A growing number of bioethics papers endorse the harm threshold when judging whether to override parental decisions. Among other claims, these papers argue that the harm threshold is easily understood by lay and professional audiences and correctly conforms to societal expectations of parents in regard to their children. English law contains a harm threshold which mediates the use of the best interests test in cases where a child may be removed from her parents. Using Diekema9s seminal paper as an example, (...) this paper explores the proposed workings of the harm threshold. I use examples from the practical use of the harm threshold in English law to argue that the harm threshold is an inadequate answer to the indeterminacy of the best interests test. I detail two criticisms: First, the harm standard has evaluative overtones and judges are loath to employ it where parental behaviour is misguided but they wish to treat parents sympathetically. Thus, by focusing only on ‘substandard’ parenting, harm is problematic where the parental attempts to benefit their child are misguided or wrong, such as in disputes about withdrawal of medical treatment. Second, when harm is used in genuine dilemmas, court judgments offer different answers to similar cases. This level of indeterminacy suggests that, in practice, the operation of the harm threshold would be indistinguishable from best interests. Since indeterminacy appears to be the greatest problem in elucidating what is best, bioethicists should concentrate on discovering the values that inform best interests. (shrink)

Best known for having declared the death of God, Nietzsche was a thinker thoroughly absorbed in the Christian tradition in which he was born and raised. Yet while the atheist Nietzsche is well known, the pious Nietzsche is seldom recognised and rarely understood. Redeeming Nietzsche examines the residual theologian in the most vociferous of atheists. Fraser demonstrates that although Nietzsche rejected God, he remained obsessed with the question of human salvation. Examining his accounts of art, truth, morality and eternity, Nietzsche's (...) thought is revealed to be a series of experiments in redemption. (shrink)

In an earlier paper entitled _Harm is all you need?_, I used an analysis of English law to claim that the harm threshold was an unsuitable mediator of the best interests test when deciding if parental decisions should be overruled. In this paper I respond to a number of commentaries of that paper, and extend my discussion to consider the claim that the harm threshold gives appropriate normative weight to the interests of parents. While I accept that parents have some (...) rights over their children, I argue these are dependent on parents’ duties to benefit their children. While many such benefits are understood pluralistically, and are thus within parents’ ambit to decide, I claim that health benefits are ordinally different, because they play a foundational role in the flourishing of an individual. In the light of this, clinicians have the moral authority to override parental refusals, although in some cases abstaining from exercising this authority may be a pragmatic way to maintain parental engagement and ensure our ability to benefit the child in future. (shrink)

One of the main points of interests in the apocalyptic literature is the salvation of God’s people. The topic is shown from a variety of perspectives. One of them is exceptional and very prominent in the apocalyptic genre – this is God’s victory. The theme of victory is a complex one. It consists of not only terminology and imagery of war, fight, rivalry, but also judgement, competition and kingdom. All of these motifs are being intertwined in the apocalyptic victory of (...) God. The problem of God’s victory can be seen as schematic, which is present in many texts from the apocalyptic genre. Altering variables inside this scheme results in a different outlook on the salvation. It is used to give the shape of the narrative in the text. From the variety of apocalyptic literature, an exceptional place is given to the Apocalypse of John. The theme of God’s victory there, although it uses the Jewish traditions, is rewritten and upgraded to a new unique form. The goal of this article is to investigate how the mentioned schematic realises through different examples of apocalyptic texts and how it is incorporated and redefined in the Book of Apocalypse. What is God’s victory? Who is being conquered? With what means? What does it all mean to the salvation of people? These are the questions, which the author will try to answer in the article. (shrink)

The experience of being famous was investigated through interviews with 15 well-known American celebrities. The interviews detail the existential parameters of being famous in contemporary culture. Research participants were celebrities in various societal categories: government, law, business, publishing, sports, music, film, television news and entertainment. Phenomenological analysis was used to examine textural and structural relationship-to-world themes of fame and celebrity. The study found that in relation to self, being famous leads to loss of privacy, entitization, demanding expectations, gratification of ego (...) needs, and symbolic immortality. In relation to other, or world, being famous leads to wealth, access, temptations, and concerns about family impact. Areas of psychological concern for celebrity mental health include character-splitting, mistrust, isolation, and an unwillingness to give up fame. Being-in-the-world of celebrity is a process involving four temporal phases: love/hate, addiction, acceptance, and adaptation. Findings are presented in the form of a Composite Textural Description and two Individual Structural Descriptions. (shrink)

Assent to medical research or treatment may be an intuitively attractive way to address the area between incapacity and capacity that might otherwise be subject to a best interests assessment. Assent has become a widely disseminated concept in law, research, and clinical ethics, but little conceptual work on assent has so far occurred. An exploration of use of assent in treatment and research in children and people with dementia suggests that at least five claims are made on behalf of assent. (...) Since at least some of these may lead to tensions with others, assent requires firmer conceptual underpinning. Whether assent remains primarily a local approach to research in children in the United States, where it appears to fit with legal background conditions, or develops its promise to overturn the dominant, binary, approach to (in)capacity will depend on the strength of future philosophical work to improve the theoretical foundations to assent. (shrink)

Background Best interests is a ubiquitous principle in medical policy and practice, informing the treatment of both children and adults. Yet theory underlying the concept of best interests is unclear and rarely articulated. This paper examines bioethical literature for theoretical accounts of best interests to gain a better sense of the meanings and underlying philosophy that structure understandings. Methods A scoping review of was undertaken. Following a literature search, 57 sources were selected and analysed using the thematic method. Results Three (...) themes emerged. The first placed best interests within the structure of wider theory, noting relationships with consequentialism, deontology, prudential value theory, rights and political philosophy. The second mapped a typology of processes of decision-making, among which best interests was ambiguously positioned. It further indicated factors that informed best interests decision-making, primarily preferences, dignity and quality of life. The final theme considered best interests from a relational perspective. Conclusions Characterisation of best interests as strictly paternalist and consequentialist is questionable: while accounts often suggested a consequentialist basis for best interests, arguments appeared philosophically weak. Deontological accounts, found in law and Kantianism, and theories of political liberalism influenced accounts of best interests, with accounts often associating best interests with negative patient preferences (i.e. individual refusals). There was much more emphasis on negative interests than positive interests. Besides preference, factors like dignity and quality of life were held to inform best interests decisions, but generally were weakly defined. To the extent that preferences were unable to inform decision making, decisions were either made by proxy authority or by an intersubjective process of diffuse authority. Differing approaches reflect bifurcations in liberal philosophy between new liberalism and neo-liberalism. Although neither account of authority appears dominant, bias to negative interests suggests that bioethical debate tends to reflect the widespread ascendancy of neo-liberalism. This attitude was underscored by the way relational accounts converged on private familial authority. The visible connections to theory suggest that best interests is underpinned by socio-political trends that may set up frictions with practice. How practice negotiates these frictions remains a key question. (shrink)

In the western healthcare, shared decision making has become the orthodox approach to making healthcare choices as a way of promoting patient autonomy. Despite the fact that the autonomy paradigm is poorly suited to paediatric decision making, such an approach is enshrined in English common law. When reaching moral decisions, for instance when it is unclear whether treatment or non-treatment will serve a child’s best interests, shared decision making is particularly questionable because agreement does not ensure moral validity. With reference (...) to current common law and focusing on intensive care practice, this paper investigates what claims shared decision making may have to legitimacy in a paediatric intensive care setting. Drawing on key texts, I suggest these identify advantages to parents and clinicians but not to the child who is the subject of the decision. Without evidence that shared decision making increases the quality of the decision that is being made, it appears that a focus on the shared nature of a decision does not cohere with the principle that the best interests of the child should remain paramount. In the face of significant pressures toward the displacement of the child’s interests in a shared decision, advantages of a shared decision to decisional quality require elucidation. Although a number of arguments of this nature may have potential, should no such advantages be demonstrable we have cause to revise our commitment to either shared decision making or the paramountcy of the child in these circumstances. (shrink)

The experience of being in love involves a longing for union with the other, where an important part of this longing is sexual desire. But what is the relation between being in love and sexual desire? To answer this it must first be seen that the expression ‘in love’ normally refers to a personal relationship. This is because to be ‘in love’ is to want to be loved back. This much would be predicted by equity and social exchange theories of (...) interpersonal attraction. Findings suggest however that love differs fundamentally from liking and, consequently, distinct approaches to the theory of love have been developed. A phenomenological theory is then put forward which suggests that the experience of being in love involves a complex of desires for reciprocal vulnerability in order to care and be cared for. Sexual desire is then seen to involve the physical expression of these desires in the form of desires for mutual baring in order to caress and be caressed. Unlike love, however, sexual desire need not refer to the other person's desires. This is supported by the existence of sexual desires like fetishism. It is concluded that other desires which often appear in instances of being in love are not basic to the experience of being in love. (shrink)

Attempts to conduct systematic reviews of ethical arguments in bioethics are fundamentally misguided. All areas of enquiry need thorough and informative literature reviews, and efforts to bring transparency and systematic methods to bioethics are to be welcomed. Nevertheless, the raw materials of bioethical articles are not suited to methods of systematic review. The eclecticism of philosophy may lead to suspicion of philosophical methods in bioethics. Because bioethics aims to influence medical and scientific practice it is tempting to adopt scientific language (...) and methods. One manifestation is the increasing innovation in, and use of, systematic reviews of ethical arguments in bioethics. Yet bioethics, as a broadly philosophical area of enquiry, is unsuited to systematic review. Bioethical arguments are evaluative, so notions of quality and bias are inapplicable. Bioethical argument is conceptual rather than numerical, and the classification of concepts is itself a process of argument that cannot aspire to neutrality. Any ‘systematic review’ of ethical arguments in bioethics thus falls short of that name. Furthermore, labels matter. Although the bioethics research community may find that adopting the language and the outward methods of clinical science offers apparent prospects of credibility, policy influence and funding, we argue that such misdirection carries risks and is unlikely to pay dividends in the long term. Bioethical sources are amenable to the review methods of the social sciences, and it is on these methods that specific methods of bioethics literature review should be built. (shrink)

The problem of personal identity is often said to be one of accounting for what it is that gives persons their identity over time. However, once the problem has been construed in these terms, it is plain that too much has already been assumed. For what has been assumed is just that persons do have an identity. A new interpretation of Hume's no-self theory is put forward by arguing for an eliminative rather than a reductive view of personal identity, and (...) by approaching the problem in terms of phenomenology, Buddhist psychology, and the idea of a constructed self-image. (shrink)

New methods to analyse social media data provide a powerful way to know publics and capture what they say and do. At the same time, access to these methods is uneven, with corporations and governments tending to have best access to relevant data and analytics tools. Critics raise a number of concerns about the implications dominant uses of data mining and analytics may have for the public: they result in less privacy, more surveillance and social discrimination, and they provide new (...) ways of controlling how publics come to be represented and so understood. In this paper, we consider if a different relationship between the public and data mining might be established, one in which publics might be said to have greater agency and reflexivity vis-à-vis data power. Drawing on growing calls for alternative data regimes and practices, we argue that to enable this different relationship, data mining and analytics need to be democratised in three ways: they should be subject to greater public supervision and regulation, available and accessible to all, and used to create not simply known but reflexive, active and knowing publics. We therefore imagine conditions in which data mining is not just used as a way to know publics, but can become a means for publics to know themselves. (shrink)

In Canada, as in many other countries, there exists an organ procurement/donation crisis. This paper reviews some of the most common kidney procurement and allocation programmes, analyses them in terms of public and private administration, and argues that privately administered living donor models are an inequitable stopgap measure, the good intentions of which are misplaced and opportunistic. Focusing on how to improve the publicly administered equitable cadaveric donation programme, and at the same time offering one possible explanation for its current (...) failure, it is suggested that the simple moral principle of “give and you shall receive”, already considered by some, be extended further. This would allow for those who are willing to sign up to be a public cadaveric donor be given a priority for receiving an organ donation should they ever require it. It is argued that this priority may provide the motivation to give that is so far lacking in Canada. This model is called the Public Cadaveric Organ Donation Program. (shrink)

Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology’s potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engineers themselves. By exploring the views of engineering researchers in a large smart-home project, we sought (...) to contribute to dialogue between ethics and the engineering community. Either face-to-face or using Skype, we conducted in-depth qualitative interviews with 20 early- and mid-career smart-home researchers from a multi-centre smart-home project, who were asked to describe their own experience and to reflect more broadly about ethical considerations that relate to smart-home design. With participants’ consent, interviews were audio-recorded, transcribed and analysed using a thematic approach. Two overarching themes emerged: in ‘Privacy’, researchers indicated that they paid close attention to negative consequences of potential unauthorised information sharing in their current work. However, when discussing broader issues in smart-home design beyond the confines of their immediate project, researchers considered physical privacy to a lesser extent, even though physical privacy may manifest in emotive concerns about being watched or monitored. In ‘Choice’, researchers indicated they often saw provision of choice to end-users as a solution to ethical dilemmas. While researchers indicated that choices of end-users may need to be restricted for technological reasons, ethical standpoints that restrict choice were usually assumed and embedded in design. The tractability of informational privacy may explain the greater attention that is paid to it. However, concerns about physical privacy may reduce acceptability of smart-home technologies to future end-users. While attention to choice suggests links with privacy, this may misidentify the sources of privacy and risk unjustly burdening end-users with problems that they cannot resolve. Separating considerations of choice and privacy may result in more satisfactory treatment of both. Finally, through our engagement with researchers as participants this study demonstrates the relevance of ethics as a critical partner to smart-home engineering. (shrink)

We develop and test a trickle-down model of how authentic leadership at the department level flows down the organizational hierarchy to encourage team leader authentic leadership and consequently, promotes team and individual-level supervisor-directed helping behavior. Analyses of multi-level and multi-source data collected from a total of 487 employees comprising 122 teams, 47 departments, and 4 different working areas of a major public sector organization in Taiwan show that team leaders’ authentic leadership mediates the relationship between departmental authentic leadership and individual-level (...) leader–member exchange. We also found that intra-team trust completely mediates the influence of team authentic leadership on both team helping behavior and individual-level supervisor-directed helping behavior. Finally, the results reveal that self-concordance mediates the influence of team authentic leadership on individual-level supervisor helping behavior as well as the influence of individual-level LMX on individual-level supervisor-directed helping behavior. Theoretical and practical implications of these findings are discussed. (shrink)

Desire is a central concept in Aristotle's ethical and psychological works, but he does not provide us with a systematic treatment of the notion itself. This book reconstructs the account of desire latent in his various scattered remarks on the subject and analyses its role in his moral psychology. Topics include: the range of states that Aristotle counts as desires ; objects of desire and the relation between desires and envisaging prospects; desire and the good; Aristotle's three species of desire: (...) epithumia, thumos and boulêsis ; Aristotle's division of desires into rational and non-rational; Aristotle and some current views on desire; and the role of desire in Aristotle's moral psychology. The book will be of relevance to anyone interested in Aristotle's ethics or psychology. (shrink)

Volume 19, Issue 6, June 2019, Page 25-27.

The value of conscience in healthcare ethics is widely debated. While some sources present it as an unquestionably positive attribute, others question both the veracity of its decisions and the effect of conscientious objection on patient access to health care. This paper argues that the right to object conscientiously should be broadened, subject to certain previsos, as there are many benefits to healthcare practice in the development of the consciences of practitioners. While effects such as the preservation of moral integrity (...) are widely considered to benefit practitioners, this paper draws on the work of Hannah Arendt to offer several original arguments in defence of conscience that may more directly benefit patients, namely that a pang of conscience may be useful in rapidly unfolding situations in which there is no time to reflect satisfactorily upon activities and that, given the hierarchical nature of healthcare institutions, a right to defy authority on the basis of conscience may benefit junior staff who lack the institutional power to challenge the orders of superiors. (shrink)

What is it about having a body that might dispose us to think it a plausible candidate for the basis of personal identity? The answer seems plain: the body is a physical object which, as long as it exists, is spatio-temporally continuous throughout the different moments of its existence. In consequence, myself of today can be said to be the same person as myself of twelve years ago so far as my body of today is spatio-temporally continuous with my body (...) of twelve years ago. Exponents of this view are not, of course, denying that over time a person's body will or may undergo various changes; rather they are claiming that so long as these changes occur within a body which maintains a spatio-temporal continuity, then the identity of the person whose body it is will be ensured. (shrink)

This collection of essays builds on the contributions of Albert Schweitzer's philosophy of "Reverence for Life" as it pertains to our world today.Albert ...

_Beyond Solidarity_ is an impassioned argument for a sharable morality in a world increasingly fractured along lines of difference. Giles Gunn asks how human solidarity can be reconceived when its expressions have become increasingly exceptionalist and outmoded, and when the pressures of globalization divide as much as they unify. He finds the terms for answering these questions in a more inclusive, cosmopolitan pragmatism—one willing to explore fundamental values without recourse to absolutist arguments. Drawing on the work of William and (...) Henry James, John Dewey, Primo Levi, Richard Rorty, and many others, as well as postcolonial writing, Jewish literature of the Holocaust, and the cultural and religious experience of African Americans in slavery, Gunn points pragmatism in a transnational direction and shows how it can better account for the consequences of diversity. _Beyond Solidarity_, then, is a study of the difference that difference makes in a globalized world. (shrink)