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  1. Ethics of care challenge to advance directives for dementia patients.William Jinwoong Choi - forthcoming - Journal of Medical Ethics.
    Advance directives for withholding life-saving treatment are controversial for dementia patients whose previously expressed wishes conflict with their currently expressed desires. To illustrate this ethical dilemma, McMahan conceives a hypothetical case in which an intellectually proud creative woman signs an advance directive stipulating her refusal to receive life-saving treatment if she contracts a fatal condition with dementia. However, when she develops dementia and forgets this advance directive, she contracts pneumonia and now expresses a desire to live. In response to such (...)
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  2. Double Effect Donation or Bodily Respect? A "Third Way" Response to Camosy and Vukov.Anthony McCarthy & Helen Watt - forthcoming - Linacre Quarterly:1-17.
    Is it possible to donate unpaired vital organs, foreseeing but not intending one’s own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on “double effect donation.” Where we disagree with these authors is that we see double-effect donation not as a morally praiseworthy act akin to mar- tyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for bodily integrity goes beyond (...)
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  3. Double effect donation or bodily respect? A 'third way' response to Camosy and Vukov.Anthony McCarthy & Helen Watt - forthcoming - The Linacre Quarterly.
    Is it possible to donate unpaired vital organs, foreseeing but not intending one's own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on 'double effect donation.' Where we disagree with these authors is that we see double effect donation not as a morally praiseworthy act akin to martyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for bodily integrity goes beyond (...)
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  4. Predicting and Preferring.Nathaniel Sharadin - forthcoming - Inquiry: An Interdisciplinary Journal of Philosophy.
    The use of machine learning, or “artificial intelligence” (AI) in medicine is widespread and growing. In this paper, I focus on a specific proposed clinical application of AI: using models to predict incapacitated patients’ treatment preferences. Drawing on results from machine learning, I argue this proposal faces a special moral problem. Machine learning researchers owe us assurance on this front before experimental research can proceed. In my conclusion I connect this concern to broader issues in AI safety.
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  5. Limits of advance directives in decision-making around food and nutrition in patients with dementia.Wayne Shelton & Cynthia Geppert - forthcoming - Journal of Medical Ethics.
    Advance directives are critically important for capable individuals who wish to avoid the burdens of life-prolonging interventions in the advanced stages of dementia. However, this paper will argue that advance directives should have less application to questions about feeding patients during the clinical course of dementia than often has been presumed. The argument will be framed within the debate between Ronald Dworkin and Rebecca Dresser regarding the moral authority of precedent autonomy to determine an individual’s future end-of-life care plan. We (...)
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  6. Guiding the Future: Rethinking the Role of Advance Directives in the Care of People with Dementia.Barak Gaster & Thaddeus Mason Pope - 2024 - Hastings Center Report 54 (S1):33-39.
    When people lose capacity to make a medical decision, the standard is to assess what their preferences would have been and try to honor their wishes. Dementia raises a special case in such situations, given its long, progressive trajectory during which others must make substituted judgments. The question of how to help surrogates make better‐informed decisions has led to the development of dementia‐specific advance directives, in which people are given tools to help them communicate what their preferences are while they (...)
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  7. Towards the implementation of law n. 219/2017 on informed consent and advance directives for patients with psychiatric disorders and dementia. Physicians’ knowledge, attitudes and practices in four northern Italian health care facilities. [REVIEW]Corinna Porteri, Giulia Ienco, Mariassunta Piccinni & Patrizio Pasqualetti - 2024 - BMC Medical Ethics 25 (1):1-11.
    Background On December 2017 the Italian Parliament approved law n. 219/2017 “Provisions for informed consent and advance directives” regarding challenging legal and bioethical issues related to healthcare decisions and end-of life choices. The law promotes the person’s autonomy as a right and provides for the centrality of the individual in every scenario of health care by mean of three tools: informed consent, shared care planning and advance directives. Few years after the approval of the law, we conducted a survey among (...)
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  8. Resolving the Ethical Quagmire of the Persistent Vegetative State.Ognjen Arandjelović - 2023 - Journal of Evaluation in Clinical Practice.
    A patient is diagnosed with the persistent vegetative state (PVS) when they show no evidence of the awareness of the self or the environment for an extended period of time. The chance of recovery of any mental function or the ability to interact in a meaningful way is low. Though rare, the condition, considering its nature as a state outwith the realm of the conscious, coupled with the trauma experienced by the patient's kin as well as health care staff confronted (...)
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  9. Default Positions in Clinical Ethics.Parker Crutchfield, Tyler Gibb & Michael Redinger - 2023 - Journal of Clinical Ethics 34 (3):258-269.
    Default positions, predetermined starting points that aid in complex decision-making, are common in clinical medicine. In this article, we identify and critically examine common default positions in clinical ethics practice. Whether default positions ought to be held is an important normative question, but here we are primarily interested in the descriptive, rather than normative, properties of default positions. We argue that default positions in clinical ethics function to protect and promote important values in medicine—respect for persons, utility, and justice. Further, (...)
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  10. Advance directives and cancer: oncology practices in Brazil.Eni Devay de Freitas & Rui Nunes - 2023 - Revista Bioética 31.
    Data on advance directives in Brazil are lacking. This study aims to assess the understanding of oncologists regarding advance directives and the frequency with which they discuss advance directives and advance care planning with their patients in Brazil. This is an observational, descriptive and cross-sectional study, conducted with cclinical oncologists associated with the Brazilian Society of Clinical Oncology. Participants were invited to answer a questionnaire prepared by the authors. In total, 72 physicians answered the questionnaire, of which 73% were under (...)
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  11. Popper’s Critical Rationalism as a Response to the Problem of Induction: Predictive Reasoning in the Early Stages of the Covid-19 Epidemic.Tuomo Peltonen - 2023 - Philosophy of Management 22 (1):7-23.
    The extent of harm and suffering caused by the coronavirus pandemic has prompted a debate about whether the epidemic could have been contained, had the gravity of the crisis been predicted earlier. In this paper, the philosophical debate on predictive reasoning is framed by Hume’s problem of induction. Hume argued that it is rationally unjustified to move from the finite observations of past incidences to the predictions of future events. Philosophy has offered two major responses to the problem of induction: (...)
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  12. Agassi’s “Sensationalism” and Popper on the Empirical Basis.Jeremy Shearmur - 2023 - Philosophy of the Social Sciences 53 (1):39-48.
    This paper discusses Agassi’s critique of Popper’s theory of the “empirical basis”. It argues that Popper’s theory should be interpreted with emphasis on its realism and anti-subjectivism, and as stressing a tentative inter-subjective consensus as to what is observed when tests are made. It agrees with Agassi’s critique of “sensationalism”, disagrees that there are residues of “sensationalism” in Popper’s approach, and argues that Popper’s view should be supplemented by a tentative realist metaphysics.
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  13. Agassi’s “Sensationalism” and Popper on the Empirical Basis.Jeremy Shearmur - 2023 - Philosophy of the Social Sciences 53 (1):39-48.
    This paper discusses Agassi’s critique of Popper’s theory of the “empirical basis”. It argues that Popper’s theory should be interpreted with emphasis on its realism and anti-subjectivism, and as stressing a tentative inter-subjective consensus as to what is observed when tests are made. It agrees with Agassi’s critique of “sensationalism”, disagrees that there are residues of “sensationalism” in Popper’s approach, and argues that Popper’s view should be supplemented by a tentative realist metaphysics.
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  14. The Moral Bindingness of Advance Directives.Gianluca Montanari Vergallo - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (3):447-449.
    Professor Latham has written a thought-provoking commentary1 on my paper about advance directives.2 I am grateful for this opportunity to integrate the debate on the moral binding nature of these manifestations of will.
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  15. Karl Popper and the Problem of Essentialism in Philosophy.Alexey V. Antonov - 2022 - RUDN Journal of Philosophy 26 (3):672-686.
    In modern philosophy, essentialism is in most cases regarded as an outdated and, in fact, incorrect philosophical trend. And one of the scientists who created such a reputation of essentialism was the famous English philosopher of Austrian origin Karl Popper. The success of his book “The Open Society and its Enemies” led to the fact that in the West essentialism began to be considered not only cognitively untenable, but also suspicious as the theoretical basis of fascism, communism and totalitarianism. In (...)
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  16. Project DECIDE, part 1: increasing the amount of valid advance directives in people with Alzheimer’s disease by offering advance care planning—a prospective double-arm intervention study.Stefanie Baisch, Christina Abele, Anna Theile-Schürholz, Irene Schmidtmann, Frank Oswald, Tarik Karakaya, Tanja Müller, Janina Florack, Daniel Garmann, Jonas Karneboge, Gregor Lindl, Nathalie Pfeiffer, Aoife Poth, Bogdan Alin Caba, Martin Grond, Ingmar Hornke, David Prvulovic, Andreas Reif, Heiko Ullrich & Julia Haberstroh - 2022 - BMC Medical Ethics 23 (1):1-12.
    BackgroundEverybody has the right to decide whether to receive specific medical treatment or not and to provide their free, prior and informed consent to do so. As dementia progresses, people with Alzheimer’s dementia (PwAD) can lose their capacity to provide informed consent to complex medical treatment. When the capacity to consent is lost, the autonomy of the affected person can only be guaranteed when an interpretable and valid advance directive exists. Advance directives are not yet common in Germany, and their (...)
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  17. Advance Directives: The Principle of Determining Authenticity.Matilda Carter - 2022 - Hastings Center Report 52 (1):32-41.
    Hastings Center Report, Volume 52, Issue 1, Page 32-41, January/February 2022.
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  18. Flaws in advance directives that request withdrawing assisted feeding in late-stage dementia may cause premature or prolonged dying.Nathaniel Hinerman, Karl E. Steinberg & Stanley A. Terman - 2022 - BMC Medical Ethics 23 (1):1-26.
    BackgroundThe terminal illness of late-stage Alzheimer’s and related dementias is progressively cruel, burdensome, and can last years if caregivers assist oral feeding and hydrating. Options to avoid prolonged dying are limited since advanced dementia patients cannot qualify for Medical Aid in Dying. Physicians and judges can insist on clear and convincing evidence that the patient wants to die—which many advance directives cannot provide. Proxies/agents’ substituted judgment may not be concordant with patients’ requests. While advance directives can be patients’ last resort (...)
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  19. Should the family have a role in deceased organ donation decision-making? A systematic review of public knowledge and attitudes towards organ procurement policies in Europe.Alberto Molina-Pérez, Janet Delgado, Mihaela Frunza, Myfanwy Morgan, Gurch Randhawa, Jeantine Reiger-Van de Wijdeven, Silke Schicktanz, Eline Schiks, Sabine Wöhlke & David Rodríguez-Arias - 2022 - Transplantation Reviews 36 (1).
    Goal: To assess public knowledge and attitudes towards the family’s role in deceased organ donation in Europe. -/- Methods: A systematic search was conducted in CINHAL, MEDLINE, PAIS Index, Scopus, PsycINFO, and Web of Science on December 15th, 2017. Eligibility criteria were socio-empirical studies conducted in Europe from 2008 to 2017 addressing either knowledge or attitudes by the public towards the consent system, including the involvement of the family in the decision-making process, for post-mortem organ retrieval. Screening and data collection (...)
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  20. Italian law n. 219/2017 on consent and advance directives: survey among Ethics Committees on their involvement and possible role. [REVIEW]Corinna Porteri, Giulia Ienco, Edda Mariaelisa Turla, Carlo Petrini & Patrizio Pasqualetti - 2022 - BMC Medical Ethics 23 (1):1-9.
    Background On December 2017 the Italian Parliament approved law n. 219/2017 “Provisions for informed consent and advance directives” regarding challenging legal and bioethical issues related to healthcare decisions and end-of-life choices. The law does not contain an explicit reference to Ethics Committees (ECs), but they could still play a role in implementing the law. Methods A questionnaire-based survey was performed among the ECs of the Italian Institute for Research and Care belonging to the Network of neuroscience and neurorehabilitation, with the (...)
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  21. Vices in autonomous paternalism: The case of advance directives and persons living with dementia 1.Sungwoo Um - 2022 - Bioethics 36 (5):511-518.
    Advance directives are intended to extend patient autonomy by enabling patients to prospectively direct the care of their future incapacitated selves. There has been much discussion about issues such as whether the future incompetent self is identical to the agent who issues the advance directives or whether advance directives can legitimately secure patient autonomy. However, there is another important question to ask: to what extent and in what conditions is it ethically appropriate for one to limit the liberty or agency (...)
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  22. Personal Identity, Possible Worlds, and Medical Ethics.Nils-Frederic Wagner - 2022 - Medicine, Health Care and Philosophy: A European Journal (3):429-437.
    Thought experiments that concoct bizarre possible world modalities are standard fare in debates on personal identity. Appealing to intuitions raised by such evocations is often taken to settle differences between conflicting theoretical views that, albeit, have practical implications for ethical controversies of personal identity in health care. Employing thought experiments that way is inadequate, I argue, since personhood is intrinsically linked to constraining facts about the actual world. I defend a moderate modal skepticism according to which intuiting across conceptually incongruent (...)
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  23. Relational Autonomy, the Right to Reject Treatment, and Advance Directives in Japan.Anri Asagumo - 2021 - Asian Bioethics Review 14 (1):57-69.
    Although the patient’s right to decide what they want for themselves, which is encompassed in the notion of ‘patient-centred medicine’ and ‘informed consent’, is widely recognised and emphasised in Japan, there remain grave problems when it comes to respecting the wishes of the no-longer-competent when death is imminent. In general, it is believed that the concepts above do not include the right to refuse treatment when treatment withdrawal inevitably results in death, even when the patient previously expressed the wish to (...)
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  24. Association between knowledge and attitudes towards advance directives in emergency services.Anna Falcó-Pegueroles, Mireia Vicente-García, Núria Pomares-Quintana, Pere Sánchez-Valero, Pilar José-Maria de la Casa & Silvia Poveda-Moral - 2021 - BMC Medical Ethics 22 (1):1-15.
    BackgroundImplementing the routine consultation of patient advance directives in hospital emergency departments and emergency medical services has become essential, given that advance directives constitute the frame of reference for care personalisation and respect for patients’ values and preferences related to healthcare. The aim of this study was to assess the levels and relationship of knowledge and attitudes of nursing and medical professionals towards advance directives in hospital emergency departments and emergency medical services, and to determine the correlated and predictor variables (...)
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  25. Reasons for endorsing or rejecting ‘self-binding directives’ in bipolar disorder: a qualitative study of survey responses from UK service users.Tania Gergel, Preety Das, Lucy Stephenson, Gareth Owen, Larry Rifkin, John Dawson, Alex Ruck Keene & Guy Hindley - 2021 - The Lancet Psychiatry 8.
    Summary Background Self-binding directives instruct clinicians to overrule treatment refusal during future severe episodes of illness. These directives are promoted as having potential to increase autonomy for individuals with severe episodic mental illness. Although lived experience is central to their creation, service users’ views on self-binding directives have not been investigated substantially. This study aimed to explore whether reasons for endorsement, ambivalence, or rejection given by service users with bipolar disorder can address concerns regarding self-binding directives, decision-making capacity, and human (...)
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  26. Advance Directives and Research Advance Directives.Dean Hart - 2021 - Voices in Bioethics 7.
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  27. Further Reflections: Surrogate Decisionmaking When Significant Mental Capacities are Retained.Jennifer Hawkins - 2021 - Cambridge Quarterly of Healthcare Ethics 30 (1):192-198.
    Mackenzie Graham has made an important contribution to the literature on decisionmaking for patients with disorders of consciousness. He argues, and I agree, that decisions for unresponsive patients who are known to retain some degree of covert awareness ought to focus on current interests, since such patients likely retain the kinds of mental capacities that in ordinary life command our current respect and attention. If he is right, then it is not appropriate to make decisions for such patients by appealing (...)
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  28. European and comparative law study regarding family’s legal role in deceased organ procurement.Marina Morla-González, Clara Moya-Guillem, Janet Delgado & Alberto Molina-Pérez - 2021 - Revista General de Derecho Público Comparado 29.
    Several European countries are approving legislative reforms moving to a presumed consent system in order to increase organ donation rates. Nevertheless, irrespective of the consent system in force, family's decisional capacity probably causes a greater impact on such rates. In this contribution we have developed a systematic methodology in order to analyse and compare European organ procurement laws, and we clarify the weight given by each European law to relatives' decisional capacity over individual's preferences (expressed or not while alive) regarding (...)
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  29. Discussion Article: Comments on Joao Pinheiro da Silva's paper: 'Popperian Hayek or Hayekian Popper?'.Mark Amadeus Notturno - 2021 - Economic Thought 10 (1):61.
  30. Popperian Hayek or Hayekian Popper?Joao Pinheiro da Silva - 2021 - Economic Thought 10 (1):46.
    Friedrich Hayek was a fervent advocate of the methodological specificity of the social sciences. However, given his contact with Karl Popper, several historians and philosophers have characterized his final position as Popperian, that is, a position that would have accepted the unity of scientific method. A closer look at Hayek's philosophy and Popper's own intellectual course shows that such a thesis is based on misconceptions that can be overcome by taking the Hayekian concept of 'spontaneous order' as the foundation of (...)
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  31. Some notes on the nature and limits of posthumous rights: a response to Persad.Sean Aas - 2020 - Journal of Medical Ethics 46 (5):345-346.
    A person’s body can, it seems, survive well after losing the capacity to support Lockean personhood. If our rights in our bodies are, basically, rights in our selves or persons, this seems to imply that we do not after all have a right to direct the disposition of our living remains via advance directive. Govind Persad argues that our rights over our bodies persist after the loss of our personhood; we have a right to insist that our bodies die after (...)
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  32. Psychiatric Advance Directives as an Ethical Communication Tool: An Analysis of Definitions.Virginia A. Brown, Jaime Thomas & Billy Table - 2020 - Journal of Clinical Ethics 31 (4):353-363.
    A psychiatric advance directive (PAD) is a communication tool that promotes patients’ autonomy and gives capacitated adults who live with serious mental illnesses the ability to record their preferences for care and designate a proxy decision maker before a healthcare crisis. Despite a high degree of interest by patients and previous studies that recommend that clinicians facilitate the completion of PADs, the rate of implementation of PADs remains low. Research indicates that many clinicians lack the necessary experience to facilitate the (...)
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  33. Advance Directives and Transformative Experience: Resilience in the Face of Change.Govind C. Persad - 2020 - American Journal of Bioethics 20 (8):69-71.
    In this commentary, I critique three aspects of Emily Walsh's proposal to reduce the moral and legal weight of advance directives: (1) the ambiguity of its initial thesis, (2) its views about the ethics and legality of clinical practice, and (3) its interpretation and application of Ronald Dworkin’s account of advance directives and L.A. Paul's view on transformative experience. I also consider what Walsh’s proposal would mean for people facing the prospect of dementia. I conclude that our reasons to honor (...)
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  34. Epistemic burdens and the incentives of surrogate decision-makers.Parker Crutchfield & Scott Scheall - 2019 - Medicine, Health Care and Philosophy 22 (4):613-621.
    We aim to establish the following claim: other factors held constant, the relative weights of the epistemic burdens of competing treatment options serve to determine the options that patient surrogates pursue. Simply put, surrogates confront an incentive, ceteris paribus, to pursue treatment options with respect to which their knowledge is most adequate to the requirements of the case. Regardless of what the patient would choose, options that require more knowledge than the surrogate possesses (or is likely to learn) will either (...)
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  35. Consent’s dominion: Dementia and prior consent to sexual relations.Samuel Director - 2019 - Bioethics 33 (9):1065-1071.
    In this paper, I answer the following question: suppose that two individuals, C and D, have been in a long-term committed relationship, and D now has dementia, while C is competent; if D agrees to have sex with C, is it permissible for C to have sex with D? Ultimately, I defend the view that, under certain conditions, D can give valid consent to sex with C, rendering sex between them permissible. Specifically, I argue there is compelling reason to endorse (...)
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  36. Some ethical considerations about the use of biomarkers for the classification of adult antisocial individuals.Marko Jurjako, Luca Malatesti & Inti A. Brazil - 2019 - International Journal of Forensic Mental Health 18 (3):228-242.
    It has been argued that a biomarker-informed classification system for antisocial individuals has the potential to overcome many obstacles in current conceptualizations of forensic and psychiatric constructs and promises better targeted treatments. However, some have expressed ethical worries about the social impact of the use of biological information for classification. Many have discussed the ethical and legal issues related to possibilities of using biomarkers for predicting antisocial behaviour. We argue that prediction should not raise the most pressing ethical worries. Instead, (...)
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  37. Authority without identity: defending advance directives via posthumous rights over one’s body.Govind Persad - 2019 - Journal of Medical Ethics 45 (4):249-256.
    This paper takes a novel approach to the active bioethical debate over whether advance medical directives have moral authority in dementia cases. Many have assumed that advance directives would lack moral authority if dementia truly produced a complete discontinuity in personal identity, such that the predementia individual is a separate individual from the postdementia individual. I argue that even if dementia were to undermine personal identity, the continuity of the body and the predementia individual’s rights over that body can support (...)
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  38. No One Who Loves Anyone.Alison Reiheld - 2019 - Journal of Medical Humanities 40 (3):451-453.
    In this bioethical poem, the narrator reflects on the experience of their father's degenerative illness, and decisions that must be made about whether to continue life support technologies such as ventilation and nutrition/hydration. What is it that is owed to family and patient at the end of life? What must no one who loves anyone ever do to the one they love?
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  39. Should Aggregate Patient Preference Data Be Used to Make Decisions on Behalf of Unrepresented Patients?Nathaniel Sharadin - 2019 - AMA Journal of Ethics 21 (7):566-574.
    Patient preference predictors aim to solve the moral problem of making treatment decisions on behalf of incapacitated patients. This commentary on a case of an unrepresented patient at the end of life considers 3 related problems of such predictors: the problem of restricting the scope of inputs to the models (the “scope” problem), the problem of weighing inputs against one another (the “weight” problem), and the problem of multiple reasonable solutions to the scope and weight problems (the “multiple reasonable models” (...)
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  40. Why letting die instead of killing? Choosing active euthanasia on moral grounds.Evangelos Protopapadakis - 2018 - Proceedings of the XXIII World Congress of Philosophy.
    Ever since the debate concerning euthanasia was ignited, the distinction between active and passive euthanasia – or, letting die and killing – has been marked as one of its key issues. In this paper I will argue that a) the borderline between act and omission is an altogether blurry one, and it gets even vaguer when it comes to euthanasia, b) there is no morally significant difference between active and passive euthanasia, and c) if there is any, it seems to (...)
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  41. Advance Directives and the Descendant Argument.Jukka Varelius - 2018 - HEC Forum 30 (1):1-11.
    By issuing an advance treatment directive, an autonomous person can formally express what kinds of treatment she wishes and does not wish to receive in case she becomes ill or injured and unable to autonomously decide about her treatment. While many jurisdictions and medical associations endorse them, advance treatment directives have also been criticized. According to an important criticism, when a person irreversibly loses her autonomy what she formerly autonomously desired ceases to be of importance in deciding about her treatment. (...)
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  42. The Medical Surrogate as Fiduciary Agent.Dana Howard - 2017 - Journal of Law, Medicine and Ethics 45 (3):402-420.
    Within bioethics, two prevailing approaches structure how we think about the role of medical surrogates and the decisions that they must make on behalf of incompetent patients. One approach views the surrogate primarily as the patient's agent, obediently enacting the patient's predetermined will. The second approach views the surrogate as the patient's custodian, judging for herself how to best safeguard the patient's interests. This paper argues that both of these approaches idealize away some of the ethically relevant features of advance (...)
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  43. Legal Briefing: New Penalties for Disregarding Advance Directives and Do-Not-Resuscitate Orders.Thaddeus Mason Pope - 2017 - Journal of Clinical Ethics 28 (1):74-81.
    Patients in the United States have been subject to an evergrowing “avalanche” of unwanted medical treatment. This is economically, ethically, and legally wrong. As one advocacy campaign puts it: “Patients should receive the medical treatments they want. Nothing less. Nothing more.” First, unwanted medical treatment constitutes waste (and often fraud or abuse) of scarce healthcare resources. Second, it is a serious violation of patients’ autonomy and self-determination. Third, but for a few rare exceptions, administering unwanted medical treatment contravenes settled legal (...)
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  44. Deciding for the Incompetent.Eric Vogelstein - 2017 - In John K. Davis (ed.), Ethics at the End of Life: New Issues and Arguments. New York: Routledge. pp. 108-125.
    This chapter discusses the moral framework for surrogate decision-making for incompetent medical patients. The chapter focuses on the question of how we can respect the autonomy of those who are no longer competent to make such decisions. The standard counterfactual account of how to respect the autonomy of the incompetent is evaluated, along with accounts that ground respect for autonomy on the patient’s most recent desires and values (regardless of whether the patient still possesses those desires and values) as well (...)
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  45. Advance Directives for Euthanasia.Eric Vogelstein - 2017 - In Michael J. Cholbi (ed.), Euthanasia and Assisted Suicide: Global Views on Choosing to End Life. Santa Barbara, CA: Praeger. pp. 327-350.
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  46. What’s Good for Them? Best Interests and Severe Disorders of Consciousness.Jennifer Hawkins - 2016 - In Walter Sinnott Armstrong (ed.), Finding Consciousness. Oxford, UK: pp. 180-206.
    I consider the current best interests of patients who were once thought to be either completely unaware (to be in PVS) or only minimally aware (MCS), but who, because of advanced fMRI studies, we now suspect have much more “going on” inside their minds, despite no ability to communicate with the world. My goal in this chapter is twofold: (1) to set out and defend a framework that I think should always guide thinking about the best interests of highly cognitively (...)
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  47. Animals, advance directives, and prudence: Should we let the cheerfully demented die?David Limbaugh - 2016 - Ethics, Medicine and Public Health 2 (4):481-489.
    A high level of confidence in the identity of individuals is required to let them die as ordered by an advance directive. Thus, if we are animalists, then we should lack the confidence required to apply lethal advance directives to the cheerfully demented, or so I argue. In short, there is consensus among animalists that the best way to avoid serious objections to their account is to adopt an ontology that denies the existence of brains, hands, tables, chairs, iced-tea, and (...)
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  48. Autonomy and the Moral Authority of Advance Directives.Eric Vogelstein - 2016 - Journal of Medicine and Philosophy 41 (5):500-520.
    Although advance directives are widely believed to be a key way to safeguard the autonomy of incompetent medical patients, significant questions exist about their moral authority. The main philosophical concern involves cases in which an incompetent patient no longer possesses the desires on which her advance directive was based. The question is, does that entail that prior expressions of medical choices are no longer morally binding? I believe that the answer is “yes.” I argue that a patient’s autonomy is not (...)
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  49. Fluctuating capacity and advanced decision making – self-binding directives and self-determination’.Tania Gergel & Gareth Owen - 2015 - International Journal of Law and Psychiatry 105 (40):92-101.
    For people with Bipolar Affective Disorder, a self-binding (advance) directive (SBD), by which they commit themselves to treatment during future episodes of mania, even if unwilling, can seem the most rational way to deal with an imperfect predicament. Knowing that mania will almost certainly cause enormous damage to themselves, their preferred solution may well be to allow trusted others to enforce treatment and constraint, traumatic though this may be. No adequate provision exists for drafting a truly effective SBD and efforts (...)
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  50. Medicine & Well-Being.Daniel Groll - 2015 - In Guy Fletcher (ed.), The Routledge Handbook of Philosophy of Well-Being. Routledge.
    The connections between medicine and well-being are myriad. This paper focuses on the place of well-being in clinical medicine. It is here that different views of well-being, and their connection to concepts like “autonomy” and “authenticity”, both illuminate and are illuminated by looking closely at the kinds of interactions that routinely take place between clinicians, patients, and family members. -/- In the first part of the paper, I explore the place of well-being in a paradigmatic clinical encounter, one where a (...)
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