Brain dead organ donors are the principal source of transplantable organs. However, it is controversial whether brain death is the same as biological death. Therefore, it is unclear whether organ removal in brain death is consistent with the ‘dead donor rule’, which states that organ removal must not cause death. Our aim was to evaluate the public9s opinion about organ removal if explicitly described as causing the death of a donor in irreversible apneic coma. We conducted a cross-sectional internet survey (...) of the American public (n=1096). Questionnaire domains included opinions about a hypothetical scenario of organ removal described as causing the death of a patient in irreversible coma, and items measuring willingness to donate organs after death. Some 71% of the sample agreed that it should be legal for patients to donate organs in the scenario described and 67% agreed that they would want to donate organs in a similar situation. Of the 85% of the sample who agreed that they were willing to donate organs after death, 76% agreed that they would donate in the scenario of irreversible coma with organ removal causing death. There appears to be public support for organ donation in a scenario explicitly described as violating the dead donor rule. Further, most but not all people who would agree to donate when organ removal is described as occurring after death would also agree to donate when organ removal is described as causing death in irreversible coma. (shrink)

Reasons can interact in a variety of ways to determine what we ought to do or believe. And there can be cases where two reasons to do an act or have a belief are individually worse than a reason to not do that act or have that belief, but the reasons together are better than the reason to not do that act or have that belief. So the reasons together―which we can call the accrual of those reasons—can have a strength (...) that is an increasing function of the strengths of the individual reasons. In this paper, we will look at how reasons determine what we ought to do and believe in cases where the accrual of reasons is relevant. Our focus will not primarily be on questions about the nature of individual reasons and their weight. Instead, we will at the outset rely on our pretheoretical grip on what reasons there are and how weighty they are individually and ask the more formal or structural question of how to determine the strength of their accrual based on these facts. In looking at these issues, my goal will not be anything as ambitious as developing a full theory of the accrual of reasons. Rather, my goal will be more modest: I will introducing some of the challenges for providing an adequate model and argue that a promising approach to resolving these challenges involves making use of the familiar distinction in moral philosophy between derivative and non-derivative normative notions. (shrink)

One of the popular albeit controversial ideas in the last century of moral philosophy is that what we ought to do is explained by our reasons. And one of the central features of reasons that accounts for their popularity among normative theorists is that they can conflict. But I argue that the fact that reasons conflict actually also poses two closely related problems for this popular idea in moral philosophy. The first problem is a generalization of a problem in deontic (...) logic concerning the existence of conflicting obligations. The second problem arises from a tension between the fact that reasons can conflict and a model of how reasons explain ‘ought’s that has been widely accepted. Having presented each of these problems, I develop a unified solution to them that is informed by results in both ethics and deontic logic. An important implication of this solution is that we must distinguish between derivative and nonderivative reasons and revise our conception how it is that reasons explain ‘ought’s. (shrink)

The concept of death and its relationship to organ transplantation continue to be sources of debate and confusion among academics, clinicians, and the public. Recently, an international group of scholars and clinicians, in collaboration with the World Health Organization, met in the first phase of an effort to develop international guidelines for determination of death. The goal of this first phase was to focus on the biology of death and the dying process while bracketing legal, ethical, cultural, and religious perspectives. (...) The next phase of the project will include a broader group of stakeholders in the development of clinical practice guidelines and will use expert consensus on biomedical criteria for death from the first phase as scientific input into normative deliberation about appropriate policies and practices. Surely, science alone cannot resolve the normative and philosophical questions intertwined in debates about moral status, legal and moral rights, the ethics of killing, and personhood and the nature of the self; however, scientific input is necessary for informed moral deliberation. An objective and unbiased investigation of the biology of death is independent of, and should be undertaken prior to, an analysis of the normative questions engendered by debate about determination of death. This strategy is explicitly endorsed by the International Guidelines for Determination of Death and reflects the prevailing view of these issues in the mainstream medical literature. However, this mainstream literature, exemplified by the IGDD group's recent report, does not exhibit any of the characteristics usually associated with a scientifically rigorous investigation, such as making empirically testable and falsifiable claims, a commitment to evidence and logic over authoritative assertion, or a willingness to revise hypotheses and theories in light of new evidence. Indeed, the core claims and methodologies of the mainstream medical literature on death, both of which are represented by the IGDD report, are not merely scientifically unjustified; they are not science at all. This situation creates a problem for the integrity of science and the academy, and it unjustly obscures and prevents legitimate democratic and moral deliberation about issues that, at bottom, are normative, not scientific. (shrink)

A traditional picture is that cases of deontic constraints--- cases where an act is wrong (or one that there is most reason to not do) even though performing that act will prevent more acts of the same morally (or practically) relevant type from being performed---form a kind of fault line in ethical theory separating (agent-neutral) consequentialist theories from other ethical theories. But certain results in the recent literature, such as those due to Graham Oddie and Peter Milne in "Act and (...) Value", do not sit well this traditional wisdom. My aim in this paper is to argue that both the traditional wisdom and Oddie and Milne are mistaken. I begin by looking more closely at the traditional wisdom and why it fails (§1). Then I develop my account of this fault line in ethical theory and its importance (§2). Finally I show that a diagnosis of where Oddie and Milne go wrong follows as a corollary of this new account (§3). An important upshot will be that discussions of cases of deontic constraints would do best to focus on the account of the nature and importance of the cases identified in this paper rather than continuing to work with the mistaken traditional picture. (shrink)

An astonishingly diverse biomolecular circuitry orchestrates the functioning machinery underlying every living cell. These biomolecules and their circuits have been engineered not only for various industrial applications but also to perform other atypical functions that they were not evolved for—including computation. Various kinds of computational challenges, such as solving NP‐complete problems with many variables, logical computation, neural network operations, and cryptography, have all been attempted through this unconventional computing paradigm. In this review, we highlight key experiments across three different ‘‘eras’’ (...) of molecular computation, beginning with molecular solutions, transitioning to logic circuits and ultimately, more complex molecular networks. We also discuss a variety of applications of molecular computation, from solving NP‐hard problems to self‐assembled nanostructures for delivering molecules, and provide a glimpse into the exciting potential that molecular computing holds for the future. Also see the video abstract here: https://youtu.be/9Mw0K0vCSQw. (shrink)

ABSTRACT:Organismal superposition holds that the same individual both is and is not an organism, as a consequence of organismal pluralism. When coupled with the assumption that death is the cessation of an organism, this entails that there is no unique answer as to whether brain death is biological death. This essay argues that concerns about organismal pluralism and superposition do not undermine a theory of biological death, nor entail any metaphysical indeterminacy about the biological vital status of a brain-dead individual.

In this essay I examine the formal structure of the concept of futility, enabling identification of the appropriate roles played by patient, professional, and society. I argue that the concept of futility does not justify unilateral decisions to forego life-sustaining medical treatment over patient or legitimate surrogate objection, even when futility is determined by a process or subject to ethics committee review. Furthermore, I argue for a limited positive ethical obligation on the part of health care professionals to assist patients (...) in achieving certain restricted goals, including the preservation of life, even in circumstances in which most would agree that that life is of no benefit to the patient. Finally, I address the objection that professional integrity overrides this limited obligation and find the objection unconvincing. In short, my aim in this essay is to see the concept of futility finally buried, once and for all. (shrink)

Two experiments investigated whether moral evaluations of organ transplantation influence judgments of death and causation. Participants’ beliefs about whether an unconscious organ donor was dead and whether organ removal caused death in a hypothetical vignette varied depending on the moral valence of the vignette. Those who were randomly assigned to the good condition were more likely to believe that the donor was dead prior to organ removal and that organ removal did not cause death. Furthermore, attitudes toward euthanasia and organ (...) donation independently predicted judgments of death and causation, regardless of experimental condition. The results are discussed in light of the framework of motivated reasoning, in which motivation influences the selection of cognitive processes and representations applied to a given domain, as well as Knobe’s person-as-moralist model, in which many basic concepts are appropriately imbued with moral features. On either explanatory framework, these data cast doubt on the psychological legitimacy of the mainstream justification for vital organ procurement from heart-beating donors, which holds that neurological criteria for death are scientifically justified, independently of concerns about organ transplantation. These data suggest that, rather than concluding that organ removal is permissible because the donor is dead, people may believe that the donor is dead because they believe organ removal to be permissible. (shrink)

Coproduction of public policy involves bringing together technical experts, practitioners, and people with lived experience of that policy to collaboratively and deliberatively codesign it. Coproduction can leverage different ways of knowing and evaluative perspectives on a policy area to enhance the legitimacy and efficaciousness of policymaking. This article argues that researcher reflexivity is crucial for getting the most out of coproduction ethically and epistemically. By reflecting on our positionality, habitus, and biases, we can gain new insights into how we affect (...) the research design, production and analysis of data, and communication of findings. This reflexivity helps to disrupt power dynamics that underly research and policymaking, helping to realise the radical potential of coproduction to democratise practice, empower citizens, and make research more relational. We demonstrate the value of reflexivity through an analysis of our work coproducing a theory of thriving in financial hardship in partnership with the UK national anti-poverty charity Turn2us. We contextualise our advocacy for reflexivity within the practical realities of advancing coproduction in the UK today. (shrink)

Can new technology enhance purpose-driven, democratic dialogue in groups, governments, and societies? Online Deliberation: Design, Research, and Practice is the first book that attempts to sample the full range of work on online deliberation, forging new connections between academic research, technology designers, and practitioners. Since some of the most exciting innovations have occurred outside of traditional institutions, and those involved have often worked in relative isolation from each other, work in this growing field has often failed to reflect the full (...) set of perspectives on online deliberation. This volume is aimed at those working at the crossroads of information/communication technology and social science, and documents early findings in, and perspectives on, this new field by many of its pioneers. -/- CONTENTS: -/- Introduction: The Blossoming Field of Online Deliberation (Todd Davies, pp. 1-19) -/- Part I - Prospects for Online Civic Engagement -/- Chapter 1: Virtual Public Consultation: Prospects for Internet Deliberative Democracy (James S. Fishkin, pp. 23-35) -/- Chapter 2: Citizens Deliberating Online: Theory and Some Evidence (Vincent Price, pp. 37-58) -/- Chapter 3: Can Online Deliberation Improve Politics? Scientific Foundations for Success (Arthur Lupia, pp. 59-69) -/- Chapter 4: Deliberative Democracy, Online Discussion, and Project PICOLA (Public Informed Citizen Online Assembly) (Robert Cavalier with Miso Kim and Zachary Sam Zaiss, pp. 71-79) -/- Part II - Online Dialogue in the Wild -/- Chapter 5: Friends, Foes, and Fringe: Norms and Structure in Political Discussion Networks (John Kelly, Danyel Fisher, and Marc Smith, pp. 83-93) -/- Chapter 6: Searching the Net for Differences of Opinion (Warren Sack, John Kelly, and Michael Dale, pp. 95-104) -/- Chapter 7: Happy Accidents: Deliberation and Online Exposure to Opposing Views (Azi Lev-On and Bernard Manin, pp. 105-122) -/- Chapter 8: Rethinking Local Conversations on the Web (Sameer Ahuja, Manuel Pérez-Quiñones, and Andrea Kavanaugh, pp. 123-129) -/- Part III - Online Public Consultation -/- Chapter 9: Deliberation in E-Rulemaking? The Problem of Mass Participation (David Schlosberg, Steve Zavestoski, and Stuart Shulman, pp. 133-148) -/- Chapter 10: Turning GOLD into EPG: Lessons from Low-Tech Democratic Experimentalism for Electronic Rulemaking and Other Ventures in Cyberdemocracy (Peter M. Shane, pp. 149-162) -/- Chapter 11: Baudrillard and the Virtual Cow: Simulation Games and Citizen Participation (Hélène Michel and Dominique Kreziak, pp. 163-166) -/- Chapter 12: Using Web-Based Group Support Systems to Enhance Procedural Fairness in Administrative Decision Making in South Africa (Hossana Twinomurinzi and Jackie Phahlamohlaka, pp. 167-169) -/- Chapter 13: Citizen Participation Is Critical: An Example from Sweden (Tomas Ohlin, pp. 171-173) -/- Part IV - Online Deliberation in Organizations -/- Chapter 14: Online Deliberation in the Government of Canada: Organizing the Back Office (Elisabeth Richard, pp. 177-191) -/- Chapter 15: Political Action and Organization Building: An Internet-Based Engagement Model (Mark Cooper, pp. 193-202) -/- Chapter 16: Wiki Collaboration Within Political Parties: Benefits and Challenges (Kate Raynes-Goldie and David Fono, pp. 203-205) -/- Chapter 17: Debian’s Democracy (Gunnar Ristroph, pp. 207-211) -/- Chapter 18: Software Support for Face-to-Face Parliamentary Procedure (Dana Dahlstrom and Bayle Shanks, pp. 213-220) -/- Part V - Online Facilitation -/- Chapter 19: Deliberation on the Net: Lessons from a Field Experiment (June Woong Rhee and Eun-mee Kim, pp. 223-232) -/- Chapter 20: The Role of the Moderator: Problems and Possibilities for Government-Run Online Discussion Forums (Scott Wright, pp. 233-242) -/- Chapter 21: Silencing the Clatter: Removing Anonymity from a Corporate Online Community (Gilly Leshed, pp. 243-251) -/- Chapter 22: Facilitation and Inclusive Deliberation (Matthias Trénel, pp. 253-257) -/- Chapter 23: Rethinking the ‘Informed’ Participant: Precautions and Recommendations for the Design of Online Deliberation (Kevin S. Ramsey and Matthew W. Wilson, pp. 259-267) -/- Chapter 24: PerlNomic: Rule Making and Enforcement in Digital Shared Spaces (Mark E. Phair and Adam Bliss, pp. 269-271) -/- Part VI - Design of Deliberation Tools -/- Chapter 25: An Online Environment for Democratic Deliberation: Motivations, Principles, and Design (Todd Davies, Brendan O’Connor, Alex Cochran, Jonathan J. Effrat, Andrew Parker, Benjamin Newman, and Aaron Tam, pp. 275-292) -/- Chapter 26: Online Civic Deliberation with E-Liberate (Douglas Schuler, pp. 293-302) -/- Chapter 27: Parliament: A Module for Parliamentary Procedure Software (Bayle Shanks and Dana Dahlstrom, pp. 303-307) -/- Chapter 28: Decision Structure: A New Approach to Three Problems in Deliberation (Raymond J. Pingree, pp. 309-316) -/- Chapter 29: Design Requirements of Argument Mapping Software for Teaching Deliberation (Matthew W. Easterday, Jordan S. Kanarek, and Maralee Harrell, pp. 317-323) -/- Chapter 30: Email-Embedded Voting with eVote/Clerk (Marilyn Davis, pp. 325-327) -/- Epilogue: Understanding Diversity in the Field of Online Deliberation (Seeta Peña Gangadharan, pp. 329-358). -/- For individual chapter downloads, go to odbook.stanford.edu. (shrink)

We thank the authors of commentaries for their thoughtful discussion of our target article. Here we briefly summarize the points made in the target article (Nair-Collins and Joffe 2023). Then we em...

Business ethics researchers and practitioners are interested in understanding the temporal mechanisms of various managerial activities, processes, and policies. In this direction, I borrow notions of time from Virginia Woolf’s _Mrs. Dalloway_ to examine how social time intersperses with the paid and (unpaid) care work of female employees during the pandemic. I explore how discussions of social time in connection to care work appear in newspaper discourses of “shecession”, i.e. the large-scale job/income losses experienced by women during the COVID-19 pandemic. (...) Since shecession is a byproduct of the pandemic times, exploring the role of time in it is crucial. In fact, my findings show that the macro social time of the pandemic affects working women with care responsibilities who are situated at the intersection of multiple vulnerable social categories by simultaneously being a penalizer and a lost opportunity. Similarly, I also find that the micro social times of working women embed, stratify, and synchronize differently during the pandemic when compared to normal times. Working women with care responsibilities are thus adversely affected by both micro and macro social time changes. My findings, therefore, could be instrumental in developing and implementing inclusive policies and processes in business organizations and labor markets. In so doing, my study also indicates how a consideration of social time enriches the application of care ethics in work contexts. Ultimately, this article is also about developing caring organizations, societies, and families which care for the caregivers (working women), since receiving care is a precondition of giving care. (shrink)

Some patients who have been diagnosed as “dead by neurologic criteria” continue to exhibit certain brain functions, most commonly, neuroendocrine functions. This preservation of neurologic function after the diagnosis of “brain death” or “brainstem death” is an ongoing source of controversy and concern in the medical, bioethics, and legal literatures. Most obviously, if some brain function persists, then it is not the case that all functions of the entire brain have ceased and hence, declaring such a patient to be “dead” (...) would be a false positive, in any nation with so-called “whole brain death” laws. Furthermore, and perhaps more concerning, the preservation of any brain function necessarily entails the preservation of some amount of brain perfusion, thereby raising the concern as to whether additional areas of neural tissue may remain viable, including areas in the brainstem. These and other considerations cast significant doubt on the reliability of diagnosing either “brain death” or “brainstem death.”. (shrink)

This study examines how meritocracy as a collective social imaginary promoting social justice and fairness reproduces class and caste inequalities and fosters ethical violence. We interrogate discourse of merit in the narratives of the professional–managerial class-in-making at an Indian business school. Empirically, we draw on interviews, full-text responses to a qualitative questionnaire, and a student’s poem. We describe how business school students articulate merit as a neoliberal ethic, emphasizing prudential, enterprising attitudes, and responsibility. However, this positive, aspirational façade of merit (...) masks practices of ethical violence, wherein individuals invoke an ethical principle as grounds for moral condemnation and linguistic injuries. These practices of ethical violence desubjectify disadvantaged students and result in silence as a form of inequality. We contribute to organizational research on inequalities by foregrounding ethical violence and desubjectification. We detail the possibilities of discursive agency in contesting and interrupting ethical violence. (shrink)

Since at least the 1960s, deontic logicians and ethicists have worried about whether there can be normative systems that allow conflicting obligations. Surprisingly, however, little direct attention has been paid to questions about how we may reason with conflicting obligations. In this paper, I present a problem for making sense of reasoning with conflicting obligations and argue that no deontic logic can solve this problem. I then develop an account of reasoning based on the popular idea in ethics that reasons (...) explain obligations and show that it solves this problem. (shrink)

How do multiple reasons combine to support a conclusion about what to do or believe? This question raises two challenges: How can we represent the strength of a reason? How do the strengths of multiple reasons combine? Analogous challenges about confirmation have been answered using probabilistic tools. Can reductive and nonreductive theories of reasons use these tools to answer their challenges? Yes, or more exactly: reductive theories can answer both challenges. Nonreductive theories, with the help of a result in confirmation (...) theory, can answer one, and there are grounds for optimism that they can answer the other. (shrink)

The didactic proposal of the post-constructivist (Grossi, 2005), takes into account the relationship between the subject, reality, others and the Other interior and considers the learning potential of all students. Its theoretical foundation is, among other things, the principle that learning is a social phenomenon, and that the spatial organization of the class, in groups of adults, promotes the teaching-learning process. Post-constructivism is a didactic proposition that allows us to respond to the purpose of teaching all students. This article on (...) group work in post-constructivism aims to analyze the change in posture of teachers, and the professional development that follows, and which demonstrates a break with the traditional form of education. The trick of the identified researcher is then to take up in a teacher training, through the aulic groups in the Geempa class and the weekly study group, the scientific approach of post-constructivism. (shrink)

The established view regarding ‘brain death’ in medicine and medical ethics is that patients determined to be dead by neurological criteria are dead in terms of a biological conception of death, not a philosophical conception of personhood, a social construction or a legal fiction. Although such individuals show apparent signs of being alive, in reality they are dead, though this reality is masked by the intervention of medical technology. In this article, we argue that an appeal to the distinction between (...) appearance and reality fails in defending the view that the ‘brain dead’ are dead. Specifically, this view relies on an inaccurate and overly simplistic account of the role of medical technology in the physiology of a ‘brain dead’ patient. We conclude by offering an explanation of why the conventional view on ‘brain death’, though mistaken, continues to be endorsed in light of its connection to organ transplantation and the dead donor rule. (shrink)

Engineering is a practice that must function in an environment of incomplete and uncertain knowledge. This environment has become even more difficult in an increasingly complex world. Engineering ethics has to be framed and taught in a way that addresses these realities. This paper proposes a combination of the philosophy of pragmatism and the ethic of care as a possible framework for the practice of engineering ethics that can provide flexibility and openness to address engineering ethics problems more realistically within (...) the ethos and culture of engineering. Embedding values into practice, pragmatism and care provide a broad, reflective, and corrective framework for engineering ethics that can accommodate the realities in which engineering operates. It is shown that these two approaches are more consonant with design methodologies and have a natural fit with design thinking, so they mesh well with what engineers do and with the complexities of their work today. As humans more and more try to alter the socio-techno-natural world, e.g., the earth’s climate, the combination of pragmatism and care will allow enhanced ethical behavior. Alterations to complex adaptive systems will produce highly uncertain results that require engineers to have a mindset that allows them to act with humility in the face of significant uncertainty and potential catastrophic failures. (shrink)

A “universalist” policy on brain death holds that brain death is death, and neurologic criteria for death determination are rightly applied to all, without exemptions or opt outs. This essay argues that advocates of a universalist brain death policy defend the same sort of coercive control of end-of-life decision-making as “pro-life” advocates seek to achieve for reproductive decision-making, and both are grounded in an illiberal political philosophy. Those who recognize the serious flaws of this kind of public policy with respect (...) to abortion must apply the same logic to brain death. (shrink)

The controversy over brain death and the dead donor rule continues unabated, with some of the same key points and positions starting to see repetition in the literature. One might wonder whether some of the participants are talking past each other, not all debating the same issue, even though they are using the same words (e.g., “death”). One reason for this is the complexity of the debate: It’s not merely about the nature of human life and death. Interwoven into this (...) debate are deep philosophical issues on realism, the normative/descriptive distinction, the relation of thought and language to the world, the mind–body problem, personhood, moral status, and the ethics of killing. There are also social and legal .. (shrink)

John P. Lizza has long been a major figure in the scholarly literature on criteria for death. His searching and penetrating critiques of the dominant biological paradigm, and his defense of a theory of death of the person as a psychophysical entity, have both significantly advanced the literature. In this special issue, Lizza reinforces his critiques of a strictly biological approach. In my commentary, I take up Lizza’s challenge regarding a biological concept of death. He is certainly right to point (...) out that science is not value-free; however, this does not imply that there cannot be a characterization of biological death that can be shown to be superior to other concepts. After characterizing and justifying such a theory of biological death, I show that patients who meet the diagnostic criteria for brain death are unequivocally biologically alive. However, with respect to concepts of personhood and related ideas, I urge the acceptance of a pluralism of such concepts for matters of public policy. (shrink)

The verdicts standard consequentialism gives about what we are obligated to do crucially depend on what theory of value the consequentialist accepts. This makes it hard to say what separates standard consequentialist theories from non-consequentialist theories. This article discusses how we can draw sharp lines separating standard consequentialist theories from other theories and what assumptions about goodness we must make in order to draw these lines. The discussion touches on cases of deontic constraints, cases of deontic options, and cases involved (...) in the so-called "actualism"/"possibilism" debate. What emerges is that there are various interesting patterns relating the different commitments of consequentialism, different principles about obligation and about goodness, and different rules concerning how facts about values determine facts about obligation. (shrink)

Legally defining “death” in terms of brain death unacceptably obscures a value judgment that not all reasonable people would accept. This is disingenuous, and it results in serious moral flaws in the medical practices surrounding organ donation. Public policy that relies on the whole-brain concept of death is therefore morally flawed and in need of revision.

The dead donor rule, which requires that organ donors not be killed by the process of organ procurement, is thought to protect vulnerable patients from exploitation and from being harmed through organ procurement. In current practice, the majority of transplantable organs are retrieved from patients who are declared dead by neurological criteria, or "brain-dead." Because brain death is considered to be sufficient for death, it is thought that brain-dead donors are neither harmed nor wronged by organ removal.In this essay I (...) argue that this is not the case. Brain-dead donors can be, and many are, harmed and wronged by... (shrink)

In this chapter, we begin by sketching in the broadest possible strokes the ideas behind two formal systems that have been introduced with to goal of explicating the ways in which reasons interact to support the actions and conclusions they do. The first of these is the theory of defeasible reasoning developed in the seminal work of Pollock; the second is a more recent theory due to Horty, which adapts and develops the default logic introduced by Reiter to provide an (...) account of reasons. However, the implementations are complex enough, in both cases, to prevent anything more than this sketch. And we would not want to give the impression that we think that work on the logic of reasons must follow the path mapped out in either of these theories—indeed, we feel that the field is wide open. In the remainder of the chapter, therefore, will concentrate on a number of issues bearing on the logic of reasons that are either not treated in the work of Pollock and Horty, or whose treatment there is, we feel, either inadequate or incomplete. These are: first, the question of whether it is necessary to understand logical interactions among reasons themselves, rather than simply between reasons and the actions or conclusions they support, and if so, what principles might govern these interactions; second, priority relations among reasons and the notion of reason accrual; and third, some problems posed by undercutting defeat. (shrink)

Drawing on a recent case report of a pregnant, brain‐dead woman who gave birth to a healthy child after over seven months of intensive care treatment, this essay rejects the established doctrine in medicine that brain death constitutes the biological death of the human being. The essay describes three policy options with respect to determination of death and vital organ transplantation in the case of patients who are irreversibly comatose but remain biologically alive.

One of the principles of health care ethics is the principle of justice. An important expression of justice is equity. The provision of basic primary health care services to all people is the key to eliminating the gross inequities in health status existing in many countries. For many years nurses in developing countries have ‘led the way’ in bringing these essential services to poor rural communities, including the diagnosis and treatment of illnesses, and the prescribing and dispensing of medications. Nurses (...) are the most appropriate health workers for this role, but most have not been prepared adequately for it. This is unsafe for patients and puts nurses at legal risk. Justice requires that patients should obtain access to safe health care and that nurses should receive appropriate education. Nurse practitioner programmes are being established to prepare nurses for this advanced practice role, but here again ethical considerations apply. Justice will be served only if nurse practitioner programmes are accessible to the nurses who are most likely to work in medically underserved communities where the need is greatest. (shrink)

A recent publication project entitled Asian Business Discourse has brought to the attention of the international readership an original body of research on business discursive practices and organizational communication issues in a variety of Asian cultures. In this Forum, we discuss some of the topics highlighted by the project, which arise from the recent indigenous research in business discourse as a multidisciplinary field.