There is a debate regarding the use of the white coat, a traditional symbol of the medical profession, by students. In a study evaluating final-year South African medical students' perceptions, the white coat was associated with traditional symbolic values (e.g., trust) and had practical uses (e.g., identification). The coat was generally perceived to evoke positive emotions in patients, but some recognized that it may cause anxiety or mistrust. Donning a white coat generally implied a responsibility to the profession. For a (...) few, without the coat, patients would not cooperate, resulting in some perceiving no need to be distinguished from qualified practitioners. There was thus some evidence of entitled (vs. earned) respect. In the light of the underresourced health care setting in which these students learn clinical medicine, we recommend that students be able to recognize the potential for unprofessional or unethical behavior. Students should also be able to identify role models. (shrink)

As support for clinical ethics committees in the UK grows, care must be taken to define their function, membership and method of working and the status of their decisions.The modern practice of medicine raises a plethora of complex issues—medical, ethical and legal. Doctors and other healthcare professionals increasingly must try to resolve these and may sometimes have to do so in the face of contrary opinion expressed by patients and/or their surrogates. While clearly qualified in the medical arena, and although (...) there is now more ethics teaching in the medical curriculum, healthcare professionals are seldom qualified to adjudicate on ethical or legal matters, or even, perhaps, to recognise them when they arise. Yet, as Doyal says, “clinical life must go on and moral and legal indeterminacy within medicine cries out for practical resolution.”1 Meanwhile, the expectations of patients and their families—and, indeed, of wider society—are that decisions about patient care, resources and therapeutic regimes should be soundly based on appropriate ethicolegal, as well as scientific, principle.Recognition of these additional burdens on healthcare professionals has generated some interest in the provision of ethics consultation. In the USA this has been undertaken by a variety of tribunals and individuals. Hospital ethics committees and ethics consultants feature in many US hospitals and perform a variety of roles. In Europe, a number of countries have also established clinical ethics committees and they are becoming more common in the UK—primarily in England and Wales for the moment. Whereas, however, “[i]n North America, CECs have … become an integral part of the organisational infrastructure of hospitals ...”,1 in the United Kingdom they remain essentially ad hoc bodies, generated for a variety of reasons and with different goals, structures, membership, methods of working and functions. The initial impetus for the …. (shrink)

The development of clinical ethic support in the UK arguably brings with it a series of legal questions, which need to be addressed. Most particularly, these concern questions of due process and formal justice, which I argue are central to the provision of appropriate ethical advice. In this article, I will compare the UK position with the more developed system in the USA, which often provides a template for development in the UK. While it is not argued that the provision (...) of clinical ethics support in the UK will necessarily follow the path mapped in the USA, there are lessons that can be learned from the US experience – particularly in terms of attention to process – from which UK clinical ethics support service might well benefit. (shrink)

The rapid rise of varieties of historicism in Germany, during the mid- to late-nineteenth century, and subsequently in England and America, resulted in a radical transformation of the principles of coherence and methods of analysis within biblical studies.1This paper will argue that the foundational ‘subject/object’ metaphysics of historicism has been subverted over the past century. For this reason, historical positivism should no longer be accorded the status of ‘normative paradigm’ and ‘gatekeeper’ over and against other interpretive approaches. This paper next (...) lays out five principles for a renewed practice of historical inquiry. It argues, first, that historical inquiry continues to serve a vital function within biblical studies in its ability to call attention to historical difference, and, thereby, to contribute to a strategy of resistance to ideology and to totalizing theories; second, that the traditional appeal to historical ‘context’ and ‘author’ in the interpretation of texts continues to be a useful practice – despite the provisional and constructed nature of both – as a way of taking into account extra-lingual reference and of avoiding presentism; third, that the substitution of new ‘grand narratives’ of Christian origins in place of the (quasi-theological) ‘historical’ narrative of traditional Christianity – under the claim of historical objectivity – should be abandoned because the very concept of ‘origins’ is the result of a literalizing of a metaphor. Such totalizing narratives always reduce history's inherent polycentricism. Fourth, I will argue that the continued use of historicism in the antiquarian attempt to reconstruct the past, disconnected from both a quest for social justice and a desire for personal self-creation, represents a form of thought that alienates scholars from themselves and from their real material contexts. Finally, and following on the previous point, this paper submits that the practice of historical analysis has an ethical dimension by virtue of the fact that the personhood of the biblical historian is indissolubly linked to other dimensions of life including the social and ethical aspects of life. These added dimensions complicate the making of choices, which is implicit within all practices of interpretation. These five principles are here suggested as points of departure for the reconceptualization of the scope and function of historical inquiry within the discipline of New Testament studies. (shrink)

An essential and neglected distinction between contract and administrative law is in how each conceives of the Crown as a juristic person. This article explores the extent of this distinction, and its implications for the rule of law and the separation of powers. It offers explanations—historical, jurisprudential and pragmatic—for why contract law conceives of the Crown as a corporation aggregate with the powers and liberties of a natural person, and why administrative law disaggregates the State into named officials.

The patient-doctor relationship has recently come under intense scrutiny, resulting in a re-evaluation of the basis of that relationship. The papers by Glannon and Ross, and McKay seek to identify the sources of authority in the patient-doctor relationship by evaluating it in terms of the concept of altruism. In this paper I argue that the analysis of Glannon and Ross, and of McKay is unnecessary and that the analysis offered by the latter is also flawed. I do acknowledge, however, that (...) Glannon and Ross's description of doctors' responsibilities and patients' roles has much to commend it. (shrink)

Anyone who has ever found herself or himself at odds with a boss, a board, a committee, a pastor, family member - or with any other institutional setting of which she or he my be a part - will find this book full of help and insight and wisdom. Conflicting Agendas is an invaluable guide to sorting out the complexities of individual moral existence in an increasingly complex and complicated world.

The new regulations on xenotransplantation pay insufficient attention to the broad ethical problems raised by this technique and that the abandonment of a national body with overall regulatory authority in this area is a mistake.Following reports from the Nuffield Council on Bioethics1 and, most importantly, the Advisory Group on the Ethics of Xenotransplantation2 , the UK Xenotransplantation Interim Regulatory Authority was established in 1997. The existence of a national body to govern xenotransplantation was deemed to be of critical importance by (...) the Kennedy report given the practical and ethical issues associated with xenotransplantation. Indeed, the Kennedy report recommended that ultimately UKXIRA should be placed on a statutory footing.2 The remit of UKXIRA was to advise the Secretary of State on particular applications, gather information on issues such as safety, and assess whether the preconditions identified by the Kennedy report had been met.3In December 2006, UKXIRA was quietly disbanded, and the Department of Health issued a statement of guidance, the terms of which now govern xenotransplantation in the UK. This document superseded procedures that had been in place since 1998, which had placed the overall regulation of applications to conduct xenotransplantation in the hands of UKXIRA and, ultimately, the Secretary of State.4 The revised guidance defines xenotransplantation as being: “… any procedure that involves the transplantation, implantation, or infusion into a human recipient of either live tissues or organs retrieved from animals, or, human body fluids, cells, tissue or organs that have undergone ex vivo contact with live non-human animal cells, tissues or organs.”5 . Given the range and nature of the procedures covered by the guidance, it is surprising, not to say a little worrying, that it is so …. (shrink)

The so-called genetics revolution rests on a history which at its least can be described as controversial. Modern genetics needs to bear this history in mind. In particular, as with the past, the area of reproductive choice seems particularly vulnerable to potential abuse. Courts in the UK and elsewhere have already shown themselves willing to interfere with the choices of women in the management of their pregnancies. Medical advance, perhaps particularly the capacity to visualise the developing foetus, has added complexity (...) to the question of whether the health care provider has one patient or two patients . Additionally, pregnancy is thoroughly monitored in modern medical practice and genetics may provide a further impetus or incentive to mandate increased policing of pregnancy. Gene therapy, once offered, will add further to the desire to ensure that women make the ‘right’ choice, especially when the invasion required is relatively minimal. Further, genetic information is at best predictive, but may, because of its scientific nature, appear to those receiving it to be certain. Thus, the provision of genetic information may reduce rather than enhance choice, unless carefully and sensitively provided. A mature and sophisticated debate about the role of genetics in reproduction is required—engaging rather than bypassing the public—if the real potential of genetics is to be vindicated. (shrink)

The purpose of this article is to advance a new understanding of gender as a routine accomplishment embedded in everyday interaction. To do so entails a critical assessment of existing perspectives on sex and gender and the introduction of important distinctions among sex, sex category, and gender. We argue that recognition of the analytical independence of these concepts is essential for understanding the interactional work involved in being a gendered person in society. The thrust of our remarks is toward theoretical (...) reconceptualization, but we consider fruitful directions for empirical research that are indicated by our formulation. (shrink)

This article argues that thinking about entrepreneurship as a potential instrument for relief from endemic poverty and disadvantage, especially among the Indigenous, has all too often been captive to a concept of entrepreneurship that is built out of constrained economic and cultural assumptions. The authors develop this argument from a critical discussion of contributions by Karl Polanyi and Robert Heilbroner. The result is that approaches to venture have been encouraged that are sometimes a poor fit for the circumstances of those (...) they are meant to benefit, and other forms that could have considerable promise have gone unexplored. This article outlines some features of Indigenous culture and build on the analysis of David Harper to construct an improved notion of entrepreneurship that allows for these distinctive features. The article concludes that research and policy making concerning entrepreneurship as an instrument of development among the Indigenous need to be undertaken with this reconstructed understanding of entrepreneurship that is a better fit for the realities of Indigenous culture. (shrink)

In recent work, Peter Hanks and Scott Soames argue that propositions are types whose tokens are acts, states, or events. Let’s call this view the type view. Hanks and Soames think that one of the virtues of the type view is that it allows them to explain why propositions have semantic properties. But, in this paper, we argue that their explanations aren’t satisfactory. In Section 2, we present the type view. In Section 3, we present one explanation—due to Hanks (2007, (...) 2011) and Soames (2010)—of why propositions have semantic properties. We criticize this first explanation in Section 4. In Section 5, we present another explanation—due to Soames (2104)—of why propositions have semantic properties. We criticize this second explanation in Section 6. (shrink)

Drawing on interviews with 140 young British males, this article explores the ways in which men talk about their own bodies and bodily practices, and those of other men. The specific focus of interest is a variety of body modification practices. We argue, however, that the significance of this analysis extends beyond the topic of body modification. In discussing the appearance of their bodies, the men we interviewed talked less about muscle and skin than about their own selves located within (...) particular social, cultural and moral universes. This article shows that, in talking about seemingly trivial questions such as whether to have one’s nose pierced or join a gym, men are actively engaged in regulating normative masculinity. Our analysis lends support to the claim that the body has become a new (identity) project in high/late/post-modernity, but shows how fraught with difficulties this project is for young men who must simultaneously work on and discipline their bodies while disavowing any (inappropriate) interest in their own appearance. The analysis highlights the pervasive individualism of young men’s discourses, and the absence of alternative ways of making sense of embodied experiences. (shrink)

Steve Biko died in detention in South Africa in 1977. Critical ethical issues are raised both by the conduct of the doctors responsible for Biko's care and by the subsequent response of the medical profession as a whole. Because those issues are relevant to all healthcare professionals everywhere, the Biko affair provides a useful case study in medical ethics. We discuss the case in this article, describing how we use it in our teaching.

The American Journal of Bioethics, Volume 11, Issue 6, Page 65-66, June 2011.

Dialogue between eastern and western philosophies -- Dialogue between Confucianism and Christianity.

Many think doing animal ethics demands we see moral humanism as a speciesist prejudice of the kind found with sexism and racism. The only serious case for this rests on the Argument from Marginal Cases. We find that argument to the point, but show that properly understood it supports humanism. Understanding why it does this lets us see how we ought to go on in animal ethics.

Drawing on interviews with 140 young British males, this article explores the ways in which men talk about their own bodies and bodily practices, and those of other men. The specific focus of interest is a variety of body modification practices. We argue, however, that the significance of this analysis extends beyond the topic of body modification. In discussing the appearance of their bodies, the men we interviewed talked less about muscle and skin than about their own selves located within (...) particular social, cultural and moral universes. This article shows that, in talking about seemingly trivial questions such as whether to have one’s nose pierced or join a gym, men are actively engaged in regulating normative masculinity. Our analysis lends support to the claim that the body has become a new (identity) project in high/late/post-modernity, but shows how fraught with difficulties this project is for young men who must simultaneously work on and discipline their bodies while disavowing any (inappropriate) interest in their own appearance. The analysis highlights the pervasive individualism of young men’s discourses, and the absence of alternative ways of making sense of embodied experiences. (shrink)

It is widely believed that Hume often wrote carelessly and contradicted himself, and that no unified, sound philosophy emerges from his writings. Don Garrett demonstrates that such criticisms of Hume are without basis. Offering fresh and trenchant solutions to longstanding problems in Hume studies, Garrett's penetrating analysis also makes clear the continuing relevance of Hume's philosophy.

The controversies in Bristol, Alder Hey and elsewhere in the UK surrounding the removal and retention of human tissue and organs have led to extensive law reform in all three UK legal systems. This paper reports a short study of the reactions of a range of health professionals to these changes. Three main areas of ethical concern were noted: the balancing of individual rights and social benefit; the efficacy of the new procedures for consent; and the helpfulness for professional practice (...) of the new legislation and regulation. Recognition of these concerns may help in forging a new partnership between professionals and patients and their families. (shrink)

Many think doing animal ethics demands we see moral humanism as a speciesist prejudice of the kind found with sexism and racism. The only serious case for this rests on the Argument from Marginal Cases. We find that argument to the point, but show that properly understood it supports humanism. Understanding why it does this lets us see how we ought to go on in animal ethics.

Xenotransplantation - the transfer of living tissue between species - has long been heralded as a potential solution to the severe organ shortage crisis experienced by the United Kingdom and other 'developed' nations. However, the significant risks which accompany this biotechnology led the United Kingdom to adopt a cautious approach to its regulation, with the establishment of a non-departmental public body - UKXIRA - to oversee the development of this technology on a national basis. In December 2006 UKXIRA was quietly (...) disbanded and replaced with revised guidance, which entrusts the regulation of xenotransplantation largely to research ethics committees. In this article we seek to problematize this new regulatory framework, arguing that specialist expertise and national oversight are necessary components of an adequate regulatory framework for a biotechnology which poses new orders of risk, challenges the adequacy of traditional understandings of autonomy and consent, and raises significant animal welfare concerns. We argue for a more considered and holistic approach, based on adequate consultation, to regulating biotechnological developments in the United Kingdom. (shrink)

Beginning with an overview of Hume's life and work, Don Garrett introduces in clear and accessible style the central aspects of Hume's thought. These include Hume's lifelong exploration of the human mind; his theories of inductive inference and causation; skepticism and personal identity; moral and political philosophy; aesthetics; and philosophy of religion. The final chapter considers the influence and legacy of Hume's thought today. Throughout, Garrett draws on and explains many of Hume's central works, including his Treatise of Human Nature (...) , Enquiries Concerning Human Understanding , and Dialogues Concerning Natural Religion . Hume is essential reading not only for students of philosophy, but anyone in the humanities and social sciences and beyond seeking an introduction to Hume's thought. (shrink)

In the present paper we give a precise definition of a hidden-variable theory for quantum mechanics, whereby we adopt the weakest possible definition of a hidden-variable theory, which is compatible with the assumption that the bounded observables of a quantum mechanical system are represented by the elements of the real part Ar of a W*-algebra A (of the most general type) and the states are represented by the “normal states” (in the mathematical sense) of A. We then go on to (...) show that an example put forward by Bell in 1966 satisfies our definition (Sec. 2). Finally we make use of Bell's famous theorem to show that for a sufficiently non-commutative W*-algebra A no hidden-variable theory in our sense exists (Theorem 3.3 and its corollaries). (shrink)

This was the book which first garnered international celebrity and notoriety for its author, and which fire-started a debate about the supernatural claims of Christianity. Rejecting Christian doctrines and metaphysics in favour of the religious consciousness which characterises human identity, Cupitt 'takes leave' of God by abandoning objective theism. Whatever one thinks of the author's views, and of the non-realist beliefs he has been seen to champion, Taking Leave of God remains an essential work, and one of the most controversial (...) theological interventions of its age. (shrink)

Altruism can be understood in terms of traditional principles of reinforcement if an outcome that is beneficial to another person reinforces the behavior of the actor who produces it. This account depends on a generalization of reinforcement across persons and might be more amenable to experimental investigation than the one proposed by Rachlin.