En 1986, H.T. Engelhardt justifiait l'autonomie de la bioéthique à l'égard des éthiques religieuses en partant du fait que les hommes de notre temps sont « moralement des étrangers », les uns pour les autres. En 1991, il entreprit de mieux discerner les relations entre éthiques séculière et religieuse, en gardant la même orientation de pensée, mais en s'attaquant à l'idéologie d'un humanisme athée. Il cherche à établir sur les bases d'une rationalité universelle un « cadre de référence neutre », (...) commun à l'ensemble des partenaires du débat éthique contemporain, mais qui laisserait la place à une pluralité de visions philosophiques, religieuses et morales. Car ce serait ruiner toute éthique que de vouloir fonder la bioéthique sur le seul recours au consentement libre et éclairé du malade et sur le respect de son autonomie, à l'exclusion de toute recherche de « buts transcendants ». – La pensée d'Engelhardt n'est pas exempte d'ambiguïtés sinon de contradictions : il ne dit pas comment son humanisme séculier donnera satisfaction aux partisans des éthiques religieuses ni quel sera le statut institutionnel de ce cadre de référence commun ni quelle issue il propose entre le nihilisme et le relativisme moral ni sur quelle base pourrait se faire une hiérarchisation des valeurs dans une bioéthique séculière. Sa pensée devrait se prolonger en direction des droits de l'homme, mieux distinguer entre principes premiers et principes dérivés, creuser davantage le concept de subjectivité.In 1986 H. T Engelhardt justified the autonomy of bioethics as regards religious ethics by starting with the fact that people in our day are “moral strangers” in regard to each other. In 1991 he studied further the relations between secular and religious ethics while keeping the same line of thougbt, but in attacking the ideology of atheistic humanism. He is trying to establish, on the basis of a universal rationality, a “neutral framework “ that would be shared by all those debating contemporaneous ethics. It would leave room for a plurality of philosophical, religious, and moral visions, For it would destroy all ethics if one wished to base bioethics only on trying to get a free and enlightened agreement from the patient and on the respect of his autonomy, in exclusion of every search.for « transcendental ends ». The thougbt of Engelhardt is not free from ambiguities, if not contradictions: he doesn't say how his secular humanism will give satisfaction to the supporters of religious ethics; nor what the institutional status of tbis common framework would be; nor what he proposes as the way out between nihilism and moral relativism; nor on what basis a hierarchy of values could be created in secular bioethics. His ideas call for further reflection : found etbics on the rights of man; distinguish more clearly between first principles and principles that are derived ; and dig deeper into the concept of subjectivity. (shrink)

Contributed articles on Buddhist doctrines and philosophy; festschrift in honor of Narayan Hemandas Samtani, Buddhist scholar.

The philosophy of medicine cum bioethics has become the socially recognized source for moral and epistemic direction in health-care decision-making. Over the last three decades, this field has been accepted politically as an authorized source of guidance for policy and law. The field's political actors have included the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, the Department of Health, Education, and Welfare, the President's Commission for the Study of Ethical Problems in Medicine and Biomedical (...) and Behavioral Research, the National Bioethics Advisory Commission, and the new Council on Bioethics; these groups and agencies have set forth rules on issues ranging from the role of humans in biomedical research to the production of human embryos for research, the definition of death, and the permissibility of human cloning. The members of the field are not just scholars and teachers in an academic realm directed to both theoretical and applied issues. They are, in addition, practitioners of a conceptual and moral trade that possesses a legal and political standing. This essay critically addresses the sudden emergence of bioethics as a societally recognized source of moral guidance, a source replete with authorized moral experts. Attention is directed to moral and conceptual assumptions that have led the philosophy of medicine, and especially bioethics, to acquire a quasi-juridical/political role in guiding clinical choices, framing health-care policy, and directing court holdings. (shrink)

The project of articulating a coherent, canonical, content-full, secular morality-cum-bioethics fails, because it does not acknowledge sin, which is to say, it does not acknowledge the centrality of holiness, which is essential to a non-distorted understanding of human existence and of morality. Secular morality cannot establish a particular moral content, the harmony of the good and the right, or the necessary precedence of morality over prudence, because such is possible only in terms of an ultimate point of reference: God. The (...) necessity of a rightly ordered appreciation of God places centrally the focus on holiness and the avoidance of sin. Because the cardinal relationship of creatures to their Creator is worship, and because the cardinal corporate act of human worship is the Liturgy, morality in general and bioethics in particular can be understood in terms of the conditions necessary, so as worthily to enter into Eucharistic liturgical participation. Morality can be summed up in terms of the requirements of ritual purity. A liturgical anthropology is foundational to an account of the content-full morality and bioethics that should bind humans, since humans are first and foremost creatures obliged to join in rightly ordered worship of their Creator. When humans worship correctly, when they avoid sin and pursue holiness, they participate in restoring created reality. (shrink)

There is little or no general agreement about what researchers should focus on when studying consciousness. The most active scientific studies often use the methods of Cognitive Neuroscience and focus mainly on vision. Other aspects and contents of consciousness, namely thoughts and emotions, are much less studied, possibly leading to a biased view of what consciousness is and how it works. In this essay we describe what we call a referential nucleus, implicit in much of consciousness research. In this context, (...) 'consciousness' refers to reportable content experienced by living individuals. We then discuss the philosophical concept of a phenomenal world and another contemporary view that conscious experience involves, besides integration of information in the brain, participation in action-perception cycles in a natural, social and cultural environment. These views imply a need to reconceptualize 'qualia'as the con-scious aspect of subjective experiences, thus stating properties of consciousness that pose serious challenges to an exclusive approach via Cognitive Neuroscience, because experimental settings oversim-plify conscious experiences, narrowing them to fragments correlated with measured brain activity and behaviour. In conclusion we argue that a science of consciousness requires a broad interdisciplinary range of research, including qualitative methods from the Human Sciences. (shrink)

The protection of rare species abounds with scientific and ethical considerations. An ethical dilemma can emerge when the life of one species is valued higher than that of another, and so we discuss the basis of ranking, protection, and valuation of plants and animals. A duty to protect rare species exists in this age of great losses to plant and animal life, but the scientific and public communities are not always in agreement regarding what species deserve protection. Using a case (...) study, we illustrate how the decision to kill beavers to protect a rare plant and rare animals found in a tidewater creek demanded an ecological ethic approach. We present the concept of a" conservation mediator" and how its use may help find a common ground between stakeholders and decision-makers in similar situations. (shrink)

Copyright © 2015 by the Society of Criti. Objective: Global lung stress varies considerably with low tidal volume ventilation for acute respiratory distress syndrome. High stress despite low tidal volumes may worsen lung injury and increase risk of death. No widely available parameter exists to assess global lung stress. We aimed to determine whether the volume delivered during a recruitment maneuver is inversely associated with lung stress and mortality in acute respiratory distress syndrome. Design: Substudy of an acute respiratory distress (...) syndrome clinical trial on esophageal pressure-guided positive end-expiratory pressure titration. Setting: U.S. academic medical center. Patients: Forty-two patients with acute respiratory distress syndrome in whom airflow, airway pressure, and esophageal pressure were recorded during the recruitment maneuver. Interventions: A single recruitment maneuver was performed before initiating protocol-directed ventilator management. Recruitment maneuvers consisted of a 30-second breath hold at 40 cm H2O airway pressure under heavy sedation or paralysis. VRM was calculated by integrating the flow-time waveform during the maneuver. End-inspiratory stress was defined as the transpulmonary pressure during end-inspiratory pause of a tidal breath and tidal stress as the transpulmonary pressure difference between end-inspiratory and end-expiratory pauses. Measurements and Main Results: VRM ranged between 7.4 and 34.7 mL/kg predicted body weight. Lower VRM predicted high end-inspiratory and tidal lung stress. After adjusting for Pao2/Fio2 and either driving pressure, tidal volume, or plateau pressure and positive end-expiratory pressure, VRM remained independently associated with both end-inspiratory and tidal stress. In unadjusted analysis, low VRM predicted increased risk of death. VRM remained significantly associated with mortality after adjusting for study arm. Conclusions: Low VRM independently predicts high lung stress and may predict risk of death in patients with acute respiratory distress syndrome. (shrink)

This paper attempts to outline some of the important concepts and ideas used in system analysis which is taken to be a general mode of analysis used in all sciences. Systems are seen from three perspectives: (1) that involving the relationship between system and environment, (2) that involving interaction between several systems, and (3) that involving one type of system composed of other types of systems. The writers also discuss the concepts "structure" and "equilibrium" as they apply to system analysis, (...) the point being made that the use of these concepts in the social sciences has often been vague or even incorrect. (shrink)

Introduction : La philosophie en Égypte -- La philosophie chretienne arabe contemporaine : Kanawati et Youssef Karam -- Le discours éthique en Égypte -- Naguib Mahfouz et la philosophie -- La philosophie et la revolution en Égypte.