familiar one in 1997 as policymakers and bioethicists responded to the announcement of the birth of Dolly the sheep. Various versions of the argument that reproductive cloning is an affront to human dignity have been made, most focusing on the dignity of the child produced by cloning. However, these arguments tend to be unpersuasive and strongly criticised in the bioethical literature. In this paper I put forward (...) a different argument that reproductive cloning is an affront to human dignity, one that looks beyond the dignity of the child produced. I suggest that allocating funds to such a pursuit can affront human dignity by diverting resources away from those existing people who lack sufficient health to enable them to exercise basic rights and liberties. This version of the argument posits cloning as an affront to human dignity in particular circumstances, rather than claiming the technology as intrinsically inconsistent with human dignity. (shrink)

Artificial intelligence is increasingly being developed for use in medicine, including for diagnosis and in treatment decision making. The use of AI in medical treatment raises many ethical issues that are yet to be explored in depth by bioethicists. In this paper, I focus specifically on the relationship between the ethical ideal of shared decision making and AI systems that generate treatment recommendations, using the example of IBM’s Watson for Oncology. I argue that use of this type of system creates (...) both important risks and significant opportunities for promoting shared decision making. If value judgements are fixed and covert in AI systems, then we risk a shift back to more paternalistic medical care. However, if designed and used in an ethically informed way, AI could offer a potentially powerful way of supporting shared decision making. It could be used to incorporate explicit value reflection, promoting patient autonomy. In the context of medical treatment, we need value-flexible AI that can both respond to the values and treatment goals of individual patients and support clinicians to engage in shared decision making. (shrink)

The words “idea” and “concept” have been, and still are, the source of so much confusion in psychology that we shall do well to banish them from the vocabulary of that science. I have urged this reform and have endeavoured to promote it by writing a psychology without ideas.It has seemed to me that the word “concept” plays a no less pernicious rôle in logic. But it was not until I began to look into the matter with a view to (...) writing this article that I became aware of the desperate degree and extent of the confusion obtaining in all that pertains to the concepts of logic. (shrink)

In the late twentieth century the United States experienced a wave of cases concerning compelled obstetric interventions, cases which attracted much legal and philosophical interest. Behind and alongside them, however, lies a little known strand of authorities which concerns a parent wishing to refuse life-sustaining treatment and a hospital seeking to prevent this on the basis of the State's interest in protecting innocent third parties, usually the patient's dependent minor children. This issue appears to be unique to the United States. (...) Although the leading case in point was influential in cases concerning compelled obstetric intervention, it has received little examination in its own right. This is a shame, since it spawned an intriguing line of cases worthy of reflection today. (shrink)

In the late twentieth century the United States experienced a wave of cases concerning compelled obstetric interventions, cases which attracted much legal and philosophical interest. Behind and alongside them, however, lies a little known strand of authorities which concerns a parent wishing to refuse life-sustaining treatment and a hospital seeking to prevent this on the basis of the State's interest in protecting innocent third parties, usually the patient's dependent minor children. This issue appears to be unique to the United States. (...) Although the leading case in point was influential in cases concerning compelled obstetric intervention, it has received little examination in its own right. This is a shame, since it spawned an intriguing line of cases worthy of reflection today. (shrink)

The problem of the relation between mechanism and purpose is of profound theoretical interest. It is the most fundamental of the great perennially disputed problems. And, unlike some other of the great unsolved problems, it is also of far-reaching and profound practical importance. The kind of answer we give to the question affects in a multitude of ways the conduct of our lives, the form and working of all our institutions, our science, our law, our politics, our economics, our morals, (...) our religion. (shrink)

There is at the present time a bewildering variety of schools of psychology in open rivalry and conflict with one another. The Press and the general public, in America, at least, seem to be aware of only two of these, namely the psychoanalytic and the behaviouristic schools; and the newspaper writers and the average highbrow are content to mix snippets and catchwords from these two utterly different schools, ignoring all the rest, unless they add to their shop-window display some uncertain (...) reference to the work of the mental testers. (shrink)

In pediatric health care, parents and clinicians sometimes have competing ideas of what should be done for a child. In this article, we explore the idea that notions of what should be done for a child partly depend on one's perception of one's role in the child's life and care. Although role‐based appeals are common in health care, role‐differentiated approaches to understanding parent‐clinician conflicts are underexplored in the pediatric bioethics literature. We argue that, while the parental role is recognized as (...) having social content or value, and sometimes legal force, it is not always recognized as having ethical content or value, as the clinician's role is. We draw together key insights from the normative and empirical literature on parental roles to show how a role‐based lens might inform clinicians’ and clinical ethicists’ approach to cases in which parents and clinicians disagree. (shrink)

The recent interest in systematic review methods in bioethics has highlighted the need for greater transparency in all literature review processes undertaken in bioethics projects. In this article, I articulate features of a good bioethics literature review that does not aim to be systematic, but rather to capture and analyse the key ideas relevant to a research question. I call this a critical interpretive literature review. I begin by sketching and comparing three different types of literature review conducted in bioethics (...) scholarship. Then, drawing on Dixon-Wood's concept of critical interpretive synthesis, I put forward six features of a good critical interpretive literature review in bioethics: answering a research question, capturing the key ideas relevant to the research question, analysing the literature as a whole, generating theory, not excluding papers based on rigid quality assessment criteria, and reporting the search strategy. (shrink)

There has recently been interest in applying the techniques of systematic review to bioethics literature. In this paper, I identify the three models of systematic review proposed to date in bioethics: systematic reviews of empirical bioethics research, systematic reviews of normative bioethics literature, and systematic reviews of reasons. I argue that all three types yield information useful to scholarship in bioethics, yet they also face significant challenges particularly in relation to terminology and time. Drawing on my recent experience conducting a (...) systematic review, I suggest that complete comprehensiveness may not always be an appropriate goal of a literature review in bioethics, depending on the research question. In some cases, all the relevant ideas may be captured without capturing all the relevant literature. I conclude that systematic reviews in bioethics have an important role to play alongside the traditional broadbrush approach to reviewing literature in bioethics. (shrink)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1902 Excerpt:...earth. r' = radius of moon, or other body. P = moon's horizontal parallax = earth's angular semidiameter as seen from the moon. f = moon's angular semidiameter. Now = P (in circular measure), r'-r = r (in circular measure);.'. r: r':: P: P', or (radius of earth): (radios of (...) moon):: (moon's parallax): (moon's semidiameter). Examples. 1. Taking the moon's horizontal parallax as 57', and its angular diameter as 32', find its radius in miles, assuming the earth's radius to be 4000 miles. Here moon's semidiameter = 16';.-. 4000::: 57': 16';.-. r = 400 16 = 1123 miles. 2. The sun's horizontal parallax being 8"8, and his angular diameter 32V find his diameter in miles. ' Am. 872,727 miles. 3. The synodic period of Venus being 584 days, find the angle gained in each minute of time on the earth round the sun as centre. Am. l"-54 per minute. 4. Find the angular velocity with which Venus crosses the sun's disc, assuming the distances of Venus and the earth from the sun are as 7 to 10, as given by Bode's Law. Since (fig. 50) S V: VA:: 7: 3. But Srhas a relative angular velocity round the sun of l"-54 per minute (see Example 3); therefore, the relative angular velocity of A V round A is greater than this in the ratio of 7: 3, which gives an approximate result of 3"-6 per minute, the true rate being about 4" per minute. Annual ParaUax. 95. We have already seen that no displacement of the observer due to a change of position on the earth's surface could apparently affect the direction of a fixed star. However, as the earth in its annual motion describes an orbit of about 92 million miles radius round the sun, the different positions in space from which an observer views the fixed stars from time to time throughout the year must be separated... (shrink)

BackgroundIn June 2019, the Australian state of Victoria joined the growing number of jurisdictions around the world to have legalised some form of voluntary assisted dying. A discourse of safety was prominent during the implementation of the Victorian legislation.Main textIn this paper, we analyse the ethical relationship between legislative “safeguards” and equal access. Drawing primarily on Ruger’s model of equal access to health care services, we analyse the Victorian approach to voluntary assisted dying in terms of four dimensions: horizontal equity, (...) patient agency, high quality care, and supportive social norms. We argue that some provisions framed as safeguards in the legislation create significant barriers to equal access for eligible patients.ConclusionsWhile safety is undoubtedly ethically important, we caution against an overemphasis on safeguarding in voluntary assisted dying legislation given the implications for equal access. (shrink)

The COVID-19 pandemic has highlighted the risks that can be involved in healthcare work. In this paper, we explore the issue of staff safety in clinical work using the example of personal protective equipment in the COVID-19 crisis. We articulate some of the specific ethical challenges around PPE currently being faced by front-line clinicians, and develop an approach to staff safety that involves balancing duty to care and personal well-being. We describe each of these values, and present a decision-making framework (...) that integrates the two. The aim of the framework is to guide the process of balancing these two values when staff safety is at stake, by facilitating ethical reflection and/or decision-making that is systematic, specific and transparent. It provides a structure for individual reflection, collaborative staff discussion, and decision-making by those responsible for teams, departments and other groups of healthcare staff. Overall the framework guides the decision maker to characterise the degree of risk to staff, articulate feasible options for staff protection in that specific setting and identify the option that ensures any decrease in patient care is proportionate to the increase in staff well-being. It applies specifically to issues of PPE in COVID-19, and also has potential to assist decision makers in other situations involving protection of healthcare staff. There are no data in this work. (shrink)

In this paper I explore the potential of virtue ethical ideas to generate a new way of thinking about the ethical questions surrounding the creation of children. Applying ideas from neo-Aristotelian virtue ethics to the parental sphere specifically, I develop a framework for the moral assessment of reproductive actions that centres on the concept of parental virtue. I suggest that the character traits of the good parent can be used as a basis for determining the moral permissibility of a particular (...) reproductive action. I posit three parental virtues and argue that we can see the moral status of a reproductive action as determined by the relationship between such an action and (at least) these virtues. Using a case involving selection for deafness, I argue that thinking in terms of the question ‘would a virtuous parent do this?’ when morally assessing reproductive action is a viable and useful way of thinking about issues in reproductive ethics. (shrink)