This essay explores the preferences, anticipations and expectations of the elderly regarding the role of family members in making health care decisions for them should they become decisionally incapacitated. Findings are presented from a series of in-depth interviews of men and women aged 67–91 years. Following a discussion of the uncertain legal status of familial surrogate decision-making, we argue that the family unit's autonomy is sufficient to justify the elderly's preferred reliance on their own family. Further, we suggest that social (...) and legal policy changes should facilitate, rather than impede, familial decision-making. (shrink)
The nature of the personal relationship between More and Elyot remains something of a mystery, but their political perspectives reflect the similarities and differences in their public experience and sources of inspiration. More’s Utopia grew out of his interaction with European scholars and political leaders; composed in Latin for an international audience, the work moves from particular social problems in England to a radical alternative conceptualized in detail. The Governor, written in English and addressed to the aristocracy, resulted from Elyot’s (...) years as a middle-level public administrator. Practical rather than imaginative, Elyot finds the principles of governance mainly in Aristotle and Cicero; on the other hand, More, inspired primarily by Plato and Lucian, creates a social construct against which contemporary societies should be measured. Each reflecting his own perspective, Elyot emphasizes individual, personal virtues while More focuses on social values. The conservative Elyot endorses the hierarchal society governed by a monarch through his governors in contrast with More, who represents an elective meritocracy. (shrink)
This book benefits from the emergence of bioethics as it has evolved from its clinical roots to address policy, politics, and social practice far removed from that origin. It situates terrorism and bioterrorism in the field of ethical inquiry. Finally, it treats the catastrophic event as a category or genre and so enables us to enrich inquiry by ranging from hurricane and flood to terrorist attack.
2500 years ago, Socrates wrestled with the question: Can virtue be taught? And I’m still at it. I recall my experience as an Ethical Culture Leader, the head of the Ethical Culture Fieldston Schools, and Board Chair of the Ethical Community Charter School in Jersey City. Once more, I reflect on a life-long vocation: the problem of knowing, judging, deciding, and acting ethically. Can virtue be taught? Socrates answered “yes” and “no.” Figuring out what that means remains a continuing puzzle, (...) which inspired this article. (shrink)
Employing the National Institute of Mental Health-funded Prevention of Suicide in Primary Care Elderly Collaborative Trial as a case study, we discuss 2 sets of ethical issues: obtaining informed consent for a clinic-based intervention study and using treatment as usual (TAU) as the control condition. We then address these ethical issues in the context of the debate about the quality improvement efforts of health care organizations. Our analysis reveals the tension between ethics and scientific integrity involved with using TAU as (...) a control condition and the difficulty in designing high-quality research in a community-based setting. (shrink)
This thought-provoking study examines the foundations of moral education from a philosophical and practical perspective. It analyzes some of the typical expectations that cannot be met in the present day approach, and recommends that the teaching of ethics be treated with `theater' as the metaphor, dialogue as the genre, and Socrates as the model. Seen as a necessary and unavoidable classroom activity, moral education is presented from a humanist point of view, with emphasis on the developmental approach of Jean Piaget (...) and his followers, while pointing out the limitations of psychological methods. (shrink)
It was probably Rousseau who first thought of dreams as ennobling experiences. Anyone who has ever read Reveries du Promeneur Solitaire must be struck by the dreamlike quality of Rousseau's meditations. This dreamlike quality is still with us, and those who experience it find themselves ennobled by it. Witness Martin Luther King's famous "1 have a dream. " Dreaming and inspiration raise the artist to the top rung in the ladder ofhuman relations. That is probably the prevailing view among educated (...) people of our time. Rousseau made that view respectable and predominant. Yet in another sense, the problem is much older. It is the problem of political philosophy and poetry, the problem of Socrates and Aristophanes, of Plato and Homer. Yet, while antiquity usually gives the crown to philosophy, since Rous seau, the alternative view tends to prevail. The distinction is not, however, a formal one. Sir Philip Sidney enlisted Plato on the side of poetry. The true distinction is between imagination and reason. If reason is to rule, as Aristotle points out,l the most architectonic of the sciences, that is political science, should rule. It is political philosophy which must determine the nature of the arts which will help or which will hinder the good of the city or the polity. That does not mean that a mere professor should stand in judgment of Shake speare, Bacon, and Rembrandt. It means that ifhe studies these three great artists, he is not over-stepping disciplinary limits. (shrink)