The four principles approach to biomedical ethics (4PBE) has, since the 1970s, been increasingly developed as a universal bioethics method. Despite its wide acceptance and popularity, the 4PBE has received many challenges to its cross-cultural plausibility. This paper first specifies the principles and characteristics of ancient Chinese medical ethics (ACME), then makes a comparison between ACME and the 4PBE with a view to testing out the 4PBE's cross-cultural plausibility when applied to one particular but very extensive and prominent cultural context. (...) The result shows that the concepts of respect for autonomy, non-maleficence, beneficence and justice are clearly identifiable in ACME. Yet, being influenced by certain socio-cultural factors, those applying the 4PBE in Chinese society may tend to adopt a "beneficence-oriented", rather than an "autonomy-oriented" approach, which, in general, is dissimilar to the practice of contemporary Western bioethics, where "autonomy often triumphs". (shrink)

Austin's lecture on this topic contributes little to the problem of freedom of the will, and so in my discussion of his ideas I shall stop short of the difficult part of that problem. His most important positive suggestion is that hypotheticals should be divided into two classes, conditionals and pseudo-conditionals. He claims that neglect of this distinction has been the cause of mistakes in certain forms of the dispositional analysis of the statement that an agent could have acted otherwise, (...) and he then goes on to criticise all forms of that analysis using arguments which do not depend on the difference between the two kinds of hypothetical.This discussion will be in two parts. In the first I shall take up Austin's distinction between conditionals and pseudos and criticise it and develop it at length, because it seems to me to be the most important thing in his lecture. Since I shall not have space for comment on fortuitous errors made by defenders of the dispositional analysis of the claim that an agent could have acted otherwise, I shall concentrate on the essential features of that analysis. (shrink)

The dispositional analysis of sentences ascribing powers and abilities to things and people runs into many difficulties. The situation is especially complex and confusing when such ascriptions are brought to bear on particular occasions, and carry some implication about the opportunities available on those occasions. Some of these difficulties are produced by superficial confusions, but I shall concentrate on those that beset any version of the dispositional analysis. Three difficulties will be examined, one presented by Lehrer, and two by Austin.Lehrer (...) presents his difficulty as a refutation of Moore's dispositional analysis of “X could have acted otherwise”, which was “If X had chosen, he would have acted otherwise”. I shall introduce his objection by relating it to the distinctions drawn in Part I.· Expressed in my terminology, his point is that Moore's analysis presupposes that choosing is not an S-factor, and yet it might conceivably be an S-factor. (shrink)

Since the discovery of incommensurability in ancient Greece, arithmeticism and geometricism constantly switched roles. After ninetieth century arithmeticism Frege eventually returned to the view that mathematics is really entirely geometry. Yet Poincaré, Brouwer, Weyl and Bernays are mathematicians opposed to the explication of the continuum purely in terms of the discrete. At the beginning of the twenty-first century ‘continuum theorists’ in France (Longo, Thom and others) believe that the continuum precedes the discrete. In addition the last 50 years witnessed the (...) revival of infinitesimals (Laugwitz and Robinson—non-standard analysis) and—based upon category theory—the rise of smooth infinitesimal analysis and differential geometry. The spatial whole-parts relation is irreducible (Russell) and correlated with the spatial order of simultaneity. The human imaginative capacities are connected to the characterization of points and lines (Euclid) and to the views of Aristotle (the irreducibility of the continuity of a line to its points), which remained in force until the ninetieth century. Although Bolzano once more launched an attempt to arithmetize continuity, it appears as if Weierstrass, Cantor and Dedekind finally succeeded in bringing this ideal to its completion. Their views are assessed by analyzing the contradiction present in Grünbaum’s attempt to explain the continuum as an aggregate of unextended elements (degenerate intervals). Alternatively a line-stretch is characterized as a one-dimensional spatial subject, given at once in its totality (as a whole) and delimited by two points—but it is neither a breadthless length nor the (shortest) distance between two points. The overall aim of this analysis is to account for the uniqueness of discreteness and continuity by highlighting their mutual interconnections exemplified in the nature of a line as a one-dimensional spatial subject, while acknowledging that points are merely spatial objects which are always dependent upon an extended spatial subject. Instead of attempting to reduce continuity to discreteness or discreteness to continuity, a third alternative is explored: accept the irreducibility of number and space and then proceed by analyzing their unbreakable coherence. The argument may be seen as exploring some implications of the view of John Bell, namely that the “continuous is an autonomous notion, not explicable in terms of the discrete.” Bell points out that initially Brouwer, in his dissertation of 1907, “regards continuity and discreteness as complementary notions, neither of which is reducible to each other.”. (shrink)

THE LEFT AND RIGHTS: A CONCEPTUAL ANALYSIS OF SOCIALIST RIGHTS by Tom Campbell Boston: Routledge and Kegan Paul, 1983. 296 pp., $12.95 Campbell's attempt to construct a socialist version of rights and the rule of law fails because it does not draw on individualism. Campbell's positive rights are ineffective barrien to both the schemes of Utopian visionaries who command political authority and more mundane sources of the abuse of power. He leaves unanswered the question of who will determine the extent (...) of the ?needs?; that would constitute socialist rights, in the absence of unlimited resources to fulfill them. And his rejection of individualism ¡eaves him no means of adjudicating among conflicting positive claim?rights. (shrink)

I have argued in other work that emotion, attentional functions, and executive functions are three interpenetrant global state variables, essentially differential slices of the consciousness pie. This paper will outline the columnar architecture and connectivities of the PAG (periaqueductal gray), its role in organizing prototype states of emotion, and the re-entry of PAG with the extended reticular thalamic activating system (“ERTAS”). At the end we will outline some potential implications of these connectivities for possible functional correlates of PAG networks that (...) are just starting to be mapped. Overall, we will look at many lines of evidence that PAG should be conceptualized as a peri-reticular structure that has a foundational role in emotion, in generating the meaningful organization of behavior by the brain through prototype emotional states, and in allowing the various emotional systems to globally influence and tune both the forebrain and brainstem. Finally, we address implications of these concepts for what is currently understood about consciousness, underlining the need for somewhat more humility within consciousness studies about our current level of understanding of consciousness in the brain, combined with a deeper appreciation of the intrinsic connections between emotion and consciousness. One hopes that more concerted empirical interest in structures underneath the thalamus, combined with a deeper appreciation for the fundamental role that organismic and social value must have in bootstrapping awareness in the developing brain, would begin more widely to influence the fundamental lines of neuroscientific research in both emotion studies and consciousness studies. (shrink)

The dissemination of information about patients through computers and multidisciplinary teams involves departures from traditional tenets of confidentiality. This raises ethical problems, exemplified by current practices in child health. In multidisciplinary teams, problems may arise because different professions utilise different types of data. Some team members may not appreciate the extent to which data may be unscientific and judgmental. Children and thier families may be labelled, without justification, preventing objective reappraisal. The ethical and legal implications are considered. Practice may not (...) conform to principles of natural justice, for example when care orders are sought. Obligations to the State may also imperil the confidentiality of the doctor-patient relationship, and of medical records, the legal status of which is confused and requires clarification. Allowing patients access to their records could be a useful safeguard, and the medical profession should devise alternatives should it not be accepted. (shrink)

In the March 1982 issue of the Journal Dr Pheby, a community health doctor, was one of several writers to discuss medical confidentiality. Dr Pheby urged doctors to minimise subjective and judgmental comments in medical records and to make clear when their assessments were speculative. He also urged `vigorous reappraisal of the extent to which information about a patient needs to be circulated' to members of other disciplines, for instance, in child health practice. If doctors did not take such steps (...) themselves legal changes might well be imposed upon them, giving patients the right of access to their medical records and perhaps making breach of medical confidentiality a criminal offence. Mr Jacob, a lawyer, commenting on the papers by Dr Pheby and Mr Kenny, a health administrator, argued that increased legal intervention in medical ethics could quite possibly actually erode traditional medical ethical standards of confidentiality based on peer review and `the ethic of virtue'. (shrink)

This paper examines whether the modern bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice proposed by Beauchamp and Childress are existent in, compatible with, or acceptable to the leading Chinese moral philosophy—the ethics of Confucius. The author concludes that the moral values which the four prima facie principles uphold are expressly identifiable in Confucius’ teachings. However, Confucius’ emphasis on the filial piety, family values, the “love of gradation”, altruism of people, and the “role specified relation oriented ethics” will (...) inevitably influence the “specification” and application of these bioethical principles and hence tend to grant “beneficence” a favourable position that diminishes the respect for individual rights and autonomy. In contrast, the centrality of respect for autonomy and its stance of “first among equals” are more and more stressed in Western liberal viewpoints. Nevertheless, if the Confucian “doctrine of Mean” and a balanced “two dimensional personhood” approach are properly employed, this will require both theorists and clinicians, who are facing medical ethical dilemmas, of searching to attain due mean out of competing moral principles thus preventing “giving beneficence a priority” or “asserting autonomy must triumph”. (shrink)

The name of A. M. Gorky is known to the broad masses of the people of our country, to the laboring population of the countries of the socialist camp, and to all advanced and progressive mankind as that of one of the greatest builders of the new socialist culture and a tireless fighter for the bright ideals of mankind. By his writings of genius, his brilliant articles of literary criticism, his speeches and public affairs writing, and all his many-faceted activity, (...) both prior to the Great October Socialist Revolution and in the epoch of transition from capitalism to socialism, Gorky made a truly invaluable contribution to the treasury of world culture. He defined the place and role of culture in the life of modern society and broke new ground for the progressive development of culture in terms of the principles of socialism and communism. There is hardly a single problem of socialist culture, of its theory and practice, with which Gorky did not concern himself one way or another, and upon the handling of which, even if his contact with it was accidental, he did not lay the unique imprint of his genius. (shrink)

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Children, because of age-related reasons, are a vulnerable population, and protecting their health is a social, scientific and emotional priority. The increased susceptibility of children and fetuses to environmental agents has been widely discussed by the scientific community. Children may experience different levels of chemical exposure than adults, and their sensitivity to chemical toxicities may be increased or decreased in comparison with adults. Such considerations also apply to unborn and newborn children. Therefore, research on children is necessary in both clinical (...) and environmental fields, to provide age-specific relevant data regarding the efficacy and safety of medical treatments, and regarding the assessment of risk from unintended environmental exposure. In this context, the stakeholders are many, including children and their parents, physicians and public health researchers, and the society as a whole, with its ethical, regulatory, administrative and political components. The important ethical issues are information of participants and consent to participate. Follow-up and protection of data should be discussed in the context of biobanks, where children obtain individual rights when they become adults. It is important to realise that there are highly variable practices within European countries, which may have, in the past, led to differences in practical aspects of research in children. A number of recommendations are provided for research with children and environmental health. Environmental research with children should be scientifically justified, with sound research questions and valid study protocols of sufficient statistical power, ensuring the autonomy of the child and his/her family at the time of the study and later in life, if data and samples are used for follow-up studies. When children are enrolled, we recommend a consent dyad, including parental informed consent and the child’s assent and/or informed consent from older minors. For evaluation of the studies including children, a paediatrician should always be involved in the research ethics committee. (shrink)

Filosofische beschouwingen over de ontwikkeling van het volkenrechtelijke begrip mensenrechten.