Під час проведення Круглого столу була розгорнута широка дискусія щодо можливостей досягнення миру в Україні, хоча питання ставилося і більш глобально: чи реально відвернути війну, тобто зняти її з порядку денного для людства взагалі. Були проаналізовані концепції західноєвропейських філософів, які підтримували Кантівську тезу щодо можливості «вічного миру». Заторкувалась тема розвитку технологічної цивілізації, яка начебто сприяє поширенню агресії і агресивної поведінки. Обговорювалось питання: чи можлива трансформація агресії, чи є способи каналізувати її в більш прийнятні форми, або через самовдосконалення людини. Пропонувалось звернутися (...) до практик співіснування, притаманні первісним спільнотам. Наголошувалося на нагальності завдання, яке полягає в тому, щоб знайти належні відповіді на виклики, які ставить перед людством війна в Україні. Або в більш ширшому плані: що має здійснити людство, щоб припинити ті війни, які вже розпочалися, або зробити для тих, хто їх розпочинає, дуже дороговартісною авантюрою. (shrink)

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 (...) completion of PADs and to use them, and, as a consequence, do not effectively engage patients about PADs. This study developed practical recommendations for clinicians to improve their ability to communicate and facilitate PADs. We (1) thematically analyze definitions of PADs published in 118 articles across disciplines, and (2) present our recommendations for enhanced communication in clinical practice that emphasize patient-centeredness, usefulness, and clarity, aligned with evidence-based practices that put patients’ autonomy and understanding first. While there is no one-sizefits- all script to engage patients in complex conversations, our recommended strategies include an emphasis on patients’ autonomy, the adaptation of word choices, the use of metaphor not simile, and checking for patients’ understanding as effective methods of clinical communication. (shrink)

In this paper it is argued that physicians’ restrictive attitudes in offering abortions during 1946–1965 in Sweden were due to their private values. The values, however, were rarely presented openly. Instead physicians’ values influenced their assessment of the facts presented—that is, the women's’ trustworthiness. In this manner the physicians were able to conceal their private values and impede the women from getting what they wanted and needed. The practice was concealed from both patients and physicians and never publicly discussed. It (...) is also argued that a similar tacit practice could currently be applied by palliative care physicians. Such practice might allow palliative care physicians to be restrictive when offering sedation therapy without appearing paternalistic or declaring conscientious objections. However, the practice runs counter to patients’ right to participate in making decisions. The women seeking abortion began to oppose the situation and eventually a new abortion law was introduced 1975. Patients at the end of life will never be able to protest against palliative care physicians’ restrictive attitudes. This is a vulnerable and weak group, unable to lodge complaints after the treatment. In order to respect patients’ autonomy, even suffering patients at the end of their lives, it is suggested that physicians should openly declare their values when it comes to providing treatments that might shorten life. Such transparency might facilitate more genuine shared decision-making and accordingly less suboptimal end-of-life care. (shrink)

Many ideas grow better when transplanted into another mind than the one where they sprang up.

Circumcision of a male child was recently ruled illegal by a court in Germany on the grounds that it violates the child's rights to bodily integrity and self-determination. This paper begins by challenging the applicability of these rights to the circumcision debate. It argues that, rather than a sweeping appeal to rights, a moral analysis of the practice of circumcision will require a careful examination of the interests of the child. I consider three of these interests in some detail. The (...) first is the interest in avoiding a moderate decrease in expected future sexual pleasure. I argue that even if such a decrease were to occur, it is not wholly unreasonable to think that this might actually be a good thing for the child. Second, I consider the interest in self-determination. I argue that this interest is not as strong as it might appear because the adult's circumcision decision is subject to a variety of biases and a significant lack of information. Finally, I consider the child's interest in avoiding the future costs of adult circumcision. I argue that this interest becomes much stronger in the religious case because the child is quite likely to choose to become circumcised as an adult. The likelihood of the child choosing circumcision in the religious case also reduces the extent to which infant circumcision violates his interest in self-determination. I conclude that male infant circumcision falls within the prerogative of parental decision-making in the secular case and even more clearly so in the religious case. Finally, I distinguish male circumcision from female genital cutting in several important respects and argue that we can coherently hold that male circumcision is permissible without also endorsing all forms of female genital cutting. (shrink)

Work organizations construct gender relations by two mechanisms. First, they allocate men and women to different positions. Instead of the traditional pattern of firm-specific segregation of waiters and waitresses, quantitative data show that most restaurants in this study have integrated wait staffs. Second, work organizations define job performances in gender terms. Qualitative data from five illustrative restaurants show that male and female servers in integrated staffs “do gender” by performing gendered service styles. Even when men and women are coservers, job (...) titles and dress codes suggest that providing service in a fine dining restaurant is waitering, whereas serving in a coffee shop is waitressing. Focusing on gendered styles of services expands our definition of gender and has serious implications for efforts to achieve occupational integration. (shrink)

This paper considers the development and judicial application of the Public Sector Equality Duty now found in section 149 Equality Act 2010, previously in a variety of forms in the Race Relations Act 1976, the Disability Discrimination Act 1995 and the Sex Discrimination Act 1975. It identifies a number of emerging themes in the jurisprudence concerned, in particular, with the relationship between the PSED and Wednesbury review, the extent of the information-gathering obligation it imposes, the delegability of PSED decision-making and (...) the timing of PSED challenge. It then considers the uncertainties which remain including, in particular, the application of the duty to various categories of decision-making, and concludes by assessing the impact of the PSED on challenges to ‘cuts’ cases arising from the reductions to public sector funding, and on domestic equality jurisprudence. (shrink)

This book explores from selected semioticians' international and cross-cultural viewpoints, the changing concepts of custom and community. The idea of the 'primitive' as a complex social system is explored in the context of recent studies of comparative law. The range of focus is from Lockean majority-rule to aboriginal self-determination, and includes a new look at waning ideologies such as the -old- feminism, Critical Legal Studies, and postmodernisms. Pragmatism is reinterpreted and reviewed with fresh eyes.".

Over the last decade, patient and public involvement (PPI) has become a requisite in applied health research. Some funding bodies demand explicit evidence of PPI, while others have made a commitment to developing PPI in the projects they fund. Despite being commonplace, there remains a dearth of engagement with the ethical and theoretical underpinnings of PPI processes and practices. More specifically, while there is a small (but growing) body of literature examining the effectiveness and impact of PPI, there has been (...) relatively little reflection on whether the concept/practice of PPI is internally coherent. Here, the authors unpick a ‘paradox’ within PPI, which highlights a tension between its moral and pragmatic motivations and its implementation. The authors argue that this ‘professionalisation paradox’ means we need to rethink the practice, and purpose, of PPI in research. (shrink)

Climate change has substantial impacts on public health and safety, disease risks and the provision of health care, with the poor being particularly disadvantaged. Management of the associated health risks and changing health service requirements requires adequate responses at local levels. Health-care providers are central to these responses. While climate change raises ethical questions about its causes, impacts and social justice, medicine and bioethics typically focus on individual patients and research participants rather than these broader issues. We broaden this focus (...) by examining awareness among health-care providers in the Caribbean region, where geographic and socioeconomic features pose particular vulnerabilities to climate change. In focus groups, Caribbean providers described rises in mosquito-borne, flood-related, heat-related, respiratory and mental illnesses, and attributed these to local impacts of climate change. Their discussions showed that the significance of these impacts differs in different Caribbean nations, raising policy and social justice questions. Bioethics and public health ethics are situated to frame, inform and initiate public and policy dialog about values and scientific evidence associated with climate change. We urge readers to initiate such dialog within their own institutions about the context-dependent nature of the burdens of climate change, and values and policies that permit it to worsen. (shrink)

Understanding dental ethics as a field separate from its much better known counterpart, medical ethics, is a relatively new, but necessary approach in bioethics. This need is particularly felt in dental education and establishing a curriculum specifically for dental ethics is a challenging task. Although certain topics such as informed consent and patient rights can be considered to be of equal importance in both fields, a number of ethical issues in dental practice are only remotely—if at all—relevant for medical practice. (...) Therefore, any sound approach to education in dental ethics has to recognise the unique aspects of dental practice in order to meet the needs of dental students and prepare them for the ethical challenges they may face during their professional practice. With this goal in mind, this paper examines the approach of the authors to dental ethics education and proposes a system to organise the topics of biomedical ethics for dental education. While the authors' perspective is based on their experience in Turkey, the proposed system of classification is not a rigid one; it is open to interpretation in other contexts with different social, cultural and professional expectations. Therefore, the paper also aims to inspire discussion on the development of an ideal dental ethics curriculum at an international level. (shrink)

It is still remarkably difficult for public health officials charged with developing and implementing pandemic influenza preparedness plans at the community levelto obtain clear, concrete, and consistent guidance on how to construct plans that are both ethical and actionable. As of mid-2007, most of the federal and state pandemic plans filed with the Centers for Disease Control and Prevention, describing how public health officials will coordinate public agencies and private entities in the event of an outbreak, failed to include ethical (...) guidance for first responders responsible for providing essential services and making fair decisions during a public health emergency. (shrink)

John MacFarlane argues against objectivism about “tasty”/”not tasty” in the following way. If objectivism were true then, given that speakers use “tasty”/”not tasty” in accordance with a rule, TP, speakers would be using an evidently unreliable method to form judgements and make claims about what is tasty. Since this is implausible, objectivism must be false. In this paper, I describe a context in which speakers deviate from TP. I argue that MacFarlane's argument against objectivism fails when applied to uses of (...) “not tasty” within this context. So objectivism about “not tasty” is still a viable position within this context. (shrink)

Se examinan las diversas modalidades de la nada como casos de pérdida del sentido y falta de consumación del conocimiento: la nada como noúmeno y su relación con el fenómeno, así como la conexión trascendental de ambos. Aunque la nada pone en jaque al concepto de sentido, este se encuentra supuesto antes de todo tipo de pregunta por el ser, y se constituye en el trasfondo de las condiciones trascendentales que posibilitan el conocimiento. Various modes of non-being are examined as (...) cases of loss of sense and as a lack of consummation of knowledge: non-being as noumena and its relationship with the phenomena, as well as the transcendental connection between them. Although non-being makes the concept of sense doubtful, it is presupposed before any kind of question regarding being and it is constituted in the background which belongs to the transcendental conditions which make knowledge possible. (shrink)

We show that the elementary theory of the recursively enumerable tt-degrees has the same computational complexity as true first-order arithmetic. As auxiliary results, we prove theorems about exact pairs and initial segments in the tt-degrees.

Held on Monday 12th October 2009, 5.30 - 7.00 pm, University of St Andrews, Scotland. Participants Dr Robert Sinnerbrink (Philosophy, Macquarie University, Sydney, Australia) Dr John Mullarkey (Philosophy, University of Dundee) Professor Berys Gaut (Philosophy, University of St Andrews) Dr David Martin-Jones (Film Studies, University of St Andrews) Dr William Brown (Film Studies, University of St Andrews)Over the course of at least the last hundred years the intellectual study of cinema has experienced a number of shifts towards and away from (...) theoretical or philosophical attempts to understand the moving image. The twenty-first century sees film-philosophy resurgent, in part due to the interest in cinema that has flourished recently in disciplines like philosophy, and in part due to the interdisciplinary nature of Film Studies. At a time when it is increasingly in vogue to return to theoretical questions previously pushed off the agenda by the dominance of historical approaches to cinema, such as the perennial "What is Cinema?", we are taking this opportunity to ask, "What is Film-Philosophy?" In a context that is witnessing the rise of digital cinema, the global dominance of multi-national media conglomerates, and the worldwide spread of "world cinemas", what role does theory or philosophy play in helping us understand cinema, and indeed, what role can cinema play in transforming philosophy? [The audio recording is of variable quality as we have had to remove a lot of background hiss and static. Please accept our apologies] Thanks to Rachel Brewster at Liverpool John Moores University for extracting the original audio. (shrink)

Background In 2002, Belgium set a legal framework for euthanasia, whereby granting and performing euthanasia is entrusted entirely to physicians, and—as advised by Belgian Medical Deontology—in the context of a trusted patient–physician relationship. Euthanasia is, however, rarely practiced, so the average physician will not attain routine in this matter. Aim To explore how general practitioners in Flanders (Belgium) deal with euthanasia. This was performed via qualitative analysis of semistructured interviews with 52 general practitioners (GPs). Results Although GPs can understand a (...) patient's request for euthanasia, their own willingness to perform it is limited, based on their assumption that legal euthanasia equates to an injection that ends life abruptly. Their willingness to perform euthanasia is affected by the demanding nature of a patient's request, by their views on what circumstances render euthanasia legitimate and by their own ability to inject a lethal dose. Several GPs prefer increasing opioid dosages and palliative sedation to a lethal injection, which they consider to fall outside the scope of euthanasia legislation. Conclusions Four attitudes can be identified: (1) willing to perform euthanasia; (2) only willing to perform as a last resort; (3) feeling incapable of performing; (4) refusing on principle. The situation where GPs have to consider the request and—if they grant it—to perform the act may result in arbitrary access to euthanasia for the patient. The possibility of installing transparent referral and support strategies for the GPs should be further examined. Further discussion is needed in the medical profession about the exact content of the euthanasia law. (shrink)

Population-based research is enhanced by biological measures, but biological sampling raises complex ethical issues. The third British National Survey of Sexual Attitudes and Lifestyles (Natsal-3) will estimate the population prevalence of five sexually transmitted infections (STIs) (Chlamydia trachomatis, Neisseria gonorrhoeae, human papillomavirus (HPV), HIV and Mycoplasma genitalium) in a probability sample aged 16–44 years. The present work describes the development of an ethical approach to urine testing for STIs, including the process of reaching consensus on whether to return results. The (...) following issues were considered: (1) testing for some STIs that are treatable and for which appropriate settings to obtain free testing and advice are widely available (Natsal-3 provides all respondents with STI and healthcare access information), (2) limits on test accuracy and timeliness imposed by survey conditions and sample type, (3) testing for some STIs with unknown clinical and public health implications, (4) how a uniform approach is easier to explain and understand, (5) practical difficulties in returning results and cost efficiency, such as enabling wider STI testing by not returning results. The agreed approach, to perform voluntary anonymous testing with specific consent for five STIs without returning results, was approved by stakeholders and a research ethics committee. Overall, this was acceptable to respondents in developmental piloting; 61% (68 of 111) of respondents agreed to provide a sample. The experiences reported here may inform the ethical decision making of researchers, research ethics committees and funders considering population-based biological sampling. (shrink)

After 150 years of scientific developments, the periodic system of chemical elements is still an icon of modern science. Its resilience is striking. The icon used today by scientists and teachers is in fact the outcome of many rearrangements and reinterpretations by the scientific community during that period. This success is often explained as a result of the underlying atomic structure, discovered in the first decades of the 20th century, an explanation that completely neglects the fine structure of the process (...) of ongoing renegotiation and successive stabilizations. How did indeed contemporary scientists navigate in times of reinterpretation? The physicist Lise Meitner and the chemist Ida Noddack were, in different ways, involved in discoveries and interpretations of the periodic system. In 1934, as part of the celebration of the centenary of Dmitri Mendeleev's birth, they each published an article on the system: Meitner in Die Naturwissenschaften, and Noddack in Angewandte Chemie. These two articles, written from the perspectives of a nuclear physicist and a chemist experienced in searching for undiscovered elements, respectively, constitute excellent sources for understanding what new discoveries and insights meant for the meaning and value of the periodic system at the very beginning of the nuclear age in science. Through an analysis of the two contributions, we will argue that resilience is the foremost value of the periodic system. We will also discuss what this value means for the future of the periodic system and its representations. (shrink)