We read with interest the extended essay published from Riisfeldt and are encouraged by an empirical ethics article which attempts to ground theory and its claims in the real world. However, such attempts also have real-world consequences. We are concerned to read the paper’s conclusion that clinical evidence weakens the distinction between euthanasia and normal palliative care prescribing. This is important. Globally, the most significant barrier to adequate symptom control in people with life-limiting illness is poor access to opioid analgesia. (...) Opiophobia makes clinicians reluctant to prescribe and their patients reluctant to take opioids that might provide significant improvements in quality of life. We argue that the evidence base for the safety of opioid prescribing is broader than that presented, restricting the search to palliative care literature produces significant bias as safety experience and literature for opioids and sedatives exists in many fields. This is not acknowledged in the synthesis presented. By considering additional evidence, we reject the need for agnosticism and reaffirm that palliative opioid prescribing is safe. Second, palliative sedation in a clinical context is a poorly defined concept covering multiple interventions and treatment intentions. We detail these and show that continuous deep palliative sedation is a specific practice that remains controversial globally and is not considered routine practice. Rejecting agnosticism towards opioids and excluding CDPS from the definition of routine care allows the rejection of Riisfeldt’s headline conclusion. On these grounds, we reaffirm the important distinction between palliative care prescribing and euthanasia in practice. (shrink)

Over the last twenty years, archaeologists have used various process-oriented modes of enquiry to undermine the belief that humans are special. Barad (2007) developed Bohr’s indeterminist interpretation of quantum mechanics into agential realism which offers an ontological basis for distributing agency away from humans and plays a crucial role in underwriting some posthumanist archaeological agendas. But its origins in quantum physics make agential realism difficult to understand and evaluate. Despite the challenge, the first two parts of this paper are devoted (...) to each task in turn, with limited success. Part three turns to the archaeological literature, where the evaluation of agential realism turns out to be even more inadequate and so I advise against its use in support of process-oriented approaches in archaeology. The final section turns to the activity of an art workshop and introduces a playful approach to working with clay. Clayful phenomenology is a way of investigating the relationship between gesture, material and ideation. During sculpting, phenomenological experience is not subjective, stable and external but is generated within a transient creative system where entities, ideas and agency reciprocally, emerge as ephemeral manifestations. Clayful phenomenology and agential realism are ontologically similar and both are controversial but agential realism has a wall of quantum conceptual complexity standing between it and a judgement about credibility whereas playing with clay can be assessed directly, through experience. (shrink)

By registering different health benefits on a common scale, CEA allows us to assess the relative social importance of different health care interventions and opens the way for the allocation decisions of health care policy. If it is really to be effective, however, CEA must be recalibrated so that it better reflects some of our widely held beliefs about the merits of different kinds of treatment.

I describe how close attention to the process of sculpting clay from the perspective of Material Engagement Theory can create a detailed description of a mutable sense of agency and of self. First, I show that sculpting is associated with a loss of sense of agency and self. Second, that to sense agency as a systemic phenomenon creates anxiety. Third, that meaning in an art encounter develops in association with an anterospective viewpoint. Fourth, that within the logic of the extended (...) mind, emergent meaning becomes openly available for further exploration. Fifth, that artistic creativity is not an opaque process. It proceeds in a similar manner to other forms of human, sense-making activities. Finally, that playing seriously with clay can be used in an investigative manner—as a tool for material conceptualisation. (shrink)

By registering different health benefits on a common scale, CEA allows us to assess the relative social importance of different health care interventions and opens the way for the allocation decisions of health care policy. If it is really to be effective, however, CEA must be recalibrated so that it better reflects some of our widely held beliefs about the merits of different kinds of treatment.

Compassion is mentioned in the Principles of the American Medical Association but not in the Code of Ethics of the Canadian Medical Association. In this article, we assess the case for including compassion in a code of ethics for physicians. We argue that, properly understood, there is a strong case for including compassion in codes of ethics for physicians on the basis that it is both clinically and ethically central to the practice of medicine.

In this contemporary classic originally published in 1963, Paul Lehmann answers the central question posed time and again to Christians throughout the ages: what am I as a believer in Jesus Christ and a member of his church to do? Lehmann argues that while principles for moral action can be rules of thumb, there are no absolute moral norms beyond the general norm of love. Lehmann contends that Christians are to act in every situation in ways that are consistent (...) with God's humanizing purposes, but what that means changes from context to context and requires strong, faith-shaped discernment.The Library of Theological Ethics series focuses on what it means to think theologically and ethically. It presents a selection of important and otherwise unavailable texts in easily accessible form. Volumes in this series will enable sustained dialogue with predecessors though reflection on classic works in the field. (shrink)

_Readings in Ethics_ offers a vast collection of carefully edited readings arranged chronologically across five historical periods. The selections cover many major Western and non-Western schools of thought, including Daoism, virtue ethics, Buddhism, natural law, deontology, utilitarianism, contractarianism, liberalism, Marxism, feminism, and communitarianism. In addition to texts from canonical philosophers such as Plato, Mill, Wollstonecraft, and Rawls, the volume draws from other sources of wisdom: stories, fables, proverbs, medieval mystical treatises, literature, and poetry. The editors have also written substantial introductions, (...) annotations, discussion questions, and suggestions for further reading, making for a thorough guided tour of our ethical past and present. (shrink)

In a world dominated by things, we must work hard to account for one another's personhood. Drawing a diverse set of thought leaders, Paul Louis Metzger helps us navigate a pluralistic world through a personalist moral framework, addressing issues such as abortion, genetic engineering, immigration, drone warfare, and more.