Conceived as a solution to clinical dilemmas, and now required by organizations for hospital accreditation, ethics committees have been subject only to small-scale studies. The wide use of ethics committees and the diverse roles they play compel study. In 1999 the University of Pennsylvania Ethics Committee Research Group (ECRG) completed the first national survey of the presence, composition, and activities of U.S. healthcare ethics committees (HECs). Ethics committees are relatively young, on average seven years in operation. Eighty-six percent of ethics (...) committees report that they play a role in ongoing clinical decision making through clinical ethics consultation. All are engaged in developing institutional clinical policy. Although 4.5% of HECs write policy on managed care, 50% of HEC chairs feel inadequately prepared to address managed care. The power and activity of ethics committees parallels the composition of those committees and the relationship of members to their institutions. The role of ethics committees across the nation in making policies about clinical care is greater than was known, and ethics committees will likely continue to play an important role in the debate and resolution of clinical cases and clinical policies. (shrink)

In 1992, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) passed a mandate that all its approved hospitals put in place a means for addressing ethical concerns.Although the particular process the hospital uses to address such concernsmay vary, the hospital or healthcare ethics committee (HEC) is used most often. In a companion study to that reported here, we found that in 1998 over 90% of U.S. hospitals had ethics committees, compared to just 1% in 1983, and that many (...) have some and a few have sweeping clinical powers in hospitals. (shrink)

Background: Some members of the general public feel that patients who cause their own organ failure through smoking, alcohol use, or drug use should not receive equal priority for scarce transplantable organs. This may reflect a belief that these patients (1) cause their own illness, (2) have poor transplant prognoses or, (3) are simply unworthy. We explore the role that social acceptability, personal responsibility, and prognosis play in people's judgments about transplant allocation. Methods: By random allocation, we presented 283 prospective (...) jurors in Philadelphia county with one of five questionnaire versions. In all questionnaires, subjects were asked to distribute transplantable hearts between patients with and without a history of three controversial behaviors (eating high fat diets against doctors’ advice, cigarette smoking, or intravenous drug use). Across the five questionnaire versions, we varied the relative prognosis of the transplant candidates and whether their behavior caused their primary organ Results: Subjects were significantly less willing to distribute organs to intravenous drug users than to cigarette smokers or people eating high fat diets (p le; 0.0005), even when intravenous drug users had better transplant outcomes than other patients. Subjects’ allocation decisions were influenced by transplant prognosis, but not by whether the behavior in question was causally responsible for the patients’ organ failure. Conclusion: People's unwillingness to give scarce transplantable organs to patients with controversial behaviors cannot be explained totally on the basis of those behaviors either causing their primary organ failure or making them have worse transplant prognoses. Instead, many people believe that such patients are simply less worthy of scarce transplantable organs. (shrink)

It is gratifying that thoughtful philosophers and bioethicists like Mahowald and Nelson are continuing to address the objections to prenatal testing that have been made by disability scholars and advocates. But it is frustrating to see those objections presented in ways that reflect the doubts of those who reject them more than the intentions of those who make them, in ways that make those objections appear censorious toward pregnant women and prospective parents or naïve about nonverbal expression. We recognize that (...) disability critics share the responsibility for these misunderstandings, that their objections to prenatal disability testing have not always been made as clearly or consistently as they might have been. We therefore welcome this opportunity for clarification and rebuttal. Briefly, we will argue against Mahowald that it is not apparent how prospective parents could have a duty to potential offspring requiring them to prevent the birth of any child expected to have a life worth living. And we will remind Nelson that our primary concern is with the perpetuation of stigma; that even if any reason for abortion can be framed in terms of a trait of the fetus to be aborted, only certain reasons for abortion are based on the rejection of future children because of stigmatized traits. (shrink)

We are gratified by Nelson's response to our commentary. It shows, for the first time, an appreciation of the distinctive character of our criticism of individual decisions to test and terminate for fetal impairment. Although we still find much to disagree with in Nelson's characterization and critique of our views, he has given us a welcome opportunity to clarify and develop them.

The American Journal of Bioethics, Volume 12, Issue 4, Page 22-24, April 2012.

It is gratifying that thoughtful philosophers and bioethicists like Mahowald and Nelson are continuing to address the objections to prenatal testing that have been made by disability scholars and advocates. But it is frustrating to see those objections presented in ways that reflect the doubts of those who reject them more than the intentions of those who make them, in ways that make those objections appear censorious toward pregnant women and prospective parents or naïve about nonverbal expression. We recognize that (...) disability critics share the responsibility for these misunderstandings, that their objections to prenatal disability testing have not always been made as clearly or consistently as they might have been. We therefore welcome this opportunity for clarification and rebuttal. Briefly, we will argue against Mahowald that it is not apparent how prospective parents could have a duty to potential offspring requiring them to prevent the birth of any child expected to have a life worth living. And we will remind Nelson that our primary concern is with the perpetuation of stigma; that even if any reason for abortion can be framed in terms of a trait of the fetus to be aborted, only certain reasons for abortion are based on the rejection of future children because of stigmatized traits. (shrink)

In this paper, we critically appraise institutions for people with disabilities, from residential facilities to outpatient clinics to social organizations. While recognizing that a just and inclusive society would reject virtually all segregated institutional arrangements, we argue that in contemporary American society, some people with disabilities may have needs that at this time can best be met by institutional arrangements. We propose ways of reforming institutions to make them less isolating, coercive, and stigmatizing, and to provide forms of social support (...) the larger society denies many people with disabilities. Although these reforms far fall far short of abolition, they draw heavily on the work of disability scholars and advocates who call for the complete replacement of institutional arrangements with systems of supported living. The consideration of non-ideal-solutions is useful not only in reforming existing institutional arrangements, but in bringing disability scholarship and advocacy to bear on bioethics, which has paid little attention to institutions for people with disabilities. We intend this paper to redress the neglect within mainstream bioethics of the complex ethical problems posed by institutions. (shrink)

Adrienne Asch inspired, challenged, and provoked a generation of bioethicists and philosophers who were discovering the subject of disability. For Adrienne, disability was a complex phenomenon that raised universal issues of embodiment, justice, well‐being, and identity. She insisted that bioethicists and philosophers who invoked disability in discussions about these issues first learn something about it, for which her own work provided critical insights. She argued eloquently that those who relied on unsupported assumptions about disability, even in the most arcane (...) debates, reinforced harmful stereotypes and impoverished their own thinking. At the same time, she urged that the claims of disability scholars concerning discrimination, fairness, and kindred issues be made with philosophical clarity. She was fearless with the smug and insular in both fields, but generous with those, like me, who were merely naive. (shrink)

Developing original accounts of the many aspects of belief, On Believing puts the believer at the heart of the story. Developing a novel account of the normativity of belief, Hunter argues that the ethics of belief concern how a believer ought to be positioned in a world of possibilities.

This chapter contains section titled: Introduction Basic Human Rights: Rawls's List Basic Human Rights: Their Nature and Function Basic Human Rights: A Rawlsian Justification Conclusion Acknowledgments Notes.

Today's social and political climate often pits conservative or traditional Christianity against "progressive" Christianity. But what is progressive Christianity? What is a progressive Christian? What is a progressive church? Christianity in Blue answers these questions by drawing from biblical scholarship, Christian history, theology, popular culture, philosophy, and cultural anthropology. Kaden shows how socially liberal values and progressive attitudes can be the fruits of taking seriously both the Bible and Christian tradition. But rather than treating these sources as static authorities and (...) the final word on every subject, Kaden argues that they are places to start one's exploration of how to be a Christian in the world. Being a progressive Christian is an ethical exhortation to "uplift human personality," as Martin Luther King Jr. once said. This exhortation structures how progressive Christians receive, interpret, and apply the Bible and Christian tradition to daily life. A robust tradition provides an anchor to avoid the illiberal trends in contemporary society, and a commitment to uplifting human personality provides a check against dehumanizing uses of Scripture and tradition. Christianity in Blue will help both progressive and conservative Christians better understand the importance of the Bible, theology, history, and philosophy for building a loving church for everyone. (shrink)

How do we know when we are investing wisely in security? Answering this question requires investigating what things are worth securing (and why); what threatens them; how best to protect them; and how to think about it. Is it possible to protect them? How best go about protecting them? What trade-offs are involved in allocating resources to security problems? This book responds to these questions by stripping down our preconceptions and rebuilding an understanding of security from the ground up on (...) the basis of a common-sense ontology and an explicit theory of value. It argues for a clear distinction between objective and subjective security threats, a non-anthropocentric understanding of security, and a particular hierarchy of security referents, looking closely at four in particular-the ecosphere, the state, culture, and individual human beings. The analysis will be of interest not only to students and scholars of International Relations, but also to practitioners. David A. Welch is University Research Chair and Professor of Political Science at the Balsillie School of International Affairs, University of Waterloo. His previous books include Justice and the Genesis of War (Cambridge University Press, 1993), which won the 1994 Edgar S. Furniss Award for an Outstanding Contribution to National Security Studies, and Painful Choices: A Theory of Foreign Policy Change (2005), which was the inaugural winner of the International Studies Association International Security Studies Section Best Book Award. He is currently co-editor of the Cambridge University Press journal, International Theory. (shrink)

This response outlines more reasons why we need the integrative framework of grandparental investments and intergenerational transfers that we advocated in the target article. We discusses obstacles that stand in the way of such a framework and of a better understanding of the effects of grandparenting in the developed world. We highlight new research directions that have emerged from the commentaries, and we end by discussing some of the things in our target article about which we may have been wrong.

This carefully-researched book offers a dynamic and expansive Deweyan vision for the arts and education. This (re)vision acknowledges the influence on Dewey's aesthetics of art collector and educator Albert Barnes, while also exploring the various ways Dewey's writings on the arts, in moving beyond Barnes' "scientific aesthetic method," were an important resource for many innovative twentieth-century American artists, art movements, and arts-related educational institutions. Neither Barnes' influence on Dewey nor the features of Dewey's naturalistic aesthetics that made his Art as (...) Experience a favorite text of many artists and arts practitioners have been fully and adequately acknowledged in existing literature on Dewey's thinking about the arts and education. This book effectively remedies that situation. (shrink)

RÉSUMÉ: Cet article propose une analyse «habermasienne» du fait de dire des conneries qui diffère de l’approche bien connue de Harry Frankfurt. Il y est question de démontrer que la théorie de l’agir communicationnel d’Habermas fournit de meilleurs outils conceptuels pour une telle analyse. Il sera également démontré que les partisans d’Habermas devraient être préoccupés par ce phénomène. Déconner perturbe la transition au discours; elle interrompt la force liante de l’agir communicationnel (qui est à la base de l’explication d’Habermas sur (...) l’intégration sociale) et, suffisamment répandu pour en altérer les attitudes fondamentales à l’égard du discours public, le déconnage met en question le statut de la théorie de l’agir communicationnel d’Habermas comme une reconstruction de la connaissance intuitive des locuteurs compétents. (shrink)

_Reinvigorates Jürgen Habermas’ early critical theory._.

Reinvigorates J rgen Habermas' early critical theory.

Engaging, interdisciplinary work exploring the influence of the Jansenist tradition on Alexis de Tocqueville's life and works. The most comprehensive treatment of the subject to date.

This essay that takes up Rawls's journey from philosophical theology through moral philosophy to democratic theory and political philosophy and pauses at, to reflect on, a few significant points early in the journey. It aims to provide a sense of some of Rawls's important early concerns and commitments that structure or at least cast significant shadows over his later work in political philosophy, A Theory of Justice and subsequent works. According to Rawl, moral philosophers construct theoretical models to explain and (...) predict familiar, everyday, noncontroversially competent moral judgments. Rawls refers to this work as “explication” and “ethics as science.” Rawls distinguishes between two tasks essential to moral philosophy. Ethical theory or moral theory starts with but takes us beyond ethics as science by helping us to refine and deepen our understanding of plausible candidate explications. (shrink)

From _atavistic_ to _folie a deux_, from _engram_ to _Weltschmerz_ and _Seashore test_, this edition of _The Concise Dictionary of Psychology_ contains more than 1,300 references to words, phrases and eminent pioneers in psychology. Updated to take account of recent developments, each definition is clear, instructive and concise. A lean and efficient source of information, written in a straightforward and readable manner, this book will be an indispensable reference tool for students of psychology, for professionals and for people in the (...) health and caring professions. (shrink)

This insightful book sheds light on three competing ideological windows on the world: conservatism, liberalism and socialism. David Reisman explores the importance of these perspectives not only to generating public policy, but also in our capacity to explain the very nature of reality.

How do we identify the "queer auteur" and their queer imaginings? Is it possible to account for such a figure when the very terms "queer" and "auteur" invoke aesthetic surprises and disorientations, disconcerting ironies and paradoxes, and biographical deceits and ambiguities? David A. Gerstner traces a history of ideas that spotlight an ever-shifting terrain associated with auteur theory and, in particular, queer-auteur theory. Engaging with the likes of Oscar Wilde, Walter Benjamin, James Baldwin, Jean Louis Baudry, Linda Nochlin, Jane (...) Gallop, Cáel Keegan, Luce Irigaray, and other prominent critical thinkers, Gerstner contemplates how the queer auteur in film theory might open us to the work of desire. Ultimately, Queer Imaginings is a journey in shared pleasures in which writing for and about cinema makes way for unanticipated cinematic friendships."--Page 4 of cover. (shrink)

'Trade in Health is a timely reflection on the interface of economics with the ethics and public policy facets of the international movement of patients. Health issues such as these are at the forefront of modern political economy."National" health is increasingly less so. Reisman's previous scholarship in this area is brought to bear in an insightful and eminently readable and engaging fashion. In an area where uncovering the facts is more difficult than "decyphering the Dead Sea Scrolls", such a reflective (...) work on the critical aspects of political economy helps to fill a void in considering whether such trade is likely to be in the interests of patients, nations and the global community. In addition to the rosy picture of healthy and wealthy tourists having a sojourn for medical care during a vacation, Reisman is not afraid to tackle the thorny issues concerning trade in organs, eggs and even death, in this sobering and comprehensive volume. It is a rare skill to bring the luminaries of Smith, Marshall, Mill and Confucius to bear on such a contemporary tale! International travel by patients is at the nexus of a revolution in global health. It is driving and affecting aspects of foreign investment, health worker migration and e-health provision. Reisman skilfully links these foundations of health care, and as such provides critical text for consideration by those seeking to build and strengthen future health systems. Trade in Health is an excellent overview. It provides critical insights for those new to the area as well as new information and challenges for those of us involved for a number of years.' - Richard Smith, Professor of Health Ssytem Economics and Dean of Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, UK. Once exports and imports meant agriculture and industry. In the global economy and the electronic age, trade is also expanding into the service sector. This timely book closely examines trade in health. It documents the growth of a cross-national service that in the past was mainly consumed at home. Following from his highly successful book Health Tourism, Professor David Reisman offers a comprehensive and searching multidisciplinary account of the way in which medical services, patients, capital and professionals are making up a global healthcare economy that crosses borders. He reflects on their pursuit of lower prices, better quality and a differentiated product, and suggests that public policy is essential if the ethical capital of interdependent societies is not to be eroded by the international market in health and care. Written in a concise and lucid form, this original book will be of great interest to all people interested in the internationalization of health care. Combining theory and empirical evidence from economics, tourism and medical care, scholars involved in health policy and social administration will find much of significance in this authoritative study. (shrink)

Arguing about origins' great theater and a grand distraction -- Ideas and idea making -- Beauty and the arts -- Suffering and sensation -- The justice paradox -- Life and afterlife.

In the twenty-first century, the debate about life on other worlds is quickly changing from the realm of speculation to the domain of hard science. Within a few years, as a consequence of the rapid discovery by astronomers of planets around other stars, astronomers very likely will have discovered clear evidence of life beyond the Earth. Such a discovery of extraterrestrial life will change everything. Knowing the answer as to whether humanity has company in the universe will trigger one of (...) the greatest intellectual revolutions in history, not the least of which will be a challenge for at least some terrestrial religions. Which religions will handle the discovery of extraterrestrial life with ease and which will struggle to assimilate this new knowledge about our place in the universe? Some religions as currently practiced appear to only be viable on Earth. Other religions could be practiced on distant worlds but nevertheless identify both Earth as a place and humankind as a species of singular spiritual religious importance, while some religions could be practiced equally well anywhere in the universe by any sentient beings. Weintraub guides readers on an invigorating tour of the world's most widely practiced religions. It reveals what, if anything, each religion has to say about the possibility that extraterrestrial life exists and how, or if, a particular religion would work on other planets in distant parts of the universe. (shrink)

A detailed treatment regarding the diverse properties and uses of evidence and the judgmental tasks they entail. Examines various processes by which evidence may be developed or discovered. Considers the construction of arguments made in defense of the relevance and credibility of individual items and masses of evidence as well as the task of assessing the inferential force of evidence. Includes over 100 numerical examples to illustrate the workings of diverse probabilistic expressions for the inferential force of evidence and the (...) subtleties they reveal. (shrink)

Chaïm Perelman, alone, and in collaboration with Lucie Olbrechts-Tyteca, developed the New Rhetoric Project, which is in use throughout the world. This book offers the first deep contextualization of the project’s origins and original translations of their work from French into English.

On the evolution of mind Harry J. Jerison Most of us think of mind as a little person in the head, the 'knower' of reality (cf. Attneave,). ...

How do people attribute responsibility in situations where the contributions of multiple agents combine to produce a joint outcome? The prevalence of over-determination in such cases makes this a difficult problem for counterfactual theories of causal responsibility. In this article, we explore a general framework for assigning responsibility in multiple agent contexts. We draw on the structural model account of actual causation (e.g., Halpern & Pearl, 2005) and its extension to responsibility judgments (Chockler & Halpern, 2004). We review the main (...) theoretical and empirical issues that arise from this literature and propose a novel model of intuitive judgments of responsibility. This model is a function of both pivotality (whether an agent made a difference to the outcome) and criticality (how important the agent is perceived to be for the outcome, before any actions are taken). The model explains empirical results from previous studies and is supported by a new experiment that manipulates both pivotality and criticality. We also discuss possible extensions of this model to deal with a broader range of causal situations. Overall, our approach emphasizes the close interrelations between causality, counterfactuals, and responsibility attributions. (shrink)