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This chapter contains sections titled: The Tree and the Bean The Taste Test A Way Out of Relativism Other Considerations Try It Yourself!

Background: In the last two decades, nursing authors have published ethical analyses of palliative sedation—an end-of-life care practice that also receives significant attention in the broader medical and bioethics literature. This nursing literature is important, because it contributes to disciplinary understandings about nursing values and responsibilities in end-of-life care. Research aim: The purpose of this project is to review existing nursing ethics literature about palliative sedation, and to analyze how nurses’ moral identities are portrayed within this literature. Research design: We (...) reviewed discussion papers, written by nurses about the ethics of palliative sedation, which were cited in MEDLINE, CINAHL, Nursing and Allied Health, or Philosopher’s Index (search date March 2018). Twenty-one papers met selection criteria. We performed a comprehensive review and analysis (using the Qualitative Analysis Guide of Leuven), of the values, responsibilities, and relationships reflected in authors’ portrayal of the nursing role. Findings: Two different tones are apparent in the extant nursing ethics literature. One is educational, while the other is critically reflective. Irrespective of tone, all authors agree on the alleviation of suffering as a fundamental nursing responsibility. However, they differ in their analysis of this responsibility in relation to other values in end-of-life care, including those that depend on consciousness. Finally, authors emphasize the importance of subjective and experience-based understandings of palliative sedation, which they argue as depending on nurses’ proximity to patients and families in end-of-life care. Discussion and conclusion: Based on our findings, we develop three recommendations for future writing by nurses about palliative sedation. These relate to the responsibility of recognizing how consciousness might matter in (some) peoples’ moral experiences of death and dying, to the importance of moral reflectiveness in nursing practice, and to the value of a relational approach in conceptualizing the nursing ethics of palliative sedation. (shrink)

Postmodern art theory is an anomaly in the history of art theory.

Delirium, a common syndrome in terminally ill people, presents specific challenges to a good death in end‐of‐life care. This paper examines the relational engagement between hospice nurses and their patients in a context of end‐of‐life delirium. Ethnographic fieldwork spanning 15 months was conducted at a freestanding residential hospice in eastern Canada. A shared value system was apparent within the nursing community of hospice; patients’ comfort and dignity were deemed most at stake and therefore commanded nurses’ primary attention. This overarching commitment (...) to comfort and dignity shaped all of nursing practice in this hospice, including practices related to end‐of‐life delirium. The findings of this study elaborate the ways in which hospice nurses interpreted and responded to the discomfort of their patients in delirium, as well as the efforts they made to understand their patients’ subjective experiences and to connect with them in supportive ways. In addition to what is already known about clinical assessment and treatment of delirium in palliative care settings, the findings of this study offer points of reflection for nurses anywhere who are contending with the relational challenges that delirium presents in end‐of‐life care. (shrink)

Background: Legislative changes are resulting in assisted death as an option for people at the end of life. Although nurses’ experiences and perspectives are underrepresented within broader ethical discourses about assisted death, there is a small but significant body of literature examining nurses’ experiences of caring for people who request this option. Aim: To synthesize what has been learned about nurses’ experiences of caring for patients who request assisted death and to highlight what is morally at stake for nurses who (...) undertake this type of care. Design: Qualitative meta-synthesis. Methods: Six databases were searched: CINAHL, Medline, EMBASE, Joanna Briggs Institute, PsycINFO, and Web of Science. The search was completed on 22 October 2014 and updated in February 2016. Of 879 articles identified from the database searches, 16 articles were deemed relevant based on inclusion criteria. Following quality appraisal, 14 studies were retained for analysis and synthesis. Results: The moral experience of the nurse is defined by a profound sense of responsibility, shaped by contextual forces that nurses navigate in everyday end-of-life care practice, and sustained by intra-team moral and emotional support. Discussion: The findings of this synthesis support the view that nurses are moral agents who are deeply invested in the moral integrity of end-of-life care involving assisted death. The findings further demonstrate that to fully appreciate the ethics of assisted death from a nursing standpoint, it is necessary to understand the broader constraints on nurses’ moral agency that operate in everyday end-of-life care. Ethical considerations: Research ethics board approval was not required for this synthesis of previously published literature. Conclusion: In order to understand how to enact ethical practice in the area of assisted death, the moral experiences of nurses should be investigated and foregrounded. (shrink)

In a fictional conversation designed to appeal to both working teachers and social philosophers, three educators take up the question of whether critical thinking itself can, or should, be taught independently of an explicit consideration of issues related to social justice. One, a thoughtful but somewhat traditional Enlightenment rationalist, sees critical thinking as a neutral set of skills and dispositions, essentially unrelated to the conclusions of morality, problems of social organization, or the content of any particular academic discipline. A second (...) interlocutor, steeped in “critical” pedagogy of Paulo Freire, insists that the problem is the pose of neutrality itself. On this view, all honest and effective approaches to teaching must confront the hegemony of unjust relationships, institutions, and conceptual schemes. The third character attempts to resolve the tension between these two opposed camps. (shrink)

In a fictional conversation designed to appeal to both working teachers and social philosophers, three educators take up the question of whether critical thinking itself can, or should, be taught independently of an explicit consideration of issues related to social justice. One, a thoughtful but somewhat traditional Enlightenment rationalist, sees critical thinking as a neutral set of skills and dispositions, essentially unrelated to the conclusions of morality, problems of social organization, or the content of any particular academic discipline. A second (...) interlocutor, steeped in “critical” pedagogy of Paulo Freire, insists that the problem is the pose of neutrality itself. On this view, all honest and effective approaches to teaching must confront the hegemony of unjust relationships, institutions, and conceptual schemes. The third character attempts to resolve the tension between these two opposed camps. (shrink)

This dialogue discusses a proposal for the legalization of torture under specific circumstances and contrasts it with arguments for a total ban on torture. We consider three types of objection: first, that the difficulty of having adequate knowledge renders the stock “ticking bomb” scenario such a low-probability hypothetical as to present no realistic threat to a policy banning all torture; second, that empirically the information gleaned from torture is so unlikely to be reliable that it could not justify the moral (...) risk; and third, that sanctioning torture, even if only under the most extreme circumstances, would generate a ‘culture of torture,’ hence undermining fragile advances in international human rights rooted in unwavering commitment to human dignity. Compelling as these arguments appear, not all the conversants are wholly convinced by them; to this extent the dialogue ends aporetically. (shrink)

This dialogue discusses a proposal for the legalization of torture under specific circumstances and contrasts it with arguments for a total ban on torture. We consider three types of objection: first, that the difficulty of having adequate knowledge renders the stock “ticking bomb” scenario such a low-probability hypothetical as to present no realistic threat to a policy banning all torture; second, that empirically the information gleaned from torture is so unlikely to be reliable that it could not justify the moral (...) risk; and third, that sanctioning torture, even if only under the most extreme circumstances, would generate a ‘culture of torture,’ hence undermining fragile advances in international human rights rooted in unwavering commitment to human dignity. Compelling as these arguments appear, not all the conversants are wholly convinced by them; to this extent the dialogue ends aporetically. (shrink)

ObjectivesIn 2015, the Province of Quebec, Canada passed a law that allowed voluntary active euthanasia. Palliative care stakeholders in Canada have been largely opposed to euthanasia, yet there is little research about their views. The research question guiding this study was the following: How do palliative care physicians in Quebec position themselves regarding the practice of VAE in the context of the new provincial legislation?MethodsWe used interpretive description, an inductive methodology to answer research questions about clinical practice. A total of (...) 18 palliative care physicians participated in semistructured interviews at two university-affiliated hospitals in Quebec.ResultsParticipants positioned themselves in opposition to euthanasia. Their justifications were framed within their professional commitment to not hasten death, which sat in tension with the value of patients’ autonomy to choose how to die. Participants described VAE as unacceptable if it impeded opportunities to evaluate and alleviate suffering. Further, they contested government rhetoric that positioned VAE as a way to improve end-of-life care. Participants felt that VAE would diminish the potential of palliative care to relieve suffering. Dilemmas were apparent in their narratives, about reconciling respect for patient autonomy with broader palliative care values, and the value of accompanying and not abandoning patients who make requests for VAE while being committed to neither prolonging nor hastening death.ConclusionsThis study provides insight into nuanced positions of experienced palliative care physicians in Quebec and confirms expected tensions between an important stakeholder and the practice of VAE as guided by the new legislation. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Method in Ancient PhilosophyDavid K. GliddenJyl Gentzler, editor. Method in Ancient Philosophy. Oxford: Clarendon Press, 1998. Pp. viii + 398. Cloth, $72.00.The fifteen papers in this collection constitute revisions of conference proceedings and reflect the varied interests of participants. The ensemble exhibits a thoroughly modern methodology. Whatever and however various ancient methods of philosophy may have been, in Anglo-American scholarship it is standard practice to first address established (...) scholarly interpretations as the primary entry point to critical discussionóoften displacing antiquity with a critical vocabulary of philosophical modernity. Scholars may come to understand each other better, but at the risk of asking the wrong questions or sacrificing ancient texts themselves as mere means of producing papers.Most scholars are progressives. They believe philosophy has advanced past the comparatively primitive wisdom of antiquity, and so such scholars feel perfectly entitled to make better sense of ancient texts, by patiently explaining what the ancients would have meant had they only been able to get it right. There are, of course, exceptions. And some papers in this collection suggest deeper faith in our philosophic fathers. So, the battle between the ancients and the moderns is joined once more, between those who would adorn their papers with footnotes for their peers and those who would attempt more anthropological an inquiry into ancient philosophic practices.Ian Mueller and Robert Bolton each address the same passage in Plato's Phaedo, both beginning with an article from Vlastos, first published in 1969. Mueller thoughtfully explores three different yet related accounts of what we might call scientific method in explaining Plato's views on natural change. Bolton wonders whether scholars are asking the wrong questions. Patricia Curd attempts a progressivist account of Eleatic thought, notwithstanding her recognition of the paucity of ancient sources. Complete with elaborately numbered sentences, Gail Fine focuses primarily on Burnyeat (1976) on Plato on Protagoras. Constance Meinwald presents a rather near-sighted account of two passages in the Philebus that employ the peras-apeiron distinction, with a view toward Plato's allegedly modernist mathematization of understanding. Lesley Brown revisits five pages of the Sophist that were hotly debated in the 1960s. With charity and elegance, she offers several plausible solutions to puzzles posed by previous scholars. Sometimes time smoothes over differences.A. A. Long's essay on Plato's presentation of Socrates in the Theaetetus might appear more philosophically anthropological. Yet Long reveals progressive sympathies, suggesting that Plato dispatches Socrates in the Theaetetus, so as to prepare the way for a more rigorously academic form of philosophizing, such as that exhibited in the Sophist. [End Page 111] In this way, Long speculates, Plato abandoned practical ethics for the academic life of research, so familiar to university professors and conference participants. It might be hard to square such speculation with Plato's Laws and the reception of Plato's writings among his own contemporaries. Still, Socrates' shifting role in Plato's dialogues is well worth pondering.By comparison, T. H. Irwin's contribution is wonderfully old-fashioned. His paper addresses the background knowledge to be presumed by ancient readers of Plato's dialogues and how that knowledge is artfully put to use in Plato's depiction of Socrates' reflections on the unity of virtue. By speculating on Plato's relation to his ancient readers, Irwin displaces many modernist preoccupations, though not without himself falling victim to that peculiar scholarly obsession of dating Plato's dialogues by their doctrines.With characteristic conservatism, Gisela Striker cautions scholars not to over-read Aristotle's Prior Analytics. While that extraordinary work may have deep implications for the history of formal logic, it probably was instead intended to be part of a general account of argument. In a similar vein, Charlotte Witt attempts to rescue Aristotle from scholars who would delimit Aristotle's multifarious uses of the "for the sake of" explanation, which altogether pervade his metaphysics, physics, biology and ethics. Yet, Witt soon finds herself competing in a contest over interpretive distinctions, a sport that will certainly never capture Aristotle's own authorial intentions.Facing another mass of scholarship, in this case on Aristotle's dialectic, C. D. C. Reeve sensibly attempts to... (shrink)

One way to determine whether a mental condition should be considered a disorder is to first give necessary and sufficient conditions for something to be a disorder and then see if it meets these conditions. But this approach has been criticized for begging normative questions. Concerning autism (and other conditions), a neurodiversity movement has arisen with essentially two aims: (1) advocate for the rights and interests of individuals with autism, and (2) de-pathologize autism. We argue that denying autism’s disorder status (...) could undermine autism’s exculpatory role in cases where individuals with autism are charged with a crime. Our argument raises a dilemma for the neurodiversity movement: advocating for the rights and interests of individuals with autism may require viewing autism as a condition that can be inherently disabling (at least for some individuals). If this is right, autism’s disorder status might be maintained (again, at least for some individuals) without deriving this result from any general account of disorder. (shrink)

Much of the sustained attention on pandemic preparedness has focused on the ethical justification for plans for the “crisis” phase of a surge when, despite augmentation efforts, the demand for life...

Book synopsis: Reissued in 1997 with corrections and a new Afterword, this book fully explores for the first time an idea common to Plato and Aristotle, which unites their treatments - otherwise very different - of love and friendship. The idea is that although persons are separate, their lives need not be. One person's life may overflow into another's, and as such, helping another person is a way of serving oneself. The author shows how their view of love and friendship, (...) within not only personal relationships, but also the household and even the city-state, promises to resolve the old dichotomy between egoism and altruism. (shrink)

This work emerged from funded research examining collaboration among stake-holder organizations present at three U.S. nuclear weapons complex sites. The authors examine issues such as how and why stakeholder groups form collaborative alliances when dealing with the target organization, what leaders of stakeholder organizations actually think about when collaborating to deal with the target organization, and what outcomes result from the collaboration process. Drawing on stakeholder theory and research in interorganizational collaboration, the authors used an inductive, interview-based methodology to build (...) a model of collaboration among nonprofit stakeholder groups. The model contributes to the descriptive stream of stakeholder theory and, in turn, has implications for the instrumental stream. The model also offers implications for future researchers, leaders of stakeholder alliances, and leaders of target organizations. (shrink)

This article presents a detailed exploration of what Sextus and Pyrrhonists regarded as mnemonic signs, where one experience reminds us of another, such as seeing smoke reminds us of a fire that is not yet evident to our present observations. For the skeptic the use of mnemonic signs obviates the need for reasoned, theoretical interpretations or elaborated belief formation. It allows the skeptic or the theory-free physician, for that matter, to live a life or practice symptomatic medicine without the need (...) for philosophizing. (shrink)

Cicero, Lucullus 38: ‘…non potest animal ullum non adpetere id quod accommodatum ad naturam adpareat …’ From earliest childhood every man wants to possess something. One man collects horses. Another wants gold. Socrates has a passion for companions. He would rather have a good friend than a quail or a rooster. In this way, Socrates begins his interrogation of Menexenus. He then congratulates Menexenus and Lysis for each having what he himself still does not possess. How is it that one (...) gets a friend, Socrates asks? Since the nineteenth century many who have read these lines have found them repulsive. Scholars have damned the Lysis for its selfish egoism, for regarding persons as personal belongings. At the turn of the century some sought to discredit the dialogue as a forgery and a calumny. Others debated the dating of the dialogue as Socratic or Platonic, seeking whom to blame rather than whom to credit. And those who have regarded the dialogue as Platonic have tried to redeem it by detecting hints of Plato's theory of Forms. A few have attempted to salvage reputations by understanding the argument of the Lysis as a reductio of egoism, or else by invoking the loyalty of Socrates' friends and the history of Plato's friendship for Dion of Syracuse to speak up for their defence. Guthrie has condemned the dialogue as a failure of method and presentation , and Vlastos has pronounced it a failure of love: ‘The lover Socrates has in view seems positively incapable of loving others for their own sake, else why must he feel no affection for anyone whose good-producing qualities he did not happen to need?’ The Lysis appears to make no positive contribution to the Greek tradition on friendship when compared to the Symposium or the Phaedrus. And in the subsequent tradition, whatever Aristotle might have borrowed from the dialogue he uses for his own purposes. Aristotle too is quite critical of specific points raised in the Lysis. Now it might seem that Aristotle made a place for the selfish love of the Lysis in his own theory, as an inferior grade of utility love. But even this cannot be so, if we are to agree with recent studies of Aristotle's ethics. According to Aristotle, if a client is friendly to his benefactor because of the latter's usefulness, this utilitarian motive must accompany a genuine concern for the benefactor's own interest in that relation, if they are to be friends. Inferior and genuine friendship may differ in purpose but not in regard for the well-being of the beloved. This respect for the object of one's love has no parallel in the Lysis, according to the standard reading of the dialogue. (shrink)

The behavior of people in the presence of scarce resources has long been a source of ethical concern and debate. Many of the responses, ranging from outright brutality and cheating on the one hand to altruism, nobility, and sacrifice on the other, were most recently demonstrated in the movie Titanic. It should come as no surprise, then, that rational efforts to allocate the very scarce life-saving resource of organs are sometimes circumvented by these natural human impulses and sheer human creativity. (...) This is especially true when the organs in question are required for continued life and cannot be temporarily or permanently replaced by technology. Thus the focus of this paper will be on the competition for livers. (shrink)

Business students have long been noted for their differential proclivity to engage in academic misconduct. Unfortunately, the potential for misconduct has been exacerbated in recent years by rapid advances in technology, easy access to information, competitive pressures, and the proliferation of websites that provide students access to information that allows them to directly circumvent the learning process. Using a convenience sample of 631 students matriculating in various business majors at four U.S. universities and structural equations modeling procedures, this study assesses (...) the effects of psychological factors on business students’ propensities to utilize the services of homework assistance websites. Specifically, we examine how “Dark Triad” personality traits (i.e., narcissism, Machiavellianism, and psychopathy) interact with Fraud Diamond elements to influence student decisions to engage the services of these websites. We find that each Dark Triad trait exerts a significant influence on at least one of the Fraud Diamond elements, which in turn have a significant direct or indirect positive association with students’ reported intentions to utilize, and reported utilization of, these websites. (shrink)

A brief philological look at a key argument in Plato’s “Lysis” reveals Plato’s philosophical interpretation of generic love, or ‘philia’, to be an asymmetrical form of possessive desire, where the interests of the self predominate.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Friendship in the Classical World by David KonstanDavid K. GliddenDavid Konstan. Friendship in the Classical World. Cambridge: Cambridge University Press, 1997. Pp. xiv + 206. Paper, $18.95.Despite its brevity, Konstan’s history of friendship in classical antiquity speaks volumes. With admirable precision and economy of expression, Konstan cites and surveys scores of ancient authors—poets, playwrights, politicians, novelists and historians, sophists, satirists, philosophers, and theologians—from Homer’s legendary portrait of (...) Achilles and Patroclus to the Christian fusions of Venantius Fortunatus in the sixth century of the common era. An impressive array of anthropologists, philosophers, and classical scholars enter into the discussion at specific interstices connecting philology, textual interpretation, ancient history, and modern social psychology all together, so as to display an evolving array of ancient philosophies, faiths, and attitudes concerned with friendly relations of one sort or another. Konstan grounds this history in a richly informed context of exacting detail. Yet, he charitably leaves his reader with the feeling that so much more needs to be explored.At the same time, what largely motivates this work is Konstan’s demonstrable conviction that ancient friendship exhibits recognizable resemblances with its contemporary counterpart, notwithstanding all the varieties exhibited over the fifteen hundred years or so of ancient Greek and Roman practices. “Ideas of friendship were adapted to different practices, but the core sense of a private bond based on mutual affection, esteem, and liberality—within the capabilities of the respective partners—abided” (148). What is foreign in ancient human relations may be considerable, but it [End Page 359] does not efface what remains familiar and what continues to be prized about the company of friends. Regardless of the peculiarities of ancient political associations, protocols of reciprocity, the relations of clients to their patrons, strains between honesty and flattery, divided loyalties among families, friends, and countries, and the dramatic effects of early Christianity on human relations when faced with a relationship to God, there is, all the same, something comfortably familiar about the ways friends related to one another throughout the ancient world. This abides even in the face of ancient/modern barriers segregating friendships from, say, sexual relationships or restricting friendships across genders, or so it would seem.Konstan’s anthropological approach employs an approximating master concept of friendship with which to tie his story together, a conception which places great emphasis on “mutual affection, esteem, and liberality.” Aristotle’s understanding of friendship consequently plays a special role in this history, both as an influential model within antiquity and also as a vehicle for Konstan’s own narrative construction.Aristotle famously portrayed a prototype of human friendship in which persons are bound together first and foremost by a personal affinity due in large part to the content of their character, in contrast to those who are friends for lesser reasons, due to usefulness or pleasure. At the same time, Aristotle’s focus on virtue friendship as a primary vehicle for fathoming other varieties of human relations became something of a self-fulfilling methodology. Armed with such a normative model, a philosophical anthropologist would then rank other varieties of human relations accordingly, as lesser forms of friendship. Aristotle’s template serves Konstan’s purpose nicely, since he too sees character affinity as primary to the various ways we human beings relate with one another. Yet, normative ideals of what friendship ought to be when at its best inevitably affect, in turn, how we read the ways friends are and were historically.Following Aristotle, Konstan lays great emphasis on the originating Greek conception of the friend (philos as a noun), as opposed to the various instantiations of whatever objects may be loved or cherished generally (philos as an adjective). So too, the broader, underlying account of caring (philein the verb; philia the abstracted noun) is displaced as well, to maintain a steady focus on the living witness of friends, both real and ideal. While this tidy terminological division between philos (noun) and philos (adjective) might work well for Aristotle and for Konstan, Plato found it less appealing. And it was Plato’s Lysis, after all, that Aristotle’s originating model of friendship was responding to. Had a modern... (shrink)

Augustine advances the view that morally devout interpreters of a Biblical text, such as the Psalter, can each advance contradictory interpretations of the very same portion of the text and yet both interpretations can be true. But the moral character of the interpreter is paramount in weighing the validity of the interpretation. I explore this hermeneutical principle Augustine advances with Donald Davidson’s secular “Principle of Charity”.

The understanding of perception advanced by Aristotle and Theophrastus is largely physiological in character, describing the mechanism of perception and its resulting epistemic value. Like Epicurean views, theirs is not a theory of sensory ideas. The Stoics develop a competing approach to perception that describes sensory phenomena in terms of conceptual, linguistic representations.