Background Empirical studies of surrogate decision-making tend to assume that surrogates should make only a 'substituted judgement'—that is, judge what the patient would want if they were mentally competent. Objectives To explore what people want in a surrogate decision-maker whom they themselves select and to test the assumption that people want their chosen surrogate to make only a substituted judgement. Methods 30 undergraduate students were recruited. They were presented with a hypothetical scenario about their expected loss of mental capacity in (...) the future and asked to answer some questions about their choice of surrogate. These data were analysed qualitatively using thematic content analysis. Results Most respondents talked about choosing someone who was caring and competent in certain ways, giving interesting evidence for their judgements. Surprisingly few highlighted how well they thought their chosen surrogate knew their preferences and would be able to make a substituted judgement. Moreover, few specified that their chosen surrogate had similar attitudes and values to their own and so would make a similar decision to theirs in the circumstances presented. Some respondents also referred to the social role of their chosen surrogate or the social dynamics of their situation which influenced their choices, as well as to ideas of reciprocity and characteristics of honesty and loyalty. Conclusion In the event that they lose mental capacity, many people will not select a surrogate to decide about medical treatments on their behalf solely on the basis that they expect their surrogate to make a substituted judgement. (shrink)

In this paper we attempt to sharpen and to provide an answer to the question of when human beings first become conscious. Since it is relatively uncontentious that a capacity for raw sensation precedes and underpins all more sophisticated mental capacities, our question is tantamount to asking when human beings first have experiences with sensational content. Two interconnected features of our argument are crucial. First, we argue that experiences with sensational content are supervenient on facts about electrical activity in the (...) cerebral cortex which can be ascertained through EEG readings. Second, we isolate from other notions of a‘functioning brain’that which is required to underpin the view that a cortex is functioning in a way which could give rise to rudimentary conscious experiences. We investigate the development in the human fetus of the anatomical and chemical pathways which underpin cortical activity and the growth and maturation of the electrical circuitry specifically associated with sensational content in adult experience. We conclude that a fetus becomes conscious at about 30 to 35 weeks after conception; an answer based on a careful analysis of EEG readings at various stages of cortical development. Finally, we survey the possible ethical ramifications of our answer. (shrink)

We prove that compactness is equivalent to the amalgamation property, provided the occurrence number of the logic is smaller than the first uncountable measurable cardinal. We also relate compactness to the existence of certain regular ultrafilters related to the logic and develop a general theory of compactness and its consequences. We also prove some combinatorial results of independent interest.

The essays collected together in this volume, many of them written by leading scholars in the field, explore the commonsensical fact that our presence as..

ABSTRACT In this paper we attempt to sharpen and to provide an answer to the question of when human beings first become conscious. Since it is relatively uncontentious that a capacity for raw sensation precedes and underpins all more sophisticated mental capacities, our question is tantamount to asking when human beings first have experiences with sensational content. Two interconnected features of our argument are crucial. First, we argue that experiences with sensational content are supervenient on facts about electrical activity in (...) the cerebral cortex which can be ascertained through EEG readings. Second, we isolate from other notions of a‘functioning brain’that which is required to underpin the view that a cortex is functioning in a way which could give rise to rudimentary conscious experiences. We investigate the development in the human fetus of the anatomical and chemical pathways which underpin (immature) cortical activity and the growth and maturation of the electrical circuitry specifically associated with sensational content in adult experience. We conclude (tentatively) that a fetus becomes conscious at about 30 to 35 weeks after conception; an answer based on a careful analysis of EEG readings at various stages of cortical development. Finally, we survey the possible ethical ramifications of our answer. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Who or What is the Preembryo?S.J. Richard A. McCormick (bio)IntroductionAlthough widely used by scientists, the term "preembryo" has raised some suspicions. Histopathologist Michael Jarmulowicz (1990), for example, asserts that the term was adopted by the American Fertility Society (AFS) and the Voluntary Licensing Authority (VLA) in Britain "as an exercise of linguistic engineering to make human embryo research more palatable to the general public."I cannot speak for the VLA, (...) but I can clarify that this was not the motive of the AFS. As a member of the AFS ethics committee that discussed and adopted this terminology, I know that our discussion was not tied to embryo research or moral issues. The term "preembryo" was adopted because the earliest stages of mammalian development primarily involve establishment of the nonembryonic trophoblast, rather than the formation of the embryo. As Clifford Grobstein (1988, p. 61), a distinguished basic scientist who also sat on the AFS committee notes:The scientific rationale for the term preembryo... is its greater accuracy in characterizing the initial phase of mammalian and human development.... The status implications of such a change in terminology were not at issue in the discussion.This is not to say that the moral status of the preembryo is not a concern worthy of independent consideration. It is an important question with significant practical implications, especially in the context of in vitro fertilization. At stake are issues such as: (1) what may be done to preembryos before transfer; (2) whether all preembryos must be transferred; and (3) what may be done to preembryos that are not transferred (Ethics Committee of the American Fertility Society (AFS) 1986, p. 29S). Furthermore, emergency treatment of rape cases may also depend on such a determination. [End Page 1]Cryopreservation, which entails freezing unused preembryos for possible later use, is one example of a procedure that raises issues associated with the moral status of the preembryo. Cryopreservation decreases the number of stimulated egg recovery cycles a woman must undergo and increases flexibility in transfer protocols. But thawing of the preembryos is not a completely benign process; significant numbers of the preembryos die in the process and injury cannot be excluded.In addition, down the road a year or so lies preimplantation genetic diagnosis, now being tested in several centers of reproductive research. This would involve the removal of one or more cells from a preembryo developing in vitro. The DNA from these cells would be studied and then only genetically normal preembryos would be transferred. With the growth in knowledge about single gene defects and the rapid advance of amplification technology, which allows gene visualization, it is not difficult to imagine scientists embarking on a variety of micromanipulations of the preembryo for the sake of gaining knowledge.Not all research with gametes involves preembryos, but clearly some experiments and procedures await resolution of the moral status of the preembryo. I contend in this paper that the moral status—and specifically the controversial issue of personhood—is related to attainment of developmental individuality (being the source of one individual). This contrasts with the view that holds that personhood occurs earlier, at the point of genetic uniqueness. I believe that an embryo that has developed to the point where it can be one individual and one individual only, differs in moral status from a preembryo that has not, even if in many cases we may choose to treat them similarly.The Scientific UnderpinningsTwo things must be kept in mind—and in a sense, in tension—in turning to science for help in assessing the status of the preembryo. First, science is not competent to decide the question of personhood or ensoulment. As the Catholic document, Declaration on Procured Abortion, which I will return to later, notes: "It is a philosophical problem" (Congregation for the Doctrine of the Faith (CDF) 1974, p. 10, endnote 19). On the other hand, another Catholic document, Donum vitae(CDF 1987), notes that the conclusions of science provide a "valuable indication" for reason's deliberations about personhood. We might say that if science cannot decide the question of personhood, neither can it be decided without science.For my review of embryological science... (shrink)

Most documented extinctions of vertebrates in the last 400 years have been island endemics. In this paper, we focus on the need to develop a historical framework to establish conservation priorities for insular faunas and, in particular, to test the validity of nominal endemics. We use the example of the islands of the North Pacific Coast of North America, a region that includes approximately one-half of all mammals endemic to North American islands north of Mexico. Few of these endemics have (...) been re-evaluated since their original descriptions, although many of these islands have been heavily impacted by habitat conversion, species introductions, over-exploitation, and secondary ripple effects. Evidence from molecular genetics and paleontology suggests that many taxa arrived in the region since the last glacial advance. Some of these nominal endemics show minimal differentiation, while others comprise multiple evolutionary lineages. The NPC may also have played an important role in the in situ diversification of some taxa during the Pleistocene. Evidence, such as new fossil discoveries and numerous described endemics, lends support for refugia hypotheses. However, these ideas cannot be tested until a better understanding of geographic variation and the evolutionary relationships of the fauna and flora of the North Pacific Coast is developed. This framework would provide significant insight into the dynamic biogeographic history of the region and help prioritize conservation efforts. (shrink)

The purpose of this article is to highlight ways in which institutional policymakers tend to insufficiently conceptualise their role as ethics practitioners. We use the case of blood product recall notification as a means of raising questions about the way in which, as we have observed it, discourse for those who make institutional ethics policies is constrained by routine balancing of simplified principles to the exclusion of reflexive practices—those that turn ethics reasoning back on itself. The latter allows ethics practitioners (...) with comparatively little formal training to take ownership of traditional parameters, which define their discussions and ultimately ought to make them more insightful when doing ethics. Thus, in the midst of calls for more training to increase the competency of ethics committees, we suggest that an additional problem of how these lay ethicists conceive of their roles also needs to be addressed. (shrink)