Medical aid in dying (MAiD), despite being legal in many jurisdictions, remains controversial ethically. Existing surveys of physicians’ perceptions of MAiD tend to focus on the legal or moral permissibility of MAiD in general. Using a novel sampling strategy, we surveyed physicians likely to have engaged in MAiD-related activities in Colorado to assess their attitudes toward contemporary ethical issues in MAiD.

While acknowledging the potential benefits of pharmacogenomics as a methodology, a number of comprehensive reports in the past several years examine a multitude of ethical, legal, and social factors that may limit the extent to which these benefits are realized — and realized in ethically acceptable ways. This article aims to identify and explore the most basic ethical and regulatory issues that are likely to arise if pharmacogenomics becomes widely enough used to have a significant impact on research and clinical (...) practice. First, however, it addresses the question of whether pharmacogenomic tests are unique when compared to other genetic tests and thus deserving of more or less stringent ethical and regulatory requirements. (shrink)

Global short-term medical volunteerism is growing, and properly conducted, is a tool in the fight for greater global health equity. It is intrinsically ethical (i.e., it involves ethics at every step) and depends upon ethical conduct for its success. At present, ethical guidelines remain in their infancy, which presents a unique opportunity. This paper presents a set of basic ethical principles, building on prior work in this area and previously developed guidelines for international clinical research. The content of these principles, (...) and the benchmarks used to evaluate them, remain intentionally vague and can only be filled by collaboration with those on-the-ground in local communities where this work occurs. Ethical review must additionally take into consideration the different obligations arising from the type of institution, type of intervention, and type of relationship involved. This paper argues that frequent and formalized ethical review, conducted from the beginning with the local community (where this community helps define the terms of debate), remains the most important ethical safeguard for this work. (shrink)

There are several reasons for the current prominence of global health issues. Among the most important is the growing awareness that some risks to health are global in scope and can only be countered by global cooperation. In addition, human rights discourse and, more generally, the articulation of a coherent cosmopolitan ethical perspective that acknowledges the importance of all persons, regardless of where they live, provide a normative basis for taking global health seriously as a moral issue. In this paper (...) we begin the task of translating the vague commitment to doing something to improve global health into a coherent set of more determinate obligations. One chief conclusion of our inquiry is that the responsibilities of states regarding global health are both more determinate and more extensive than is usually assumed. We also argue, however, that institutional innovation will be needed to achieve a more comprehensive, fair distribution of concrete responsibilities regarding global health and to provide effective mechanisms for holding various state and nonstate actors accountable for fulfilling them. (shrink)

Contemporary medical practice and health policy are increasingly animated by the concept of providing high value care. Nevertheless, there can be disagreements about how value is defined and from whose perspective. Individual patients suffering from terminal cancer, for example, may have a different perception of the value of an expensive chemotherapy when compared to health policymakers, insurers, or others responsible for the financial solvency of health care organizations. Thus it seems reasonable to ask what is meant by “value” in high (...) value care. In light of Edmund Pellegrino’s significant contributions to the philosophy of medicine, medical humanities, and bioethics, it seems equally reasonable to examine how he might answer it. This paper describes a Pellegrino-inspired theory of value that is instrumental, agent relative, and pluralistic. It then compares and contrasts this to the contemporary view and argues that only when individual patients incorporate concern for societal-level value into their conceptions of the highest good can the Pellegrino-inspired and contemporary views of value be reconciled. (shrink)

The UN Convention against Torture defines torture as “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person” by someone acting in an official capacity for purposes such as obtaining a confession or punishing or intimidating that person.1 It is unethical for healthcare professionals to participate in torture, including any use of medical knowledge or skill to facilitate torture or allow it to continue, or to be present during torture.2-7 Yet medical participation (...) in torture has taken place throughout the world and was a prominent feature of the US interrogation practice in military and Central Intelligence Agency (CIA) detention facilities in the years after the attacks of 11 September 2001.8-11 Little attention has been paid, however, to how a regime of torture affects the ability of health professionals to meet their obligations regarding routine clinical care for detainees. -/- The 2016 release of previously classified portions of guideline from the CIA regarding medical practice in its secret detention facilities sheds light on that question. These show that the CIA instructed healthcare professions to subordinate their fundamental ethical obligations regarding professional standards of care to further the objectives of the torturers. (shrink)

OBJECTIVE: How outside factors affect physician decision making remains an open question of vital importance. We sought to investigate the importance of various influences on physician decision making when clinical guidelines differ from patient preference. -/- METHODS: An online survey asking 469 primary care providers (PCPs) across four practice sites whether they would order magnetic resonance imaging for a patient with uncomplicated back pain. Participants were randomized to one of four scenarios: a patient's preference for imaging (control), a patient's preference (...) plus a colleague's opinion against imaging (colleague), a patient's preference plus a professional society's recommendation against imaging (profession), or a patient's preference plus an accountable care organization's quality metric that measures physician use of imaging (ACO). Demographic information and the reasoning behind participants' decisions also were obtained. -/- RESULTS: A total of 168 PCPs completed the survey, yielding a 36% completion rate. A majority chose not to pursue imaging: control 68%, colleague 85%, profession 87%, and ACO 78%. Multivariate logistic regression revealed that participants were more likely not to order advanced imaging only when reminded of a professional society recommendation (P = 0.017). Regression also suggested that practice site exerted an effect on the primary outcome. Evidence-based medicine and clinical judgment were the most cited reasons for the decision. -/- CONCLUSIONS: Our results reinforce the potential to leverage professional societies to advance evidence-based medicine and reduce unnecessary testing. At the same time, practice site appeared to exert influence, suggesting that these recommendations must be part of local institutional culture to be effective. (shrink)

The American Journal of Bioethics, Volume 12, Issue 8, Page 36-38, August 2012.

In this important study D. M. Armstrong offers a comprehensive system of analytical metaphysics that synthesises but also develops his thinking over the last twenty years. Armstrong's analysis, which acknowledges the 'logical atomism' of Russell and Wittgenstein, makes facts the fundamental constituents of the world, examining properties, relations, numbers, classes, possibility and necessity, dispositions, causes and laws. All these, it is argued, find their place and can be understood inside a scheme of states of affairs. This is a comprehensive and (...) rigorously this-worldly account of the most general features of reality, argued from a distinctive philosophical perspective, and it will appeal to a wide readership in analytical philosophy. (shrink)

" -- Africa Today "The excellence of this book lies in the wealth of perspectives that it brings to the discussion on what constitutes philosophy, rationality, ...

Authors philosophical notes on life, conduct of life from the perspective of a life.

A comprehensive introduction to the ways in which meaning is conveyed in language. Alan Cruse covers semantic matters, but also deals with topics that are usually considered to fall under pragmatics. A major aim is to highlight the richness and subtlety of meaning phenomena, rather than to expound any particular theory. Rich in examples and exercises, Meaning in Language provides an invaluable descriptive approach to this area of linguistics for undergraduates and postgraduates alike.

This book: * assumes no mathematical background and keeps the technicalities to a minimum * explains the most important applications of probability theory to ...

A record of the words and teachings of Confucius, _The Analects_ is considered the most reliable expression of Confucian thought. However, the original meaning of Confucius's teachings have been filtered and interpreted by the commentaries of Confucianists of later ages, particularly the Neo-Confucianists of the Song dynasty, not altogether without distortion.In this monumental translation by Professor D. C. Lau, an attempt has been made to interpret the sayings as they stand. The corpus of the sayings is taken as an organic (...) whole and the final test of the interpretation rests on the internal consistency it exhibits. In other words, _The Analects_ is read in the light of _The Analects._This results in a truer understanding of Confucius' thought than the traditional interpretation and paves the way for a re-assessment of its importance in the history of Chinese thought and its relevance to the present day world.This volume also contains an introduction to the life and teachings of Confucius, and three appendices on the events in the life of Confucius, on his disciples, and on the composition of _The Analects._. (shrink)

In this entry we provide a critical review of recent work on the nature and ethics of blame, including issues of moral standing.

In identifying that the 'essential tension' is the balance between conservative and innovative approaches in the development of knowledge - tried-and tested or new directions - Kuhn pointed out that these two attitudes are both appropriate. This study adds to this picture the social and psychological dynamics that underpin any such balancing.

The Greeks have long been regarded as innovators across a wide range of fields in literature, culture, philosophy, politics and science. However, little attention has been paid to how they thought and felt about novelty and innovation itself, and to relating this to the forces of traditionalism and conservatism which were also present across all the various societies within ancient Greece. What inspired the Greeks to embark on their unique and enduring innovations? How did they think and feel about the (...) new? This book represents the first serious attempt to address these issues, and deals with the phenomenon across all periods and areas of classical Greek history and thought. Each chapter concentrates on a different area of culture or thought, while the book as a whole argues that much of the impulse towards innovation came from the life of the polis which provided its setting. (shrink)

Abstract:Contemporary common sense holds that authenticity is an ethical ideal: that there is something bad about inauthenticity, and something good about authenticity. Here we criticize the view that authenticity is bad because it detracts from the wellbeing of the inauthentic person, and propose an alternative moral account of the badness of inauthenticity, based on the idea that inauthentic behaviour is potentially misleading.

In Rationalities in history, the distinguished historian David d'Avray writes a new comparative history in the spirit of Max Weber. In a strikingly original reassessment of seminal Weberian ideas, d'Avray applies value rationality to the comparative history of religion and the philosophy of law. Integrating theories of rational choice, anthropological reflections on relativism, and the recent philosophy of rationality with Weber's conceptual framework, d'Avray seeks to disengage 'rationalisation' from its enduring association with Western 'modernity.' This mode of analysis is contextualised (...) through the examples of Buddhism, Imperial China, and sixteenth-century Catholicism--in the latter case building upon unpublished archival research. This ambitious synthesis of social theory and comparative history will engage social scientists and historians from advanced undergraduate level upwards, stimulating interdisciplinary discourse, and making a significant contribution to the methodology of history. D'Avray explores the potential of this new Weberian analysis further in his companion volume, Medieval religious rationalities"--Provided by publisher. (shrink)

The verb 'imagine' admits of perspectival modification: we can imagine things from above, from a distant point of view, or from the point of view of a Russian. But in such cases, there need be no person, either real or imagined, who is above or distant from what is imagined, or who has the point of view of a Russian. We call this the puzzle of perspectival displacement. This paper sets out the puzzle, shows how it does not just concern (...) language, but also states of imagining themselves, and then presents a solution. The solution draws on the idea that many reports of imagining conceal a distinctive kind of question, and such concealed questions have an extra argument place for (what we will call) an experiencer from whose perspective things are imagined. This solution has a range of advantages over other proposals in the literature, and helps to advance two debates concerning perspectival engagement with fiction. (shrink)

This paper is an original attempt to understand the foundations of economic reasoning. It endeavors to rigorously define the relationship between subjective interpretations and objective valuations of such interpretations in the context of theoretical economics. This analysis is substantially expanded through a dynamic approach, where the truth of a valuation results in an updated interpretation or changes in the agent's subjective belief regarding the effectiveness of the selected action as well as the objective reality of the effectiveness of all other (...) possible actions (i.e. consequence realization). Complications arise when the economic agent is presented with a set of actions that render ambiguous preference, or when the effectiveness of an action cannot be perceived upon its selection, thereby necessitating a different theory of choice and consequence realization. (shrink)

Classical treatise on Advaita Ontology; critical edition with commentary and supercommentaries.

In diesem Band deckt Diego D'Angelo semiotische Strukturen in der Husserl’schen Phänomenologie der Wahrnehmung auf. Ist es der Phänomenologie darum zu tun, die Erfahrung von Dingen in unserer Umwelt zu beschreiben, so ist dabei der Begriff des Horizontes von zentraler Bedeutung: Was wir unmittelbar wahrnehmen, verweist immer schon auf anderes, was nur „mitgegeben“ ist. Wenn wir Dinge wahrnehmen, haben wir nur eine bestimmte Perspektive, d.h. wir sehen lediglich einen Aspekt. Aber wir nehmen immer ganze Gegenstände wahr (wir sehen Tische und (...) Stühle und andere Menschen). Jeder dieser Gegenstände erscheint in einem Feld weiterer Gegenstände, und es ist der Horizontbegriff, der es erlaubt, das Verhältnis zwischen Selbstgegebenheit und Mitgegebenheit zu explizieren. Dieses Buch stellt den ersten detaillierten Versuch dar, die Ursprünge solcher horizontaler Felder in semiotischen Strukturen zu suchen. Aus der Verbindung zwischen Husserls eigener Semiotik und seiner Phänomenologie der Wahrnehmung ergibt sich, dass das wahrgenommene Phänomen als Zeichen verstanden werden muss. Das Zeichen wiederum bezeichnet etwas, was in leiblicher Bewegung eingeholt werden kann. Mit der Verbindung von Leiblichkeit, Semiotik und Wahrnehmung thematisiert diese Monographie das Verhältnis zwischen folgenden phänomenologischen Forschungsgebieten: • Husserls Semiotik der Wahrnehmung in den Logischen Untersuchungen • Phänomenologische Raumanalyse – kinästhetische Indikation • Horizont und Noema • Passive Anzeige • Zeichen und Leiblichkeit als Grundlagen der Fremderfahrung • Genetische Phänomenologie und Semiotik der Erfahrung • Protentionen und teleologische Semiose • Induktion und Ursprung des menschlichen Ichs Das Buch eröffnet die Möglichkeit, Husserls Phänomenologie jenseits einer Metaphysik der Präsenz zu verstehen. Zudem leisten D'Angelos Einzeluntersuchungen einen Beitrag zu aktuellen Diskussionen in der Philosophie der leiblichen Kognition. – Eine hilfreiche Leseempfehlung für • Interessierte Themenneulinge • Bachelor- und Masterstudenten der Geisteswissenschaften • Hochschulabsolventen sowie Forschungswissenschaftler. (shrink)

The theme of the relationship between art and society is certainly not a central topic in the aesthetic reflection of Italian neo-idealism. Neither in Croce nor in Gentile it is ever discussed at length, and the few writings in which it is addressed are brief and polemically oriented. This essay, however, proposes to discuss the few hints present in Croce and Gentile on this subject. First, the debate on the materialistic interpretation of history will be examined, to which both Croce (...) and Gentile made important contributions at the end of the 19th century. Secondly, Croce’s own way of doing the history of literature will be discussed, showing the differences that distance him from the Desanctisian model and also from the model derived from the Hegelian Aesthetics. Croce’s way of making history of literature, indeed, aroused harsh criticism after World War II and provoked a request for a “return to De Sanctis”.Finally, but the theme will be only hinted at in the essay, a brief reference will be proposed to the opinions of Antonio Gramsci and his reading of Croce. (shrink)