A Philosophy of Mitzvot by Rabbi Dr. Gersion Appel sets forth the Hinnukh's objectives and his approach to revealing the religious and ethical meaning of the mitzvot. In his wide-ranging study, the author presents a comprehensive view of Jewish philosophy as developed by the Hinnukh and the classical Jewish philosophers. The Hinnukh emerges in this study as a great educator and moral and religious guide, and his classic work as a treasure-trove of Jewish knowledge, religious inspiration, and brilliant (...) insight in the molding of human character. (shrink)

Neurocognitive enhancement, or cosmetic neurology, offers the prospect of improving the learning, memory and attention skills of healthy individuals well beyond the normal human range. Much has been written about the ethics of such enhancement, but policy-makers in the USA, the UK and Europe have been reluctant to legislate in this rapidly developing field. However, the possibility of discrimination by employers and insurers against individuals who choose not to engage in such enhancement is a serious threat worthy of legislative intervention. (...) While lawmakers should not prevent individuals from freely pursuing neurocognitive enhancement, they should act to ensure that such enhancement is not coerced. This paper offers one model for such legislation, based upon a proposed US law, the Genetic Information Nondiscrimination Act of 2008, to address precisely this particular pitfall of the impending neuroscience revolution. (shrink)

Whether the law should permit individuals to opt out of accepted death standards is a question that must be faced and clarifiedWhile media coverage of the Terri Schiavo case in Florida has recently refocused public attention on end of life decision making, another end of life tragedy in Utah has raised equally challenging—and possibly more fundamental—questions about the roles of physicians and families in matters of death. The patient at the centre of this case was Jesse Koochin, a six year (...) old boy suffering from “inoperable and incurable” brain cancer. He had been undergoing care at Primary Children’s Medical Center in Salt Lake City since September 15, 2004 when “his tumor pushed his brain stem down through the skull”.1 Subsequently, two physicians independently determined that the child was “brain dead” and informed his parents that they would order life support removed within twenty four hours. Steve and Gayle Koochin overtly rejected the hospital’s definition of death. The couple, relying on traditional notions of cardiopulmonary death, obtained a restraining order to keep Jesse on a ventilator and ultimately removed the brain dead child from the hospital. The ongoing case raises the complex question of whether patients’ families should be permitted to opt out of widely accepted definitions of death in favour of their own standards.The definition of death has evolved rapidly in the United States over the past thirty five years. Until the middle of the twentieth century, the medical community, the legal system, and an overwhelming majority of the public understood death to …. (shrink)

Dieser Band ist der erste Teil einer Lekture von Hegels Phanomenologie des Geistes, in dem die ersten drei Hauptkapitel - d.h. -Bewusstsein-, -Selbstbewusstsein- und -Vernunft- - von Hegels erstem Hauptwerk umfassend kommentiert werden. Der Text entstand dabei wahrend eines uber viele Jahre laufenden Seminars, welches am Institut fur Philosophie der Universitat Wien unter Leitung von Professor Dr. Friedrich Grimmlinger abgehalten wurde und in dem der Hegelsche Text gemeinsam Satz fur Satz gelesen und ausgelegt wurde.".

“An original, compelling, and provocative exploration of ethical issues in our society, with thoughtful and balanced commentary. I have not seen anything like it.” —Alan Lightman, author of Einstein’s Dreams Drawing upon the author’s two decades teaching medical ethics, as well as his work as a practicing psychiatrist, this profound and addictive little book offers up challenging ethical dilemmas and asks readers, What would you do? A daughter gets tested to see if she’s a match to donate a kidney to (...) her father. The test reveals that she is not the man’s biological daughter. Should the doctor tell the father? Or the daughter? A deaf couple prefers a deaf baby. Should they be allowed to use medical technology to ensure they have a child who can’t hear? Who should get custody of an embryo created through IVF when a couple divorces? Or, when you or a loved one is on life support, Who says you’re dead? In short, engaging scenarios, Dr. Appel takes on hot-button issues that many of us will confront: genetic screening, sexuality, privacy, doctor-patient confidentiality. He unpacks each hypothetical with a brief reflection drawing from science, philosophy, and history, explaining how others have approached these controversies in real-world cases. Who Says You’re Dead? is designed to defy easy answers and to stimulate thought and even debate among professionals and armchair ethicists alike. (shrink)

Between inventing the concept of a universal computer in 1936 and breaking the German Enigma code during World War II, Alan Turing, the British founder of computer science and artificial intelligence, came to Princeton University to study mathematical logic. Some of the greatest logicians in the world--including Alonzo Church, Kurt Gödel, John von Neumann, and Stephen Kleene--were at Princeton in the 1930s, and they were working on ideas that would lay the groundwork for what would become known as computer science. (...) Though less well known than his other work, Turing's 1938 Princeton PhD thesis, "Systems of Logic Based on Ordinals," which includes his notion of an oracle machine, has had a lasting influence on computer science and mathematics. This book presents a facsimile of the original typescript of the thesis along with essays by Andrew Appel and Solomon Feferman that explain its still-unfolding significance. A work of philosophy as well as mathematics, Turing's thesis envisions a practical goal--a logical system to formalize mathematical proofs so they can be checked mechanically. If every step of a theorem could be verified mechanically, the burden on intuition would be limited to the axioms. Turing's point, as Appel writes, is that "mathematical reasoning can be done, and should be done, in mechanizable formal logic." Turing's vision of "constructive systems of logic for practical use" has become reality: in the twenty-first century, automated "formal methods" are now routine. Presented here in its original form, this fascinating thesis is one of the key documents in the history of mathematics and computer science. (shrink)

As a result of workplace clean air regulations and strict guidelines imposed by the Joint Commission on Accreditation of Healthcare Organizations in 1993, most hospitals in the United States are now virtually smoke free. Although evidence suggests that these restrictions both cause smoking employees to consume fewer cigarettes per day and induce some employees to quit smoking entirely, the policies have also driven many healthcare providers—including physicians—onto the public sidewalks for their cigarette breaks. Patients entering many hospitals pass white-coated medical (...) students and residents puffing away at the curbside. (shrink)

Aims to show graduate students and researchers the vital benefits of integrating mathematics into their study and experience of the physical world. This book details numerous topics from the frontiers of modern physics and mathematics such as convergence, Green functions, complex analysis, Fourier series and Fourier transform, tensors, and others.

Die Arbeit setzt sich mit der neuzeitlichen Theodizeefrage auseinander. In einem ersten Schritt wird versucht, den genuinen Gehalt der Philosophie von Leibniz darzustellen, dessen Werk für die weitere Diskussion dieser Thematik maßgeblich wurde. Dabei wird aufgewiesen, dass die Argumente von Leibniz empiristischen und fideistischen Bestreitungen einer Theodizee standzuhalten und den Glauben an den allmächtigen und gütigen Gott mit dem Phänomen menschlicher Freiheit in Verbindung zu bringen vermögen. In einem zweiten Schritt werden die Positionen von Kant und Leibniz konfrontiert. Dabei zeigt (...) sich, dass Kant den von Leibniz bezeichneten Weg nicht verwirft, sondern weiterführt und die Theodizeefrage konsequent in der Praxis menschlichen Weltumgangs zu verorten vermag. (shrink)

In 1233 a certain R. Joseph bar Moses of Würzburg commissioned an illuminated copy of Rashi's Bible commentary, now in Munich. After the text was finished, the task of illuminating was put into the hands of a Christian painter, apparently a man named Heinrich, who kept a lay workshop in Würzburg . Three years later a giant Bible, now in Milan, was commissioned perhaps by the same patron, but not necessarily in the same city . It, too, was illuminated; this (...) time, however, it cannot be excluded that the paintings were made by Jewish artists. Both manuscripts are richly decorated with narrative scenes involving human figures. In the following decades it became more and more customary for wealthy Jews of Germany and northern France to have their Bibles, prayer books, and other texts adorned with figural miniatures. Yet there is no evidence that during the Middle Ages human figures were painted in any form in a Jewish context before the 1230s. A few textual references from the twelfth century indicate wall paintings and stained-glass windows in synagogues with images of animals and dragons, but none have survived. Some decades after the first illuminated books made their appearance, the most outstanding authority on religious law of his time, R. Meir ben Barukh of Rothenburg , was asked his opinion of this phenomenon. R. Meir was worried, as his reply shows, but not for reasons of religious law; his concern was that images in painted books would distract believers from their pious concentration during prayer. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work. This work is in the public domain (...) in the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work. As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

Revised habilitation - Universitèat, Wien.

Substituted judgment has increasingly become the accepted standard for rendering decisions for incapacitated adults in the USA. A broad exception exists with regard to patients with diminished capacity secondary to depressive disorders, as such patients’ previous wishes are generally not honoured when seeking to turn down life-preserving care or pursue aid-in-dying. The result is that physicians often force involuntary treatment on patients with poor medical prognoses and/or low quality of life as a result of their depressive symptoms when similarly situated (...) incapacitated patients without such depressive symptoms would have their previous wishes honoured via substituted judgment. This commentary argues for reconsidering this approach and for using a substituted judgment standard for a subset of EMP/LQL patients seeking death. (shrink)

Because the number of organs available for transplantation does not meet the needs of potential recipients, some have proposed that a potentially effective way to increase registration is to offer a self‐benefit incentive that grants a 'preferred status' or some degree of prioritization to those who register as potential donors, in case they might need organs. This proposal has elicited an ethical debate on the appropriateness of such a benefit in the context of a life‐saving medical procedure. In this paper (...) we review arguments and ethical concerns raised by scholars, and studies of views of members of the public regarding the prioritization incentive system. We also report on our study of the views of those involved in organ transplant and of other medical professionals in Israel, as over half a decade ago Israel implemented a prioritization incentive system. Bioethicists propose that key stakeholders' views can provide additional arguments and perspectives on controversial issues. Proponents justify the prioritization incentive drawing mainly on arguments related to its potential effectiveness, reciprocity and fairness. Opponents point to the fact that registering is not binding and not an actual donation, and raise concerns regarding equity, autonomy and gaming the system. Ethical concerns raised by the practitioners in the study were examined in light of scholars' arguments and actual registration and donation data. Practitioners involved in transplantation raised ethical concerns corresponding to those raised by scholars as well as additional concerns. They also challenged proponents' assumptions regarding the utility of the incentive system from their own experience and argued that proponents obscure the meaning of reciprocity. (shrink)

The public discourse surrounding sex and severe disability over the past 40 years has largely focused on protecting vulnerable populations from abuse. However, health professionals and activists are increasingly recognising the inherent sexuality of disabled persons and attempting to find ways to accommodate their intimacy needs. This essay explores several ethical issues arising from such efforts.

Apolitical, amoral, an aesthete whose writings point toward some form of liberation: this is the figure who emerges from most recent scholarship on Friedrich ...

Physicians expressing opinions on medical matters that run contrary to the consensus of experts pose a challenge to licensing bodies and regulatory authorities. While the right to express contrarian views feeds a robust marketplace of ideas that is essential for scientific progress, physicians advocating ineffective or dangerous cures, or actively opposing public health measures, pose a grave threat to societal welfare. Increasingly, a distinction has been made between professional speech that occurs during the physician-patient encounter and public speech that transpires (...) beyond the clinical setting, with physicians being afforded wide latitude to voice empirically false claims outside the context of patient care. This paper argues that such a bifurcated model does not sufficiently address the challenges of an age when mass communications and social media allow dissenting physicians to offer misleading medical advice to the general public on a mass scale. Instead, a three-tiered model that distinguishes between citizen speech, physician speech and clinical speech would best serve authorities when regulating physician expression. (shrink)

Priority for solid organ transplant generally does not consider the underlying cause of the need for transplantation. This paper argues that a distinctive set of factors justify assigning lower priority to willfully unvaccinated individuals who require transplant as a result of suffering from COVID‐19. These factors include the personal responsibility of the patients for their own condition and the public outrage likely to ensue if willfully unvaccinated patients receive organs at the expense of vaccinated ones. The paper then proposes a (...) three‐prong test for similar deviations from the current allocation standard that incorporates patient responsibility, foreseeability and avoidability, and the frequency of the occurrence. (shrink)

The integrity of the patient–physician relationship depends on maintaining professional boundaries. While ethicists and professional organisations have devoted significant consideration to the subject of sexual boundary transgressions, the subject of non-sexual boundaries, especially outside the mental health setting, has been largely neglected. While professional organisations may offer guidance on specific subjects, such as accepting gifts or treating relatives, as well as general guidance on transparency and conflict of interest, what is missing is a principle-based method that providers can use to (...) assess non-sexual interactions with patients that transcend norms of practice. This paper attempts to offer an operational model for such assessment that considers not only the traditional emphasis on beneficence, but also incorporates concerns over entanglement and concordance. (shrink)

The “Goldwater rule,” a policy adopted by the American Psychiatry Association in 1973, prohibits organization members from diagnosing or offering professional opinions regarding the mental health of public figures without both first-hand evaluation and authorization. Initially developed in response to a controversial survey of APA members during the 1964 Presidential election campaign, the ethics rule faced few large scale challenges until the election of Donald Trump in 2016. Since that time, a significant number of psychiatrists have either violated or criticized (...) the rule openly. This paper argues that whatever the initial merits of the rule, the prohibition has since been rendered obsolete by the combined lack of professional consensus supporting the policy, absence of a meaningful enforcement mechanism, and the credible statements of non-APA members in the mental health professions regarding public figures. (shrink)

Since several landmark legal decisions in the 1970s and 1980s, substituted judgment has become widely accepted as an approach to decision‐making for incapacitated patients that incorporates their autonomy and interests. Two notable exceptions have been cases involving minors and those involving cognitively or psychiatrically impaired individuals who never previously possessed the ability to contemplate the medical decisions involved in their care. While a best interest standard may have universal merit in pediatric cases, this paper argues that substituted judgement has been (...) rejected too broadly for “never‐capacitated” patients. It then lays out a three‐condition test for using substituted judgment in these cases. For a subset of “never‐capacitated” patients who belong to distinctive religious or cultural communities with clear medical values and have an appropriate surrogate, these values may prove helpful in vindicating the interests of the never‐capacitated and should not be blanketly dismissed. (shrink)

The American Journal of Bioethics, Volume 12, Issue 9, Page 9-11, September 2012.

Artificial intelligence (AI) holds considerable promise for transforming clinical diagnostics. While much has been written both about public attitudes toward the use of AI tools in medicine and about uncertainty regarding legal liability that may be delaying its adoption, the interface of these two issues has so far drawn less attention. However, understanding this interface is essential to determining how jury behaviour is likely to influence adoption of AI by physicians. One distinctive concern identified in this paper is a ‘negative (...) outcome penalty paradox’ (NOPP) in which physicians risk being penalised by juries in cases with negative outcomes, whether they overrule AI determinations or accept them. The paper notes three reasons why AI in medicine is uniquely susceptible to the NOPP and urges serious further consideration of this complex dilemma. (shrink)

Capacity evaluation has become a widely used assessment device in clinical practice to determine whether patients have the cognitive ability to render their own medical decisions. Such evaluations, which might be better thought of as “capacity challenges,” are generally thought of as benign tools used to facilitate care. This paper proposes that such challenges should be reconceptualized as significant medical interventions with their own set of risks, side effects, and potentially deleterious consequences. As a result, a cost–benefit analysis should be (...) implemented prior to imposing such capacity challenges, and efforts should be made to minimize such challenges in situations where they are unlikely to alter the course of treatment. (shrink)

Although considerable attention has been devoted to the concepts of “visible” and “invisible” victims in general medical practice, especially in relation to resource allocation, far less consideration has been devoted to these concepts in behavioral health. Distinctive features of mental health care in the United States help explain this gap. This essay explores three specific ways in which the American mental health care system protects potentially “visible” individuals at the expense of “invisible victims” and otherwise fails to meet the needs (...) of great numbers of people with serious psychiatric conditions: prioritization of the wrong patients, incentivization of excessive caution among providers, and a narrow definition of psychiatry's purview. While each of these practices has been discussed elsewhere in the literature, they are rarely considered as part of an interrelated and systemic problem. Reconceptualizing these three issues as aspects of the larger conflict between the interests of “visible” and “invisible” victims may prove a path toward reform. (shrink)