Minors are generally considered incompetent to provide legally binding decisions regarding their health care, and parents or guardians are empowered to make those decisions on their behalf. Parental authority is not absolute, however, and when a parent acts contrary to the best interests of a child, the state may intervene. The best interests standard is the threshold most frequently employed in challenging a parent''s refusal to provide consent for a child''s medical care. In this paper, I will argue that the (...) best interest standard provides insufficient guidance for decision-making regarding children and does not reflect the actual standard used by medical providers and courts. Rather, I will suggest that the Harm Principle provides a more appropriate threshold for state intervention than the Best Interest standard. Finally, I will suggest a series of criteria that can be used in deciding whether the state should intervene in a parent''s decision to refuse medical care on behalf of a child. (shrink)

The case of Ashley X involved a young girl with profound and permanent developmental disability who underwent growth attenuation using high-dose estrogen, a hysterectomy, and surgical removal of her breast buds. Many individuals and groups have been critical of the decisions made by Ashley's parents, physicians, and the hospital ethics committee that supported the decision. While some of the opposition has been grounded in distorted facts and misunderstandings, others have raised important concerns. The purpose of this paper is to provide (...) a brief review of the case and the issues it raised, then address 25 distinct substantive arguments that have been proposed as reasons that Ashley's treatment might be unethical. We conclude that while some important concerns have been raised, the weight of these concerns is not sufficient to consider the interventions used in Ashley's case to be contrary to her best interests, nor are they sufficient to preclude similar use of these interventions in the future for carefully selected patients who might also benefit from them. (shrink)

Journal Name: Apeiron Issue: Ahead of print.

Like a pack of cigarettes, a library’s philosophy section should have a warning label: “Something you learn here may ruin your life.” Only here can a flip through a book persuade someone to accept an idea without considering its repercussions. The bad side of philosophy that hardly anyone writes about, is that some philosophies cause people to become hobos. When I use the term ‘hobo’, I’m not referring to just any homeless person – that is, I’m not referring to a (...) handicapped person, an alcoholic, or someone else whose homeless situation is a result of his or her misfortune. Rather, by ‘hobo’, I’m specifically referring to a person who has lived by his or her philosophical convictions and is miserable as a result. No one wants his philosophy to lead him under a dark bridge somewhere, draped in a used sleeping bag, his only defense a rusty pocket knife. Rather, he wants the good life. But what is the good life? And how, you may ask, does all this tie into Epicureanism? -/- Around 300 BC, in Greece’s... (shrink)

I argue here that a properly Platonic theory of the nature of number is still viable today. By properly Platonic, I mean one consistent with Plato's own theory, with appropriate extensions to take into account subsequent developments in mathematics. At Parmenides 143a-4a the existence of numbers is proven from our capacity to count, whereby I establish as Plato's the theory that numbers are originally ordinal, a sequence of forms differentiated by position. I defend and interpret Aristotle's report of a Platonic (...) distinction between form and mathematical numbers, arguing that mathematical numbers alone are cardinals, by reference to certain non-technical features of a set-theoretical approach and other considerations in philosophy of mathematics. Finally I respond to the objections that such a conception of number was unavailable in antiquity and that this theory is contradicted by Aristotle's report in Metaph . XIII that Platonic numbers are collections of units. I argue that Aristotle reveals his own misinterpretation of the terms in which Plato's theory was expressed. (shrink)

A functioning democracy depends on the free flow of information in the marketplace of ideas, creating an informed citizenry that can engage in public debate.This study examines the most-used online news portal, Yahoo!, to determine if the news media industry can be simultaneously profitable and socially responsible, providing the public with news that is both informative and engaging in an increasingly global world.

Acknowledging the unique and potentially powerful positions held by activist stakeholders, the author argues that organizations and activists signal thestate of their relationships using public statements about their shared issues of concern as reported by the news media. The findings of three case studies ofAustralia’s major banks and their activist stakeholders over 21 years are reported.

The best interest standard is the threshold most frequently employed by physicians and ethics consultants in challenging a parent’s refusal to provide consent for a child’s medical care. In this article, I will argue that the best interest standard has evolved to serve two different functions, and that these functions differ sufficiently that they require separate standards. While the best interest standard is appropriate for choosing among alternative treatment options for children, making recommendations to parents, and making decisions on behalf (...) of a child when the legal decision makers are either unable to make a decision or are in dispute, a different standard is required for deciding when to seek state interference with parental decision-making authority. I will suggest that the harm principle provides a more appropriate threshold for determining when to seek state intervention than the best interest standard. (shrink)

Clinical ethics training programs are responsible for preparing their trainees to be competent ethics consultants worthy of the trust of patients, families, surrogates, and healthcare professionals. While the American Society for Bioethics and Humanities (ASBH) offers a certification examination for healthcare ethics consultants, no tools exist for the formal evaluation of ethics trainees to assess their progress toward competency. Medical specialties accredited by the Accreditation Council for Graduate Medical Education (ACGME) use milestones to report trainees’ progress along a continuum of (...) professional development as a means of “operationalizing and implementing” medical competencies. Utilizing the Core Competencies for Healthcare Ethics Consultation and the ACGME and American Board of Pediatrics’ (ABP) Pediatric Milestones Project, we developed milestones for 17 subcompetencies in clinical ethics consultation and academic bioethics. As the field of clinical ethics becomes more standardized, such tools will be needed to promote the development of robust training programs and to certify that their graduates are competent practitioners. (shrink)

Many traditional Mahayana, and modern Tibetan, Buddhist texts relate meditation attainment to psychic ability. This teaching served as the hypothesis—that more advanced meditators would choose a psi target correctly, significantly more often than beginners. A basic free-response design was used in which a computer programme (PreCOG) chose a target picture at random from a 4-picture set. There were 25 sets, all pictures of Tibet. PreCOG guided the participants through the procedure, in which they aimed to become aware of the target. (...) 18 participants, Tibetan monks, nuns and Western Buddhist meditators, completed 8 sessions each. Half the sessions used a clairvoyance, and half a precognition, protocol. Age and years of meditation practice correlated significantly with the psi scores (Pearson r = 0.52, p < 0.05). This suggests that, as one practices meditation, psychic awareness begins to manifest more reliably. This result was confounded by a non-significant psi-missing trend. There was no significant difference between the clairvoyance and precognition trials (t-diff (142) = 0.800). There was, however, significant psi-missing from the group of Rinpoches (t = -2.09, 2tail p < 0.05). The three participants who scored most strongly in the psi-missing direction all reported childhood memories of previous lives as monks in Tibet. Keywords: psychic awareness—Tibetan Buddhists—meditation. (shrink)

Thousands of U.S. parents choose to refuse or delay the administration of selected vaccines to their children each year, and some choose not to vaccinate their children at all. While most physicians continue to provide care to these families over time, using each visit as an opportunity to educate and encourage vaccination, an increasing number of physicians are choosing to dismiss these families from their practice unless they agree to vaccinate their children. This paper will examine this emerging trend along (...) with the reasons given by those who advocate such an approach. I will argue that the strategy of refusing to allow families into a clinic unless they agree to vaccinate their children is misguided, and the arguments for doing so fail to stand up to close scrutiny. Such a strategy does not benefit the child or the health of the community, and may have a negative impact on both. Furthermore, some of the arguments in support of dismissal policies ignore the importance of professional obligation and appear to favor self-interest over the interest of the patient. (shrink)

With each novel infectious disease outbreak, there is scholarly attention to healthcare providers’ obligation to assume personal risk while they care for infected patients. While most agree that healthcare providers have a duty to assume some degree of risk, the extent of this obligation remains uncertain. Furthermore, these analyses rarely examine healthcare institutions’ obligations during these outbreaks. As a result, there is little practical guidance for healthcare institutions that are forced to weigh whether or when to exclude healthcare providers from (...) providing care or allow them to opt out from providing care to protect themselves. This article uses the COVID-19 pandemic to examine the concept of risk and the professional duties of both healthcare providers and healthcare institutions, and proposes a framework that can be used to make concrete institutional policy choices. This framework should be a useful tool for any hospital, clinic, or health agency that must make these choices during the current pandemic and beyond. (shrink)

In _Aristotle’s Ever-turning World in _Physics _8_ Blyth analyses the reasoning in Aristotle’s explanation of cosmic movement, with detailed evaluation of ancient and modern commentary on this central text in the history of ancient and medieval philosophy and science.

The case of Ashley X involved a young girl with profound and permanent developmental disability who underwent growth attenuation using high-dose estrogen, a hysterectomy, and surgical removal of her breast buds. Many individuals and groups have been critical of the decisions made by Ashley's parents, physicians, and the hospital ethics committee that supported the decision. While some of the opposition has been grounded in distorted facts and misunderstandings, others have raised important concerns. The purpose of this paper is to provide (...) a brief review of the case and the issues it raised, then address 25 distinct substantive arguments that have been proposed as reasons that Ashley's treatment might be unethical. We conclude that while some important concerns have been raised, the weight of these concerns is not sufficient to consider the interventions used in Ashley's case to be contrary to her best interests, nor are they sufficient to preclude similar use of these interventions in the future for carefully selected patients who might also benefit from them. (shrink)

Thirty years ago, Buchanan and Brock distinguished between guidance principles and interference principles in the setting of surrogate decision making on behalf of children and incompetent adult patients. They suggested that the best interest standard could serve as a guidance principle, but was insufficient as an interference principle. In this issue of The Journal of Clinical Ethics, Ross argues that the best interest standard can serve as neither a guidance nor interference principle for decision making on behalf of children, but (...) that her model of constrained parental autonomy can serve as both. I will argue that Buchanan and Brock were correct that a single model or standard cannot serve as both a guidance and interference principle in pediatrics and that the best interest standard is a sufficient guidance principle. The harm principle fulfills the conditions necessary for an interference principle, at least insofar as deciding when state intervention to interfere with parental decision making is justified. (shrink)

Programmes serving international patients are increasingly common throughout the USA. These programmes aim to expand access to resources and clinical expertise not readily available in the requesting patients’ home country. However, they exist within the US healthcare system where domestic healthcare needs are unmet for many children. Focusing our analysis on US children’s hospitals that have a societal mandate to provide medical care to a defined geographic population while simultaneously offering highly specialised healthcare services for the general population, we assume (...) that, given their mandate, priority will be given to patients within their catchment area over other patients. We argue that beyond prioritising patients within their region and addressing inequities within US healthcare, US institutions should also provide care to children from countries where access to vital medical services is unavailable or deficient. In the paper, we raise and attempt to answer the following: (1) Do paediatric healthcare institutions have a duty to care for all children in need irrespective of their place of residence, including international patients? (2) If there is such a duty, how should this general duty be balanced against the special duty to serve children within a defined geographical area to which an institution is committed, when resources are strained? (3) Finally, how are institutional obligations manifest in paradigm cases involving international patients? We start with cases, evaluating clinical and contextual features as they inform the strength of ethical claim and priority for access. We then proceed to develop a general prioritisation framework based on them. (shrink)

Healthcare-associated infections due to multidrug-resistant organisms continue to increase in incidence. To control the transmission of these pathogens, such as methicillin-resistant Staphylococcus aureus , some have advocated active surveillance cultures of all hospitalized patients, followed by institution of contact precautions. While there has been extensive debate about the effectiveness of this approach in reducing infections, little attention has been given to the ethical issues raised by the intervention. Active surveillance for multidrug-resistant organisms is a quality improvement measure and ethical implications (...) arise through the potential to inadvertently cause harm. Unintended adverse effects may include decreased contact with healthcare workers, increased depression and anxiety, and increased rates of noninfectious adverse events among patients placed in contact precautions. The potential risks and benefits are not distributed fairly; patients placed in contact precautions are exposed to the risks, while those not isolated experience the benefit. Ethical challenges involve a conflict between the interests of the individual patient and the patient population not already colonized with the organism. For healthcare systems, active surveillance increases the complexity of bed management, exacerbating problems with patient placement, patient throughput, emergency department overcrowding and ambulance diversion for some hospitals. It also poses ethical dilemmas regarding societal resource allocation. Investing in an unproven or marginally beneficial quality improvement activity such as this must be balanced against other public health priorities competing for scarce resources. CiteULike Connotea Del.icio.us What's this? (shrink)

The case presented here is tragic, not just in the sense of being a sad story, but in the dramatic meaning of tragedy. It presents us with a situation where there is no clear path, where moral ambiguity exists, and where no possible solution could unequivocally be declared the right or good one. Ethical deliberation can help here, but only as a way of clarifying the issues and offering reasonable solutions. It cannot show us the one right way.Baby G has (...) profound medical conditions, including respiratory failure, a chest wall deformity that will require surgery, and profound neurodevelopmental disability. Even a best case scenario portends a shortened lifespan and.. (shrink)

In the 1960s, human experimentation and public funding of research increased significantly, and with the rise of the modern teaching hospital, the distinction between clinical care and experimentation became more and more blurred. Yet little in the way of meaningful government regulation existed in the United States prior to 1970. In 1966, Paul Freund, the president of the American Academy of Arts and Sciences, appointed an interdisciplinary working group to consult on the issues being raised by human experimentation. Contributions from (...) the group were published in a 1969 issue of Daedalus titled Ethical Aspects of Experimentation with Human Subjects. In the lead essay, Hans Jonas challenged then‐conventional understandings of the moral problems posed by research involving humans and argued for an alternative moral framework. To Jonas, it mattered whether the physician was trying to make the patient well rather than trying to find out how to improve the health of future patients. (shrink)

In his recent book Where the Conflict Really Lies, Alvin Plantinga articulates a number of arguments about the conceptual relationship between science and faith, especially Christian faith. He uses Herbert Simon’s evolutionary account of altruism and David Sloan Wilson’s evolutionary account of religion as exemplars of theories that are in genuine but superficial conflict with Christian faith. This paper argues that any conflict between Christian faith and evolutionary psychology or Simonian science is even more superficial than Plantinga himself admits. We (...) argue that apparent conflicts between Christian control beliefs and social scientific theorizing are due predominantly to misunderstanding the scope of a theory or metatheoretical overreaching on the part of one side or the other. Specifically, the apparent conflict between Simon’s account and Christian faith is rooted in a misunderstanding of Simon’s limited definitions of rationality and altruism. The apparent conflict between Wilson’s account and Christian faith is a result of failing to distinguish Wilson’s broader metatheoretical commitments from the more limited scope of his scientific theory of religion. (shrink)

In some Platonic dialogues Socrates apparently shares significant characteristics with contemporary sophists, especially a technique of antithetical argumentation. Since sophists anticipated later Academic philosophers in arguing antithetically and a resultant form of, then, with Socrates’ repeated claims to ignorance, Plato’s depiction of him arguing antithetically suggests later Academics could plausibly appeal to Plato for evidence that Socrates and he were, as it seems they actually did.

Plato’s treatment of poetry is usually discussed without reference to other contemporary reception of Greek poetry, leading to divergent political or aesthetic accounts of its meaning. Yet the culture of the Greek polis, in particular Athens, is the defining context for understanding his aims. Four distinct points are made here, and cumulatively an interpretation of Plato’s opposition to poetry: on the basis of other evidence, including Aristophanes’ Frogs, that Plato would quite reasonably understand poetry to claim the craft of looking (...) after a city ; that Socrates makes a rival claim that philosophy is the pursuit of this skill; that Plato considers the poets, owing to this rivalry, to aim to exclude philosophy from Athens; and finally, that Plato’s exclusion of poetry from the theoretical just city of the Republic is part of his defence of the possibility of philosophy in Athens. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Socrates' Trial and Conviction of the Jurors in Plato's ApologyDougal BlythI am going to argue in this paper that, in the three speeches constituting his Apology of Socrates, Plato presents the judicial proceedings that led to Socrates' execution as having precisely the opposite significance to their superficial legal meaning. This re-evaluation will lead to some reflections on the politics of Socrates' defence, and, similarly, on Plato's own aims in (...) writing the Apology. I want to show not only that the trial as portrayed demonstrates an inevitable dereliction of duty by the democratic jury, but also, more interestingly, that throughout the proceedings Socrates understands the meaning of the trial precisely in terms of his anticipation of the jurors' judicial incapacity.In the prooimion to his defence speech, Socrates requests that the jurors ignore his manner of speaking and concentrate on whether his case is just, "since this is a judge's virtue (), while that of a rhêtôr is to speak the truth" (18a5-6, cf. 35c2-5). We can gloss the expression "a judge's aretê" in this context as his function, or responsibility.1 Socrates claims that he, himself, fulfills his own responsibility as a defendant to tell the truth (17b4-c4, 33c1-2, cf. 34b5, 35b9-c2) in a speech that asserts his exemplary piety in Apollo's service and his beneficial influence on the Athenian youth. But if, in claiming that he is innocent of the charge, Socrates does tell the truth, then those jurors who thereupon convict him of impiety and corruption, and subsequently sentence him to death, have failed in their duty to judge rightly.My claim is that Socrates sees the trial as a test of the jurors' abilities. It is characteristic of Socrates to test people regarding their concern for virtue and justice, a habit to which he devotes extended discussion during his defence, even dramatising it provocatively in a central passage (29d7-e5) that I aim shortly to analyse in detail. Moreover, Socrates specifically withholds from the jury the title of dikastai or judges; he does finally award the title in his address following the sentence, but only to those who have voted [End Page 1] to acquit him (40a2-3).2 The possibility thus emerges that Socrates has treated the legal proceedings all along as a moral (and intellectual) test, or trial, of the empanelled jurors themselves, to see whether they are capable of the legal function to which they have been allotted. In that case, Socrates is putting on trial, not just those individual citizens, but the very legal system of democratic Athens.Socratic irony and truthfulnessBefore considering Socrates' own explicit judgement during those final remarks on the jurors' moral offence and punishment, I should first address briefly the issue of Socrates' irony. In the past, some writers have asserted that this irony involves him in not telling the truth about himself during his defence, in which case the jury might well have been justified in convicting him. Actually, there does seem to be a consensus among the more extended treatments of the Apology that have emerged during the last decade, at least on the point that Plato presents Socrates as committed to making as sincere an attempt at a defence of his case as is consistent with his philosophical commitment to virtue, and so to telling the truth.3I shall not re-argue this point in detail, but shall take it to be secured by two basic considerations: consistency with the Crito would require Socrates to recognise a legal obligation to make a sincere attempt at defence while his obligation to Apollo to continue his mission in Athens if possible would motivate that attempt with the goal of acquittal.4 Instead, I want to show what role irony does have in Socrates' defence, given that his principled law-abidingness requires him to attempt to persuade the jury, in accordance with truth and justice, that he is innocent (cf. 19a6-7, 18a7-b1, 18e5).Where Socrates acknowledges the obligation to defend himself, he remarks on the difficulty he faces, a difficulty that has resulted from the slander to which he has long... (shrink)

Ch.9 of Metaph. 12 gives no support to the common view (against which I have argued elsewhere) that in ch.7 Aristotle identifies his Prime Mover not only as a god but also as an intellect. Rather, ch.9 approaches the divinity of intellect as a common belief (ἔνδοξον) from the Greek philosophical and poetic tradition (as at ch.7, 1072b23) that now requires dialectical testing. Here Aristotle initially establishes that there is a most active intellect (proposed ch.7, 1072b18–19: demonstrated ch.9, 1074b17–21, b28–9), (...) and that it contemplates what is best (proposed loc. cit.: demonstrated ch.9, 1074b21–7). Thus ch.9 proceeds by deducing, as a new result, characteristics implying that this intellect is itself the Prime Mover, since its object, qua best, must be the god of ch.7, and divine intellect is essentially identical (1074b33–1074a5), and an indivisible unity (a5–10), with that object. (shrink)

In Timothie Bright and the Origins of Early Modern Shorthand, J. D. Fleming brings together two areas of sixteenth-century intellectual history. One is the period emergence of artificial systems for verbatim shorthand notation-a crucial episode in the history of information. The other is the ancient medical discourse of melancholy humour, or black bile. Timothie Bright (1550-1615), physician and priest, prompts the juxtaposition. For he was the author, not only of the period's original shorthand manual-Characterie (1588)-but also of the first book (...) in English on the dark humour: The Treatise of Melancholy (1586). Bright's account of melancholy involves a cybernetic phenomenology of the human. Essentially, we are psyches (souls or minds). We are sealed off from our bodies, operating them as automata across an interface. Psychological presence, for Bright, is illusion and pathology. Engrossing performances or representations therefore bring great danger, and so does the doctrine of predestination-less for its content than its typical delivery. Painful preaching was indispensable in sixteenth-century English Protestantism. But it falls foul of Bright's proscriptions. This is followed by his publication of the first known system for verbatim shorthand notation since antiquity, its technique heavily inflected toward a vocabulary of the pulpit. The passionate, oral performance of the inspired preacher receives an unprecedented textual preservative-and prophylactic. Bright's technology of information serves his phenomenology of alienation. This book will be of interest to students and scholars of the early modern period, the tradition of melancholy, and the history of information-as theory, and technology. (shrink)

We all have had convictions that we were unable to substantiate on a purely logical basis. Such intuitive experiences have intrigued philosophers for centuries, although the construct of intuition as such has generally been given an undeserved cold shoulder by researchers. As Peugeot, in this issue, observes, ‘It is therefore very surprising that so few studies have been dedicated to the study of the subjective experience which is associated with it’ . Peugeot is correct in her observation that modern research (...) has had little to say explicitly about intuition and its subjective concomitants. However, this omission may be as much a matter of terms as it is of fact. Specifically, if we consider the definition of intuition we see that a considerable amount of research that has been called by other names, actually reveals important insights into both the cognitive processes that lead to intuition and the subjective experiences associated with it. Moreover, because this research explicitly relates subjective experiences to more objective measures and methodologies, it circumvents a central criticism that can be levelled against the first-person phenomenological methodology used by Peugeot; namely that it may not reflect underlying processes, nor even necessarily the subjective experiences that it purports to measure. (shrink)