In debates about criteria for human death, several camps have emerged, the main two focusing on either loss of the "organism as a whole" (the mainstream view) or loss of consciousness or "personhood." Controversies also rage over the proper definition of "irreversible" in criteria for death. The situation is reminiscent of the proverbial blind men palpating an elephant; each describes the creature according to the part he can touch. Similarly, each camp grasps some aspect of the complex reality of death. (...) The personhood camp, in contrast to the mainstream "organism" camp, recognizes that a human organism can still be a biological living whole even without brain function. The mainstream camp, in contrast to the personhood camp, recognizes that a person can be permanently, even irreversibly unconscious, and still be a living person so long as his/her body is alive. The author proposes that hylomorphic dualism incorporates both these key insights. But to complete the picture of the entire "death elephant," a fundamental paradigm shift is needed to make sense of other seemingly conflicting insights. The author proposes a "semantic bisection" of the concept of death, analogous to the traditional distinction at the beginning of life between "conception" and "birth." To avoid the semantic baggage associated with the term "death," the two new death-related concepts are referred to as "passing away" (or "deceased") and "deanimation," corresponding, respectively, to sociolegal ceasing-to-be (mirror image of birth) and ontological/theological ceasing-to-be of the bodily organism (mirror image of conception). Regarding criteria, the distinguishing feature is whether the cessation of function is permanent (passing away) or irreversible (deanimation). If the "dead donor rule" were renamed the "deceased donor rule" (both acronyms felicitously being "DDR"), the ethics of organ transplantation from non–heart-beating donors could, in principle, be validly governed by the DDR, even though the donors are not yet ontologically "deanimated." Thus, the paradigm shift satisfies both those who insist on maintaining the DDR and those who claim that it has all along been receiving only lip service and should be explicitly loosened to include those who are "as good as dead." Even so, a number of practical caveats remain to be worked out for non–heart-beating protocols. (shrink)

The mainstream rationale for equating brain death (BD) with death is that the brain confers integrative unity upon the body, transforming it from a mere collection of organs and tissues to an organism as a whole. In support of this conclusion, the impressive list of the brains myriad integrative functions is often cited. Upon closer examination, and after operational definition of terms, however, one discovers that most integrative functions of the brain are actually not somatically integrating, and, conversely, most integrative (...) functions of the body are not brain-mediated. With respect to organism-level vitality, the brains role is more modulatory than constitutive, enhancing the quality and survival potential of a presupposedly living organism. Integrative unity of a complex organism is an inherently nonlocalizable, holistic feature involving the mutual interaction among all the parts, not a top-down coordination imposed by one part upon a passive multiplicity of other parts. Loss of somatic integrative unity is not a physiologically tenable rationale for equating BD with death of the organism as a whole. (shrink)

Discrepancies between the Uniform Determination of Death Act (UDDA) and the adult and pediatric diagnostic guidelines for brain death (BD) (the “Guidelines”) have motivated proposals to revise the UDDA. A revision proposed by Lewis, Bonnie and Pope (the RUDDA), has received particular attention, the three novelties of which would be: (1) to specify the Guidelines as the legally recognized “medical standard,” (2) to exclude hypothalamic function from the category of “brain function,” and (3) to authorize physicians to conduct an apnea (...) test without consent and even over a proxy’s objection. One hundred seven experts in medicine, bioethics, philosophy, and law, spanning a wide variety of perspectives, have come together in agreement that while the UDDA needs revision, the RUDDA is not the way to do it. Specifically, (1) the Guidelines have a non-negligible risk of false-positive error, (2) hypothalamic function is more relevant to the organism as a whole than any brainstem reflex, and (3) the apnea test carries a risk of precipitating BD in a non-BD patient, provides no benefit to the patient, does not reliably accomplish its intended purpose, and is not even absolutely necessary for diagnosing BD according to the internal logic of the Guidelines; it should at the very least require informed consent, as do many procedures that are much more beneficial and less risky. Finally, objections to a neurologic criterion of death are not based only on religious belief or ignorance. People have a right to not have a concept of death that experts vigorously debate imposed upon them against their judgment and conscience; any revision of the UDDA should therefore contain an opt-out clause for those who accept only a circulatory-respiratory criterion. (shrink)

From the start, I followed the case of Jahi McMath with great interest. In December 2013, she clearly fulfilled the diagnostic criteria for brain death. As a neurologist with a special interest in chronic brain death, I was not surprised that, after she was flown to New Jersey, where she became statutorily resurrected and was treated as a comatose patient, Jahi's condition quickly improved. In 2014, her family reported that she sometimes responded to simple motor commands. I shared the general (...) skepticism regarding these reports, assuming that the family was in denial and was misinterpreting spinal myoclonus (a rapid, involuntary twitch generated by the spinal cord) as volitional. The family had noticed that when Jahi's heart rate was above eighty beats per minute, she was more likely to respond, as though the heart rate reflected some sort of inner level of arousal. So they began to make video recordings. I have been privileged to be entrusted with copies of these recordings, forty‐eight of which proved suitable for assessing alleged responsiveness. All have been certified by a forensic video expert as unaltered. The first thing that struck me was that the great majority of the alleged responses were not spinal myoclonus. In fact, they did not resemble any type of spontaneous, involuntary movement described in patients paralyzed from high spinal cord lesions. (shrink)

At its inception, “brain death” was proposed not as a coherent concept but as a useful one. The 1968 Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death gave no reason that “irreversible coma” should be death itself, but simply asserted that the time had come for it to be declared so. Subsequent writings by chairman Henry Beecher made clear that, to him at least, death was essentially a social construct, and society could define (...) it however it pleased. The first widely endorsed attempt at a philosophical justification appeared thirteen years later, with a report from the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and a seminal paper by James Bernat, Charles Culver, and Bernard Gert, which introduced the insightful tripartite scheme of concept, criterion, and tests for death. Their paper proposed that the correct concept of death is the “permanent cessation of functioning of the organism as a whole,” which tenuously remains the mainstream concept to this day. In this essay, I focus on this mainstream concept, arguing that equating brain death with death involves several levels of incoherence: between concept and criterion, between criterion and tests, between tests and concept, and between all of these and actual brain death praxis. (shrink)

: American society traditionally has assumed a univocal notion of "death," largely because we have only one word for it and, until recently, have not needed a more nuanced notion. The reality of death-processes does not preclude the reality of death events. Linguistically, "death" can be understood only as an event; there are other words for the process. Our death vocabulary should expand to reflect multiple events along the process from sickness to decomposition. Depending on context, some death-related events may (...) constitute a more obvious discontinuity than others and more justifiably may be considered "death" within that context. There is no reason to assume a priori that there must be an overarching, unitary concept of death from which all diagnostic criteria must derive. Regarding organ transplantation, the relevant question is not "Is the patient dead?" but rather "Can organs X, Y, Z . . . be removed without causing or hastening death or harming the patient?". (shrink)

The main goal of Brain Death and Disorders of Consciousness is to provide a suitable scientific platform to discuss all topics related to human death and coma.

Jahi McMath's case has raised challenging uncertainties about one of the most profound existential questions that we can ask: how do we know whether someone is alive or dead? The case is striking in at least two ways. First, how can it be that a person diagnosed as dead by qualified physicians continued to live, at least in a biological sense, more than four years after a death certificate was issued? Second, the diagnosis of brain death has been considered irreversible; (...) in fact, there has never been a case of a person correctly diagnosed as brain‐dead who improved to the point that the person no longer fulfilled the diagnostic criteria. If the neurologist Alan Shewmon is correct that, prior to her cardiac arrest in June 2018, McMath no longer met the criteria for brain death and was actually in a minimally conscious state, this case could have momentous implications for how we think about this diagnosis going forward. In this essay, I will offer a hypothesis that could, perhaps, explain both these aspects of the case. The hypothesis is based on differences in how we distinguish between biological and legal categories. The law tends to prefer to draw bright‐line distinctions between categories, whereas biological categories tend to fall along a spectrum, without sharp distinctions. (shrink)

Lexical Semantics is about the meaning of words. Although obviously a central concern of linguistics, the semantic behaviour of words has been unduly neglected in the current literature, which has tended to emphasize sentential semantics and its relation to formal systems of logic. In this textbook D. A. Cruse establishes in a principled and disciplined way the descriptive and generalizable facts about lexical relations that any formal theory of semantics will have to encompass. Among the topics covered in depth are (...) idiomaticity, lexical ambiguity, synonymy, hierarchical relations such as hyponymy and meronymy, and various types of oppositeness. Syntagmatic relations are also treated in some detail. The discussions are richly illustrated by examples drawn almost entirely from English. Although a familiarity with traditional grammar is assumed, readers with no technical linguistic background will find the exposition always accessible. All readers with an interest in semantics will find in this original text not only essential background but a stimulating new perspective on the field. (shrink)

Revisiting African philosophy’s classic questions, D. A. Masolo advances understandings of what it means to be human—whether of African or other origin. Masolo reframes indigenous knowledge as diversity: How are we to understand the place and structure of consciousness? How does the everyday color the world we know? Where are the boundaries between self and other, universal and particular, and individual and community? From here, he takes a dramatic turn toward Africa’s current political situation and considers why individual rights and (...) freedoms have not been recognized, respected, demanded, or enforced. Masolo offers solutions for containing socially destructive conduct and antisocial tendencies by engaging community. His unique thinking about community and the role of the individual extends African philosophy in new, global directions. (shrink)

This paper presents a new formal model for D–N explanation that gives intuitive criteria of acceptability, avoids the known trivializations, and links explanation with confirmation theory. Although set in the twenty-five year tradition of attempts to formalize D–N explanation, it proposes a new direction for the model that is to be distinguished from the syntactical and informational approaches by its introduction of restrictions which derive from the use which the D–N model can have in hypothesis testing. This model, illustrating the (...) verificational approach, revises the classic H–O requirements and amends the notion of partial self-explanation to meet a criticism to which the H–O notion is vulnerable. (shrink)

" -- Africa Today "The excellence of this book lies in the wealth of perspectives that it brings to the discussion on what constitutes philosophy, rationality, ...

A three-valued propositional logic is presented, within which the three values are read as ?true?, ?false? and ?nonsense?. A three-valued extended functional calculus, unrestricted by the theory of types, is then developed. Within the latter system, Bochvar analyzes the Russell paradox and the Grelling-Weyl paradox, formally demonstrating the meaninglessness of both.

In some languages every statement must contain a specification of the type of evidence on which it is based: for example, whether the speaker saw it, or heard it, or inferred it from indirect evidence, or learnt it from someone else. This grammatical reference to information source is called 'evidentiality', and is one of the least described grammatical categories. Evidentiality systems differ in how complex they are: some distinguish just two terms (eyewitness and noneyewitness, or reported and everything else), while (...) others have six or even more terms. Evidentiality is a category in its own right, and not a subcategory of epistemic or some other modality, nor of tense-aspect. Every language has some way of referring to the source of information, but not every language has grammatical evidentiality. In English expressions such as I guess, they say, I hear that, the alleged are not obligatory and do not constitute a grammatical system. Similar expressions in other languages may provide historical sources for evidentials. True evidentials, by contrast, form a grammatical system. In the North Arawak language Tariana an expression such as "the dog bit the man" must be augmented by a grammatical suffix indicating whether the event was seen, or heard, or assumed, or reported. This book provides the first exhaustive cross-linguistic typological study of how languages deal with the marking of information source. Examples are drawn from over 500 languages from all over the world, several of them based on the author's original fieldwork. Professor Aikhenvald also considers the role evidentiality plays in human cognition, and the ways in which evidentiality influences human perception of the world.. This is an important book on an intriguing subject. It will interest anthropologists, cognitive psychologists and philosophers, as well as linguists. (shrink)

Physicians have developed a number of implicit and explicit approaches to complex medical decisions. Decision analysis is an explicit, quantitative method of clinical decision making that involves the separation of the probabilities of events from their relative values, or utilities. Its use can help physicians make difficult choices in a manner that promotes true patient participation. Decision analysis also provides a framework for the incorporation of data from multiple sources and for the assessment of the impact of uncertain data on (...) the final decision. Although this approach is imperfect, it represents a significant advance in clinical decision making. (shrink)

Signals to the brain from the flows of energy around the body, varied primarily by declining amounts of food energy in the stomach, can explain the pattern of meals in the laboratory rat, the differences between dark and light phases, and the development of obesity ion the rat wioth VMH lesions but normal sating.

D. A. Lloyd Thomas; VIII—Political Decision Procedures1, Proceedings of the Aristotelian Society, Volume 70, Issue 1, 1 June 1970, Pages 141–160, https://doi.or.

Justice will once take the place which the Magians are keeping now, for it is they who lord it over the world.

There are a number of grounds for criticizing what the state requires of one, and for thinking that one no longer has an obligation to obey it. I will begin by attempting to locate liberalism amongst such grounds. It is useful for this purpose to contrast two headings under which these grounds may fall. Firstly, there are criticisms concerning the content of the requirements of the state. In this case exception is taken to what it is that the law requires (...) quite apart from the process by which it was arrived at. If Jews are legally prevented from practising certain professions, and objection is taken because no state should make laws debarring persons from certain professions on religious grounds, the objection is one of content. Secondly, there are grounds concerning the procedure by which a decision was reached. If it is thought that the British Government ought not to have signed the Treaty of Rome because no referendum was taken on whether the electorate wanted Britain to join, exception is taken to the procedure by which this decision was made. The objection could be made by one who thought that British entry was the best policy. liberalism lays down principles concerning the permissible content of what is required by the state. (shrink)

This volume explores the reasons for Hans Kelsen’s lack of influence in the United States and proposes ways in which Kelsen’s approach to law, philosophy, and political, democratic, and international relations theory could be relevant to current debates within the U.S. academy in those areas. Along the way, the volume examines Kelsen’s relationship and often hidden influences on other members of the mid-century Central European émigré community whose work helped shape twentieth-century social science in the United States. The book includes (...) major contributions to the history of ideas and to the sociology of the professions in the U.S. academy in the twentieth century. Each section of the volume explores a different aspect of the puzzle of the neglect of Kelsen’s work in various disciplinary and national settings. Part I provides reconstructions of Kelsen’s legal theory and defends that theory against negative assessments in Anglo-American jurisprudence. Part II focuses both on Kelsen’s theoretical views on international law and his practical involvement in the post-war development of international criminal law. Part III addresses Kelsen’s theories of democracy and justice while placing him in dialogue with other major twentieth-century thinkers, including two fellow émigré scholars, Leo Strauss and Albert Ehrenzweig. Part IV explores Kelsen’s intellectual legacies through European and American perspectives on the interaction of Kelsen’s theoretical approach to law and national legal traditions in the United States and Germany. Each contribution features a particular applications of Kelsen’s approach to doctrinal and interpretive issues currently of interest in the legal academy. The volume concludes with two chapters on the nature of Kelsen’s legal theory as an instance of modernism. (shrink)

In this essay an ‘objective’ account of intrinsic value is proposed and partly defended. It is claimed that a kind of value exists which is, or may reasonably be supposed to be, a property of certain objects. The presence of such value is not to be wholly accounted for as the ‘projection’ of certain human feelings elicited by the object thought to be of value, nor by the object's meeting certain operative human conventions prescribing what is to be admired, nor (...) by its being conformable, in some way, to human needs or desires. Hume, of course, would have none of this. It is hoped to show that if one adopts Hume's account, then his attempt to show that there nevertheless will be convergence in the long run as to what is of aesthetic value is forced and unsuccessful. By contrast, on the ‘objective’ account convergence is to be expected. This, of course, only shows the superiority of the ‘objective’ account so long as there is an expectation of long-term convergence. This is not an expectation of most contemporary value ‘subjectivists’, and therefore the argument will not be directly relevant to their positions. (shrink)

Mill says that the object of his essay On Liberty is to defend a certain principle, which I will call the ‘liberty principle’, and will take to say the following: ‘It is permissible, in principle, for the state or society to control the actions of individuals “only in respect to those actions of each, which concern the interest of other people”’. The liberty principle is a prescription of intermediate generality. Mill intends it to support more specific political prescriptions, such as (...) liberty of conscience, of expressing and publishing opinions, of framing a plan of life to suit our own character, and of combination for any purpose not involving harm to others . The liberty principle is more general than these prescriptions but less general than its possible moral foundations, such as utilitarianism. My concern will be with attempts to defend the liberty principle by showing it to be supported by an acceptable moral position. (shrink)

Mill says that the object of his essay On Liberty is to defend a certain principle, which I will call the ‘liberty principle’, and will take to say the following: ‘It is permissible, in principle, for the state or society to control the actions of individuals “only in respect to those actions of each, which concern the interest of other people”’. The liberty principle is a prescription of intermediate generality. Mill intends it to support more specific political prescriptions, such as (...) liberty of conscience, of expressing and publishing opinions, of framing a plan of life to suit our own character, and of combination for any purpose not involving harm to others. The liberty principle is more general than these prescriptions but less general than its possible moral foundations, such as utilitarianism. My concern will be with attempts to defend the liberty principle by showing it to be supported by an acceptable moral position. (shrink)

If the world were wholly just, the following inductive definition would exhaustively cover the subject of justice in holdings.1. A person who acquires a holding in accordance with the principle of justice in acquisition is entitled to that holding.2. A person who acquires a holding in accordance with the principle of justice in transfer, from someone else entitled to the holding, is entitled to the holding.3. No one is entitled to a holding except by applications of i and 2.The complete (...) principle of distributive justice would say simply that a distribution is just if everyone is entitled to the holdings they possess under the distribution. (shrink)