A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. Within moral case deliberation, healthcare professionals (...) bring in their actual moral questions during a structured dialogue. The ethicist facilitates the learning process by using various conversation methods in order to find answers to the case and to develop moral competencies. The case deliberations are not unique events, but are a structural part of the professional training on the work floor within healthcare institutions. This article presents the underlying theory on ethics and illustrates this approach with an example of a moral case deliberation project in a Dutch psychiatric hospital. The project was evaluated using the method of responsive evaluation. This method provided us with rich information about the implementation process and effects the research process itself also lent support to the process of implementation. (shrink)

This paper notes how Jim influenced my own use of Foucault and also focuses on two of James Marshall's New Zealand oriented texts. In the first, Discipline and Punishment in New Zealand Education he provides a Foucauldian genealogy of New Zealand approaches to both punishment and discipline, in particular corporal punishment. The second, his 1996 book co‐written with Michael Peters, Individualism and Community: Education and Social Policy in the Postmodern Condition, analyses political philosophy and social and educational policy as New (...) Zealand changed from being a welfare state since the 1930s to a neoliberal one since the mid 1980s. Foucauldian understandings about power, bio‐power, governmentality, autonomy and subjectivity are brought to bear in their analysis. (shrink)

Purpose: Explore public attitudes towards the trade-offs between justice and medical outcome inherent in organ allocation decisions.Background: The US Task Force on Organ Transplantation recommended that considerations of justice, autonomy and medical outcome be part of all organ allocation decisions. Justice in this context may be modeled as a function of three types of need, related to age, clinical urgency, and quality of life.Methods: A web-based survey was conducted in which respondents were asked to choose between two hypothetical patients who (...) differed in clinical urgency , age, pretransplant and post-transplant quality of life, and life expectancy.Results: A pool of 1600 people were notified via email about the survey; 623 responded. Respondents preferred giving organs to younger people up to an age difference of <15.4 years and more clinically urgent people up to a difference in urgency of <2.54 months . Priority varied with the quality of life of the worst-off patient and the relative status of the patients. If both had worse than average quality of life, respondents preferred the better-off patient. When both had better than average quality of life, they preferred the worse-off patient. In analysis according to age versus clinical urgency, the older the patient, the more urgency needed to receive priority. In quality of life versus clinical urgency, the better the control’s quality of life, the more urgency the competing patient required. The worse the patient’s post-transplant outcome, the more urgency needed to receive priority.Conclusions: It appears that clinical urgency is only one of many factors influencing attitudes about allocation decisions and that respondents may invoke different principles of fairness depending the relative clinical status of patients. (shrink)

The following notes are the result of an examination of all the early Epic passages containing λλ which I made for the purposes of the lexicon of Homer and the older Epic now under preparation by the Archiv für griechische Lexikographie at Hamburg. The texts surveyed were Homer, including the Hymns, Hesiod, and the Epic fragments. I also examined Apollonius Rhodius for the purpose of comparison.

This article is a discussion of the relationships of objectivity of value with subjectivist and naturalist ethics. the author considers and clarifies both the subjectivist and the naturalist views of ethics and how they assert judgments in relation to the objectivity of ethical values, and the role of intuition in terms of achievement of agreement that affirms the objectivity of ethical values. (staff).