The practical goal of preventing premature death seems uncontroversial. But the term ‘premature death’ is vague with several, sometimes conflicting definitions. This ambiguity results in several conceptions with which not all will agree. Moreover, the normative rationale behind the goal of preventing premature deaths is masked by the operational definition of existing measures. In this article, we argue that ‘premature death’ should be recognized as a normative concept. We propose that normative theories should (...) be used to justify measures of premature death to provide them with normative validity and public legitimacy. (shrink)

The one who dies is deprived of goods that this person would have enjoyed if he or she had continued living, according to the popular “deprivation account of harm.” The person who dies “prematurely” is generally thought to suffer the most harm from death. However, the concept of a premature death is unclear, as will be shown. I will evaluate various definitions of a premature death and will argue that the existing definitions are too ambiguous (...) and unreliable to serve as the basis for estimating the degree of harm from death. (shrink)

Much public policy analysis requires us to place a monetary value on the bad- ness of a premature human death. Currently dominant approaches to determining this ‘value of a life’ focus exclusively on the ‘self-regarding’ value of life — that is, the value of a person’s life to the person whose death is in question — and altogether ignore effects on other people. This procedure would be justified if, as seems intuitively plausible, other-regarding effects were negligible in (...) comparison with self-regarding ones. I argue that in the light of the issue of overpopulation, that intuitively plausible condition is at best highly questionable. Unless the world is in fact underpopulated, the social disvalue of a premature death is likely to be significantly lower than the current estimates. (shrink)

The aim of this article is to generate knowledge about parents’ participation in life-and-death decisions concerning their very premature and/or critically ill infants in hospital neonatal units. The question is: what are parents’ attitudes towards their involvement in such decision making? A descriptive study design using in-depth interviews was chosen. During the period 1997-2000, 20 qualitative interviews with 35 parents of 26 children were carried out. Ten of the infants died; 16 were alive at the time of the (...) interview. The comparative method (grounded theory) was used to analyse the data. The analysis was carried out continuously and in parallel with data collection. Six categories were revealed by the analysis: indecision and uncertainty (ambivalence); information and communication; participate, but do not decide; seeming to be included; the parents’ child; and individual consideration. The findings appear to indicate that parents agree that they should not have the final word in decisions concerning their infants’ future life or death. Such a responsibility would put too heavy a burden on parents who lack the medical knowledge and the professional experience needed to make such a decision, and would be likely to lead to them experiencing strong feelings of guilt. The findings show that parents should be well informed and listened to during the whole decision-making process. Their primary concern was how nurses and physicians communicate with parents who are experiencing a crisis, and how this serious information is presented. (shrink)

The ancient philosophical school of Epicureanism tried to argue that death is "nothing to us." Were they right? James Warren provides a comprehensive study and articulation of the interlocking arguments against the fear of death found not only in the writings of Epicurus himself, but also in Lucretius' poem De rerum natura and in Philodemus' work De morte. These arguments are central to the Epicurean project of providing ataraxia (freedom from anxiety) and therefore central to an understanding of (...) Epicureanism as a whole. They also offer significant resources for modern discussions of the value of death--one which stands at the intersection of metaphysics and ethics. If death is the end of the subject, and the subject can not be benefited nor harmed after death, is it reasonable nevertheless to fear the ceasing-to-be? If the Epicureans are not right to claim that the dead can neither be benefited nor harmed, what alternative models might be offered for understanding the harm done by death and do these alternatives suffer from any further difficulties? The discussion involves consideration of both ethical and metaphysical topics since it requires analysis not only of the nature of a good life but also the nature of personal identity and time. A number of modern philosophers have offered criticisms or defences of the Epicureans' views. Warren explores and evaluates these in the light of a systematic and detailed study of the precise form and intention of the Epicureans' original arguments. Warren argues that the Epicureans also were interested in showing that mortality is not to be regretted and that premature death is not to be feared. Their arguments for these conclusions are to be found in their positive conception of the nature of a good and complete life, which divorce the completeness of a life as far as possible from considerations of its duration. Later chapters investigate the nature of a life lived without the fear of death and pose serious problems for the Epicureans being able to allow any concern for the post mortem future and being able to offer a positive reason for prolonging a life which is already complete in their terms. (shrink)

Obstetricians face difficult decisions when the interests of fetus and mother conflict. An example is the problem of choosing the delivery method when labour begins prematurely and the fetus is breech. Vaginal delivery involves risks for the breech fetus of brain damage or death caused by umbilical cord compression and head entrapment. Caesarean section might avoid these dangers but involves risks for the mother, including infection, haemorrhage and even death in a small percentage of cases. If a caesarean (...) section is performed the infant might die anyway, due to complications of prematurity. Thus, decisions about delivery method involve balancing the risks to mother and fetus. Uncertainty about the frequency of fetal injuries in vaginal breech deliveries adds to the difficulty of these decisions. (shrink)

Throughout much of human history most people conceived of death as a transitional event. An alternative, secular, conception of death is as the permanent cessation of all life‐sustaining biological functions. The death of the physical organism is the death of the person or human being. However death be conceived, human beings are the only creatures that are aware of their mortality. The death penalty is often thought to be the most severe punishment of all, (...) far worse than life imprisonment. Attitudes towards death vary according to the acceptance or rejection of belief in an afterlife. Death in old age is generally held to be less deplorable than death in one's prime. Premature death, however, is commonly deemed to be tragic, but not because merely being alive is a good of one kind or another, let alone good in itself. Lucretius exaggerated the symmetry between prenatal and post‐ mortem events. (shrink)

Philosophers have said less than is needed about the nature of premature death, and about the badness or otherwise of that death for the one who dies. In this paper, premature death’s nature is clarified in Epicurean terms. And an accompanying argument denies that we need to think of such a death as bad in itself for the one who dies. Premature death’s nature is conceived of as a death that arrives (...) before ataraxia does. (Ataraxia’s nature is also clarified. It is a pervasive inner peace that is a kind of purity and completeness in how one is living.) Whatever harm we might attribute to a premature death is better attributed to a life’s being lived at that time without ataraxia. The paper ends by explaining how its Epicurean account, more so than comparativist or narrativist accounts, could allow a person to know that her death will not be premature. (shrink)

Death beyond Disavowal utilizes "difference" as theorized by women of color feminists to analyze works of cultural production by people of color as expressing a powerful antidote to the erasures of contemporary neoliberalism. According to Grace Kyungwon Hong, neoliberalism is first and foremost a structure of disavowal enacted as a reaction to the successes of the movements for decolonization, desegregation, and liberation of the post-World War II era. It emphasizes the selective and uneven affirmation and incorporation of subjects and (...) ideas that were formerly categorically marginalized, particularly through invitation into reproductive respectability. It does so in order to suggest that racial, gendered, and sexualized violence and inequity are conditions of the past, rather than the foundations of contemporary neoliberalism's exacerbation of premature death. Neoliberal ideologies hold out the promise of protection from premature death in exchange for complicity with this pretense. Using various books and films as case studies, Death beyond Disavowal finds the memories of death and precarity that neoliberal ideologies attempt to erase. Hong posits cultural production as a compelling rejoinder to neoliberalism's violences. She situates women of color feminism, often dismissed as narrow or limited in its effect, as a potent diagnosis of and alternative to such violences. And she argues for the importance of women of color feminism to any critical engagement with contemporary neoliberalism. (shrink)

To be Black means to have ancestors whose humanity has been de-nied by slavery, colonialism, neo-colonialism, and segregation, as well as by many theories elaborated in order to justify and intensify these modes of domination. To be Black also means having to face the enduring legacies of these systems and theories, which predomi-nantly manifest through overexposure to violence and death. Today, premature death and habituation to loss remain constitutive fea-tures of Black experience. Dignity, often de????ined as the (...) inherent value of every single human being, has been a core concept in ethics since Kant, at least. But in both philosophy and modern politics, the claim of respect for the dignity of people has coexisted with deep antiblack-ness. However, apart from the Western understanding of dignity stands another tradition. The concept of dignity is pervasive in Black radicalism, Caribbean philosophy, and African thought since the 18th century. This article draws inspiration from the legacy of these thinkers to elaborate an ethics centred on the speci????icities of racial-ized life. (shrink)

BackgroundThe state of the world is one with scarce medical resources where longevity is not equally distributed. Given such facts, setting priorities in health entails making difficult yet unavoidable decisions about which lives to save. The business of saving lives works on the assumption that longevity is valuable and that an early death is worse than a late death. There is a vast literature on health priorities and badness of death, separately. Surprisingly, there has been little cross-fertilisation (...) between the academic fields of priority setting and badness of death. Our aim is to connect philosophical discussions on the badness of death to contemporary debates in health priorities.DiscussionTwo questions regarding death are especially relevant to health priorities. The first question is why death is bad. Death is clearly bad for others, such as family, friends and society. Many philosophers also argue that death can be bad for those who die. This distinction is important for health priorities, because it concerns our fundamental reasons for saving lives. The second question is, ‘When is the worst time to die?’ A premature death is commonly considered worse than a late death. Thus, the number of good life years lost seems to matter to the badness of death. Concerning young individuals, some think the death of infants is worse than the death of adolescents, while others have contrary intuitions. Our claim is that to prioritise between age groups, we must consider the question of when it is worst to die.ConclusionsDeprivationism provides a more plausible approach to health priorities than Epicureanism. If Deprivationism is accepted, we will have a firmer basis for claiming that individuals, in addition to having a health loss caused by morbidity, will have a loss of good life years due to mortality. Additionally, Deprivationism highlights the importance of age and values for health priorities. Regarding age, both variants of Deprivationism imply that stillbirths are included in the Global Burden of Disease. Finally, we suggest that the Time-Relative Interest Account may serve as an alternative to the discounting and age weighting previously applied in the Global Burden of Disease. (shrink)

In this paper, I am concerned with elucidating and expanding our attitudes toward our own death. As it is, our common attitudes toward our death are the following: we fear our premature death, and we dread our inevitable death. These attitudes are rational, but I want to argue that our attitudes toward death should be more complicated than this. A condition upon our value, our preciousness, as creatures is that we are vulnerable, and our (...) vulnerability is, at bottom, a vulnerability to death. A corollary of this is that we could not be loved, either by ourselves or by others, for one cannot love—be concerned for—a being invulnerable to death. As a consequence, death plays a deep and abiding role in our value systems. Our susceptibility to premature and inevitable death is a condition upon our being valuable creatures and, in turn, it is a condition upon our being loved. Given the high value that we place on being valuable creatures who deserve love, we should equally place a high value on the const.. (shrink)

Most legal analyses of selective nontreatment of seriously ill children centre on the question of whether it is in a child’s best interests to be kept alive in the face of extreme suffering and/or an intolerable quality of life. Courts have resisted any direct confrontation with the question of whether the child’s death is in his or her best interests. Nevertheless, representations of death may have an important role to play in this field of jurisprudence. The prevailing philosophy (...) is to configure death as a release from a futile or painful existence and/or as a dignified end in an objectively hopeless situation. However, there can be disagreement about the meaning of death in these settings. Some parents object that death would be premature or that it represents a culpable neglect of their child. A closer examination of these discordant interpretations allows for a better comprehension of the cultural understandings that underscore clinical and legal accounts of death following end-of-life decisions. (shrink)

Cryonic suspension is a relatively new technology that offers those who can afford it the chance to be 'frozen' for future revival when they reach the ends of their lives. This paper will examine the ethical status of this technology and whether its use can be justified. Among the arguments against using this technology are: it is 'against nature', and would change the very concept of death; no friends or family of the 'freezee' will be left alive when he (...) is revived; the considerable expense involved for the freezee and the future society that will revive him; the environmental cost of maintaining suspension; those who wish to use cryonics might not live life to the full because they would economize in order to afford suspension; and cryonics could lead to premature euthanasia in order to maximize chances of success. Furthermore, science might not advance enough to ever permit revival, and reanimation might not take place due to socio-political or catastrophic reasons. Arguments advanced by proponents of cryonics include: the potential benefit to society; the ability to cheat death for at least a few more years; the prospect of immortality if revival is successful; and all the associated benefits that delaying or avoiding dying would bring. It emerges that it might be imprudent not to use the technology, given the relatively minor expense involved and the potential payoff. An adapted and more persuasive version of Pascal's Wager is presented and offered as a conclusive argument in favour of utilizing cryonic suspension. (shrink)

Critical care is in an emerging crisis of conflict between what individuals expect and the economic burden society and government are prepared to provide. The goal of critical care support is to prevent suffering and premature death by intensive therapy of reversible illnesses within a reasonable timeframe. Recently, it has become apparent that early support in an intensive care environment can improve patient outcomes. However, life support technology has advanced, allowing physicians to prolong life (and postpone death) (...) in circumstances that were not possible in the recent past. This has been recognized by not only the medical community, but also by society at large. One corollary may be that expectations for recovery from critical illness have also become extremely high. In addition, greater numbers of patients are dying in intensive care units after having receiving prolonged durations of life-sustaining therapy. Herein lies the emerging crisis – critical care therapy must be available in a timely fashion for those who require it urgently, yet its provision is largely dependent on a finite availability of both capital and human resources. Physicians are often placed in a troubling conflict of interest by pressures to use health resources prudently while also promoting the equitable and timely access to critical care therapy. In this commentary, these issues are broadly discussed from the perspective of the individual clinician as well as that of society as a whole. The intent is to generate dialogue on the dynamic between individual clinicians navigating the complexities of how and when to use critical care support in the context of end-of-life issues, the increasing demands placed on finite critical care capacity, and the reasonable expectations of society. (shrink)

Around people who were close to him, Philippe Lacoue-Labarthe would sometimes cry out with anger: “Death is a scandal! It is intolerable!” When he died almost fourteen years ago, prematurely and af...

In this article, the vitality of premature infants will be described and discussed. Vitality was one of the main factors in a grounded theory study in which the aim was to generate knowledge concerning the ethical decision-making processes with which nurses and physicians are faced in a neonatal unit. Which assessments underlie decisions about whether to start, continue or stop medical treatment of very sick premature babies?A descriptive study design, including 120 hours of field observations and 22 qualitative (...) in-depth interviews with doctors and nurses, was chosen. Strauss and Glaser’s comparative method was used to analyse the field observations and interviews.The findings indicate that life-and-death decisions are somewhat ambivalent; experience does not always make them easier. In situations of ambiguity, decisions also seem to be based upon the vitality of the babies concerned. (shrink)

In this article, the vitality of premature infants will be described and discussed. Vitality was one of the main factors in a grounded theory study in which the aim was to generate knowledge concerning the ethical decision-making processes with which nurses and physicians are faced in a neonatal unit. Which assessments underlie decisions about whether to start, continue or stop medical treatment of very sick premature babies? A descriptive study design, including 120 hours of field observations and 22 (...) qualitative in-depth interviews with doctors and nurses, was chosen. Strauss and Glaser’s comparative method was used to analyse the field observations and interviews. The findings indicate that life-and-death decisions are somewhat ambivalent; experience does not always make them easier. In situations of ambiguity, decisions also seem to be based upon the vitality of the babies concerned. (shrink)

James Warren, Facing Death, Epicurus and his Critics. Oxford: Clarendon Press, 2004. Pp. viii, 240. ISBN 0-19-925289-0. $45.00. Reviewed by Thornton Lockwood, Sacred Heart University Word count: 2152 words ------------------------------- To modern ears, the word Epicurean indicates an interest in fine dining. But at least throughout the early modern period up until the 19th century, Epicureanism was known less for its relation to food preparation and more so, if not scandalously so, for its doctrine about the annihilation of the (...) human soul at death, its denial of human immortality, and its attempt to justify the claim that death should not be feared since "Death is nothing to us". Epicureans -- like many ancient schools of thought -- sought to establish an objective "morality of happiness" or rational teaching about right conduct which allowed its practitioners to arrive at a kind of well-being. Epicureans identified such well-being or happiness with "freedom from disturbance" taraci/a ), and insofar as the fear of death undermined such contentedness in life, they presented arguments against the claim that death was a bad thing. Put more concisely, Epicureans believe that, "if we think about death correctly, we think about living a good life correctly, and vice versa". But whereas other ancient thinkers -- most famously Socrates and his students -- had sought to cure the fear of death by positing an immortal soul which philosophy was to prepare for life after the death of one's body, Epicureans took the opposite route and argued that in part it was the longing for an impossible immortality that contributed to the fearfulness of death. JW has done both classicists and philosophers the service of presenting a detailed analysis of the philosophical arguments which Epicureanism -- as found principally in the sayings and correspondence of Epicurus, Lucretius' De Rerum Natura, and Philodemus' De Morte -- presented about facing death. As the book's title accurately reflects, the presentation of the arguments is organized in large part as a response to the criticisms which both ancient and modern thinkers such as Cicero, Thomas Nagel and Bernard Williams have made against the Epicurean belief about death. JW is principally concerned with the accurate presentation and fair evaluation of philosophical arguments. Much of his analysis will appeal to philosophers interested in the problem of death or the cogency of ancient ethical thought, but, as he also notes, questions about death and how to live a good life are hardly the problem only of philosophical specialists. "If any questions are worth pursuing, these are". Insofar as JW's task requires careful scrutiny of ancient texts, he also sheds light on the proper understanding of difficult Epicurean texts, especially in those cases where different passages from different Epicurean authors appear to be in tension.[[1]] For the aid of philosophers coming to Epicurus without the skills of classicists, JW translates all Greek and Latin texts into English; at the same time, all translations are accompanied by the passage in its original language. The citations and corresponding bibliography are extensive, covering not only the relevant works of contemporary philosophers such as Nagel, Williams, Feldman, and Parfit, but also the philological works of classicists writing on Epicureanism in English, French, Italian, and German. The volume concludes with a helpful index locorum. The Epicurean belief that "death is nothing to us" is meant to correct the mistaken beliefs which people have that generate a fear of death. But as JW acutely notes, precisely what is fearful about death is ambiguous. On his analysis, it could include at least four analytically distinct fears: 1) the fear of being dead ; 2) the fear that one will die ; 3) the fear of premature death ; and 4) the fear of the process of dying. JW claims that "there is no single Epicurean 'argument against death'. Rather, they had an armoury of arguments which could be deployed against the various different kinds of fear of death". Thus, JW organizes his book into chapters which consider the "armoury"of arguments made against each of these four fears. After an initial introductory chapter which analytically distinguishes the different fears of death, JW next devotes chapters to: the argument that, since humans are without perception of death and the process of death, neither should be feared ; the "symmetry argument" which seeks to prove that apprehension about the coming end of life is as irrational as apprehension that one's life did not begin earlier ; and the Epicurean analysis of what constitutes "completeness" in life. In these first four chapters, JW lays out all the arguments which the Epicurean makes against each of the four fears, considers counterarguments which have been made by ancient and modern authors, and then evaluates the overall strengths and weaknesses of each argument. A fifth chapter considers a slightly different argument, namely one which alleges that either the historical fact that Epicurus wrote a will or the Epicurean attitude towards suicide generate inconsistencies between Epicurean theories and actual Epicurean practice. Finally, a sixth chapter summarizes and evaluates as a whole the Epicurean project to rid humans of their fear of death. Although all of JW's analyses are thorough and detailed, let me focus upon his evaluation of some of the more central -- and more difficult to justify -- claims which Epicureans make to give a sense of JW's argumentation. With respect to the fear of being dead or not existing, Epicureans claim that since the atoms which make up a person dissipate upon death, then there is no person who could perceive any postmortem harm, and thus there is nothing to fear about death itself. Philosophers like Thomas Nagel have raised against this argument examples which appear to justify the belief that postmortem non-perceived harms are something in fact that should be feared.[[2]] For instance, there seems to be something fearful about the death of an individual who does not get the chance to see his or her children grow up, but such a scenario seems to be an example of something which "harms" that individual even though the individual is dead and incapable of feeling or perceiving anything. The case is related to the problem of dying before one's life is "complete," but a merit of JW's analyses of the different fears of death is that it shows that the Epicurean has two distinct arguments against the claim that such a scenario is fearful, one of which concerns the question of fearing something which happens after one's death, the other which concerns the question of fearing that one's life ends before it is complete. With respect to the first question, JW suggests that the source behind our intuition that premature death could be an unperceived harm is a "comparative" evaluation with a non-tragic death. For instance, it is not implausible to say that a child raised in a less developed country has been "harmed" in comparison to a child growing up in a country with adequate access to schooling and health care.[[3]] Even if the child raised in the less developed country never perceives the harm, in comparison to the life she or he might have lived elsewhere such lowered access to resources seems to be a "harm". But, although the case of children being raised with different levels of access to resources may have a place within the question of global justice, the case of such "unperceived" comparative posthumous harms fails as a counter argument to the Epicurean position. In the original example, it was thought that dying before seeing one's children grow up is an unperceived harm because we know of other individuals who have had that opportunity, and comparatively the former individual seems to be "harmed." One of the main problems with such a counter argument, according to JW, is that it ends up proving too much. Since one could imagine for almost every death a comparative case which was better, the counter argument makes almost every conceivable death a "harm" to the individual who died. In JW's words, "given the thought that death may rob us of goods we would have experience were we to die later, it is difficult to resist the thought that any death will fit this description". But the force of the counter argument is supposed to seize upon the case of a "tragic death" where someone is prematurely struck down before life is complete. If all deaths are tragic, none is. If the claim that death is to be feared because of unperceived harms in the case of comparative loss is unpersuasive, what about the claim that death is to be feared instead because it sometimes strikes before one has arrived at completeness or fullness in life? Solon famously claimed that we must "look to the end" and call no man happy until his life is complete; Aristotle picks up on Solon's remarks in part because eudaemonists have traditionally placed special emphasis on "completeness" as a criterion of a life well-lived. Should not all fear death because death can strike prematurely, before one has reached the various goals and stages of a life well-lived? JW persuasively argues that Epicureans were concerned with addressing the fear of premature death but that they countered such a fear on the basis of their understanding of completeness and pleasure. A complete life is a good life, but for the Epicureans, the good is pleasure and the highest pl. (shrink)

This paper identifies two possible versions of the Epicurean 'Symmetry argument', both of which claim that post mortem non-existence is relevantly like prenatal non-existence and that therefore our attitude to the former should be the same as that towards the latter. One version addresses the fear of the state of being dead by making it equivalent to the state of not yet being born; the other addresses the prospective fear of dying by relating it to our present retrospective attitude to (...) the time before birth. I argue that only the first of these is present in the relevant sections of Lucretius (DRN 3.832-42, 972-5). Therefore, this argument is not aimed at a prospective fear of death, or a fear of 'mortality'. That particular fear is instead addressed by the Epicureans through the additional premise (found in the Letter to Menoeceus 125) that it is irrational to fear in prospect an event which is known to be painless when present. This still leaves unaddressed the related fear of 'premature death', which is to be removed through the acceptance of Epicurean hedonism. (shrink)

Andrew was a desperately premature baby weighing under two pounds. He died after months of "heroic' efforts in an intensive care facility. The story of his short cruel institutionalised life is a case study in the limits and excesses of modern medicine. The night he told us our son Andrew was about to die the doctor who had taken charge of him six months before also told us we were "intellectually tight' that we had "no feelings only thoughts and (...) words and strategies'. We were "bad parents'. As the parents of a five-year-old daughter we knew the love a mother and father feels for children. Yet as Andrew's parents we were used to condemnation and insult. Andrew was a baby born 15 weeks prematurely weighing only 1lb 12oz and in a state of painful deterioration almost from the start. We wanted him to be allowed to die a natural death. Andrew's story is the story of what can happen when a baby becomes hopelessly entrapped in an intensive care unit where the machinery is more sophisticated than the code of law and ethics governing its use. The letter printed below was sent to the administrator and numerous personnel of the hospital that controlled the life and death of our son. The physician-in-chief of that hospital characterised it as a "carefully documented critique'. The letter appear here somewhat edited and abridged and the names of people and institutions have been changed all but our own. It is the personal record of what happened to our baby and to us. (shrink)

This issue’s “Legal Briefing” column covers recent legal developments involving total brain failure. Death determined by neurological criteria (DDNC) or “brain death” has been legally established for decades in the United States. But recent conflicts between families and hospitals have created some uncertainty. Clinicians are increasingly unsure about the scope of their legal and ethical treatment duties when families object to the withdrawal of physiological support after DDNC. This issue of JCE includes a thorough analysis of one institution’s (...) ethics consults illustrating this uncertainty. This experience is not unique. Hospitals across the country are seeing more DDNC disputes. Because of the similarity to medical futility disputes, some court cases on this topic were reviewed in a prior “Legal Briefing” column. But a more systematic review is now warranted. I categorize recent legal developments into the following nine categories: 1. History of Determining Death by Neurological Criteria2. Legal Status of Determining Death by Neurological Criteria3. Legal Duties to Accommodate Family Objections4. Protocols for Determining Death by Neurological Criteria5. Court Cases Seeking Physiological Support after DDNC6. Court Cases Seeking Damages for Intentionally Premature DDNC7. Court Cases Seeking Damages for Negligently Premature DDNC8. Court Cases Seeking Damages for Emotional Distress9. Pregnancy Limitations on DDNC. (shrink)

This paper outlines the Epicurean conception of rationality and then tries to assess the merits of the notorious contention of the Epicurean philosophers that it is irrationalto fear death. At the outset, I talk about the nature of harmful emotions or passions, of which the fear of death is an outstanding example: their dependence on one‘s disposition, their cognitive and non-cognitive components, the ways in which these elements may be related to each other, and the healthy counterparts of (...) the passions, namely the ‚bites‘. Next, I distinguish different kinds of fears involving the thought of death and I examine the Epicurean arguments against each one of them: fears about the state of being dead, others about dying prematurely, yet others concerning the dying process and especially the moment when the soul leaves the body and, finally,the fear that we must die sometime. Much of the discussion focuses on the writings of Philodemus . Philodemus offers the most sustained discussion of the fear of premature death and of the fear of dying that survive in the Epicurean literature. In addition, in the peroration of his treatise On Death, he gives a brilliant example of how we can reconcile ourselves with the fact that we shall die sometime and accept our own mortality. My provisional conclusion is that although the Epicurean philosophers often succeed in appeasing our fears about death, for the most part they fail to prove that these fears are irrational. (shrink)

A recent commentary defends 1) the concept of 'brain arrest' to explain what brain death is, and 2) the concept that death occurs at 2–5 minutes after absent circulation. I suggest that both these claims are flawed. Brain arrest is said to threaten life, and lead to death by causing a secondary respiratory then cardiac arrest. It is further claimed that ventilation only interrupts this way that brain arrest leads to death. These statements imply that brain (...) arrest is not death itself. Brain death is a devastating state that leads to death when intensive care, which replaces some of the brain's vital functions such as breathing, is withdrawn and circulation stops resulting in irreversible loss of integration of the organism. Circulatory death is said to occur at 2–5 minutes after absent circulation because, in the context of DCD, the intent is to not attempt reversal of the absent circulation. No defense of this weak construal of irreversible loss of circulation is given. This means that paents in identical physiologic states are dead (in the DCD context) or alive (in the resuscitation context); the current state of death (at 2–5 minutes) is contingent on a future event (whether there will be resuscitation) suggesting backward causation; and the commonly used meaning of irreversible as 'not capable of being reversed' is abandoned. The literature supporting the claim that autoresuscitation does not occur in the context of no cardiopulmonary resuscitation is shown to be very limited. Several cases of autoresuscitation are summarized, suggesting that the claim that these cases are not applicable to the current debate may be premature. I suggest that brain dead and DCD donors are not dead; whether organs can be harvested before death from these patients whose prognosis is death should be debated urgently. (shrink)

Núñez and colleagues (2019) question whether cognitive science still exists “as a coherent academic field with a well‐defined and cohesive interdisciplinary research program.” This worry may be premature on two grounds. First, we are not convinced that the Lakatosian criterion of coalescence around a core framework is the best standard for judging whether a field is well‐defined and productive. Second, although we acknowledge that cognitive science is not as visible as we would like, we doubt that this low profile (...) accurately reflects the state of actual research and teaching programs based on the cognitive science approach. (shrink)

Núñez and colleagues (2019) question whether cognitive science still exists “as a coherent academic field with a well‐defined and cohesive interdisciplinary research program.” This worry may be premature on two grounds. First, we are not convinced that the Lakatosian criterion of coalescence around a core framework is the best standard for judging whether a field is well‐defined and productive. Second, although we acknowledge that cognitive science is not as visible as we would like, we doubt that this low profile (...) accurately reflects the state of actual research and teaching programs based on the cognitive science approach. (shrink)

_A collection of illuminating observations on life and art, from an acclaimed Swiss modernist__ “[Tess Lewis’s] translation is worthy of her willfully demanding subject, leaping between what Hohl calls the ‘incandescence’ of the aphorism and, in his dream narratives and miniature fairy tales, a shadowy beauty reminiscent of his better-known compatriot Robert Walser.”—Max Norman, _Wall Street Journal___ “_The Notes_ should be celebrated: it is wonderful that this volume of [Hohl’s] compact, aphoristic observations has finally arrived in English.”—Alexandra Sattler, ___Arts Fuse__ (...) Revered by Bertolt Brecht and Max Frisch as one of Switzerland’s most commanding writers, Ludwig Hohl spent most of his waking hours with a pen in hand, collecting quotes from others and recording ruminations of his own. Composed between 1934 and 1936 during his residence in the Netherlands in a state of “extreme spiritual desolation,” _The Notes_ is Hohl’s magnum opus: an assemblage of his epiphany-like observations, disparate in subject yet threaded together by a relentless exploration of the nature and origins of creativity. Inspired by Spinoza, Goethe, and many others, _The Notes_ contends with the purpose of work, the vitality of art, and the inevitability of death—a valiant, uncompromising exercise in hope against the devastating backdrop of twentieth-century Europe. This abridged edition, expertly translated by Tess Lewis and with an illuminating foreword by Joshua Cohen, introduces the reader to this remarkable work and its writer. (shrink)

One of the most potent arguments against physician‐assisted death hinges on the worry that people with disabilities will be subtly coerced to accept death prematurely. The argument is flawed. There is nothing new in PAD: the risk of coercion is already present in current policies about end of life care. And to hold that any such risk is too much is tacitly to endorse vitalism and to deny that people with disabilities are capable of choosing authentically.

The purpose of the study was to analyse the level and the trends of Potential Years of Life Lost due to the main causes of death in Poland in the years 2002-2011. The material for the study was the information from the Central Statistical Office on the number of deaths due to the main causes of death in Poland in the years 2002-2011. The premature mortality analysis was conducted with the use of the PYLL indicator. PYLL rate (...) was calculated following the method proposed by J. Romeder, according to which premature mortality was defined as death before the age of 70. Time trends of PYLL rate and the average annual percent change were assessed using jointpoint models and the Joinpoint Regression Program. In the years 2002-2011, PYLL rate for all-cause deaths decreased by 7.0% among men and 8.1% among women. In 2011, the main reasons for PYLL among men were: external causes, cardiovascular diseases and cancers. Among women the leading causes were: cancers, cardiovascular diseases and external causes. PYLL rate increased among men for colorectal cancer, and among women for colorectal and lung cancer. The presented epidemiological situation for premature mortality in Poland shows that in the majority of cases it is caused by preventable deaths, which highlights a need to intensify measures in primary and secondary prevention. (shrink)

This study identified the influences of maternal socio-demographic and antenatal factors on stillbirths and neonatal deaths in New South Wales, Australia. Bivariate and multivariate analyses were used to explore the association of selected antenatal and maternal characteristics with stillbirths and neonatal deaths. The findings of this study showed that stillbirths and neonatal deaths significantly varied by infant sex, maternal age, Aboriginality, maternal country of birth, socioeconomic status, parity, maternal smoking behaviour during pregnancy, maternal diabetes mellitus, maternal hypertension, antenatal care, plurality (...) of birth, low birth weight, place of birth, delivery type, maternal deaths and small gestational age. First-born infants, twins and infants born to teenage mothers, Aboriginal mothers, those who smoked during the pregnancy and those of lower socioeconomic status were at increased risk of stillbirths and neonatal deaths. The most common causes of stillbirths were conditions originating in the perinatal period: intrauterine hypoxia and asphyxia. Congenital malformations, including deformities and chromosomal abnormalities, and disorders related to slow fetal growth, short gestation and low birth weight were the most common causes of neonatal deaths. The findings indicate that very low birth weight (less than 2000 g) contributed 75·6% of the population-attributable risks to stillbirths and 59·4% to neonatal deaths. Low gestational age (less than 32 weeks) accounted for 77·7% of stillbirths and 87·9% of neonatal deaths. The findings of this study suggest that in order to reduce stillbirths and neonatal deaths, it is essential to include strategies to predict and prevent prematurity and low birth weight, and that there is a need to focus on anti-smoking campaigns during pregnancy, optimizing antenatal care and other healthcare programmes targeted at the socially disadvantaged populations identified in this study. (shrink)

The aim of this book, by providing a set of conceptual tools drawn from critical theory, is to open up questions and new problems and new research agendas for the study of environmental politics.