Michael J. Zimmerman explores whether and how our ignorance about ourselves and our circumstances affects what our moral obligations and moral rights are. He rejects objective and subjective views of the nature of moral obligation, and presents a new case for a 'prospective' view.

This paper argues that doctors ought to make all things considered value judgments about what is best for their patients. It illustrates some of the shortcomings of the model of doctor as 'fact-provider'. The 'fact-provider' model fails to take account of the fact that practising medicine necessarily involves making value judgments; that medical practice is a moral practice and requires that doctors reflect on what ought to be done, and that patients can make choices which fail to express their autonomy (...) and which are based on mistaken judgments of value. If doctors are properly to respect patient autonomy and to function as moral agents, they must make evaluations of what their patients ought to do, all things considered. This paper argues for 'rational, non-interventional paternalism'. This is a practice in which doctors form conceptions of what is best for their patients and argue rationally with them. It differs from old-style paternalism in that it is not committed to doing what is best. (shrink)

Our aim is to expand the regulative ideal governing consent. We argue that consent should not only be informed but also based on rational beliefs. We argue that holding true beliefs promotes autonomy. Information is important insofar as it helps a person to hold the relevant true beliefs. But in order to hold the relevant true beliefs, competent people must also think rationally. Insofar as information is important, rational deliberation is important. Just as physicians should aim to provide relevant information (...) regarding the medical procedures prior to patients consenting to have those procedures, they should also assist patients to think more rationally. We distinguish between rational choice/action and rational belief. While autonomous choice need not necessarily be rational, it should be based on rational belief. The implication for the doctrine of informed consent and the practice of medicine is that, if physicians are to respect patient autonomy and help patients to choose and act more rationally, not only must they provide information, but they should care more about the theoretical rationality of their patients. They should not abandon their patients to irrationality. They should help their patients to deliberate more effectively and to care more about thinking rationally. We illustrate these arguments in the context of Jehovah's Witnesses refusing life-saving blood transfusions. Insofar as Jehovah's Witnesses should be informed of the consequences of their actions, they should also deliberate rationally about these consequences. (shrink)

We critically evaluate the ways in which competence in medical ethics has been evaluated. We report the initial stage in the development of a relevant, reliable and valid instrument to evaluate core critical thinking skills in medical ethics. This instrument can be used to evaluate the impact of medical ethics education programmes and to assess whether medical students have achieved a satisfactory level of performance of core skills and knowledge in medical ethics, within and across institutions.

The most publicly justifiable application of human cloning, if there is one at all, is to provide self-compatible cells or tissues for medical use, especially transplantation. Some have argued that this raises no new ethical issues above those raised by any form of embryo experimentation. I argue that this research is less morally problematic than other embryo research. Indeed, it is not merely morally permissible but morally required that we employ cloning to produce embryos or fetuses for the sake of (...) providing cells, tissues or even organs for therapy, followed by abortion of the embryo or fetus. (shrink)

In a recent article entitled, Requests "for inappropriate" treatment based on religious beliefs, Orr and Genesen claim that futile treatment should be provided to patients who request it if their request is based on a religious belief. I claim that this implies that we should also accede to requests for harmful or cost-ineffective treatments based on religious beliefs. This special treatment of religious requests is an example of special pleading on the part of theists and morally objectionable discrimination against atheists. (...) It also provides an excellent illustration of how different the practices of religion and ethics are. (shrink)

This manuscript reports on a landmark symposium on the ethical, legal and technical challenges of xenotransplantation in the UK. King’s College London, with endorsement from the British Transplantation Society (BTS), and the European Society of Organ Transplantation (ESOT), brought together a group of experts in xenotransplantation science, ethics and law to discuss the ethical, regulatory and technical challenges surrounding translating xenotransplantation into the clinical setting. The symposium was the first of its kind in the UK for 20 years. This paper (...) summarises the content of the expert lectures showcasing the progress which has been made in xenotransplantation including—the history of xenotransplantation, advances in gene edited animals and progress towards clinical xenotransplantation. We then set out the ethical and legal issues still to be resolved. Finally, we report the themes of the roundtable discussion highlighting areas of consensus and controversy. While the detail of the legal discussion was directed towards the UK, the principles and summary reported here are intended to be applicable to any jurisdiction seeking to implement clinical xenotransplantation. (shrink)

J.N. Findlay was a South African philosopher who published from the late 1940s into the 1980s. He had a prestigious international academic career, holding many academic posts around the world. This article uses a textual comparative approach and focuses on Findlay’s Gifford Lecture at St Andrews University between 1965 and 1970. The objective of the article is to highlight the extent to which Findlay’s philosophical writings were influenced by Mahāyāna Buddhism. Although predominantly a Platonist, Findlay drew influence from Asian philosophy (...) and religion, particularly Mahāyāna Buddhism. In these lectures, he applies the metaphor of the Platonic Cave to investigate Hegelian and Husserlian approaches to knowledge. Though he was a leading Hegel and Husserl scholar, his reading of these two philosophers is strongly influenced by Mahāyāna Buddhism, resulting in a unique mystical interpretation of these two philosophers. Revisiting Findlay’s writings is significant for two reasons; firstly, he investigated Buddhism prior to the Asian religions being included in Religious Studies departments’ purview in South African universities, and secondly, his interpretation of two prominent Western philosophers along Buddhist lines provides an early attempt at decolonising the predominance of Western philosophical views of knowledge.Contribution: This contribution forms part of a larger collection of essays investigating philosophical works that have had a significant impact on the study of religion. This contribution investigates the Buddhist influence on J.N. Findlay’s philosophical readings of Husserl and Hegel. (shrink)

Patients have a right to refuse medical treatment. But what should happen after a patient has refused recommended treatment? In many cases, patients receive alternative forms of treatment. These forms of care may be less cost-effective. Does respect for autonomy extend to providing these alternatives? How for does justice constrain autonomy? I begin by providing three arguments that such alternatives should not be offered to those who refuse treatment. I argue that the best argument which refusers can appeal to is (...) based on the egalitarian principle of equality of outcome. However, this principle does not ultimately support a right to less cost-effective alternatives. I focus on Jehovah's Witnesses refusing blood and requesting alternative treatments. However, the point applies to many patients who refuse cost-effective medical care. (shrink)

The spirit of Aelius Donatus must be uneasy of late years; so many scholars have attempted to evoke his ghost. Professor H. J. Thomson professes to see in the additional notes to Servius an image once removed from the true Donatus. ‘The question’, he writes, ‘how far we can assume that the words of Donatus are directly reproduced [in the additions first published by Daniel ] can hardly be satisfactorily answered.’ That Donatus was not the immediate source of D, Thomson (...) endeavours to show from three instances, in two of which we know for certain, either from the Glossaries or from Servius himself, the substance of a part, at least, of the note of Donatus on these passages. In the other the argument rests on the comparative meagreness of the note in the enlarged Servius. In all three cases, according to this theory, we have a rehandling of the D comment. The note on the passage from the Aeneid has already been discussed by Professor Thomson in his study of the Virgil scholia in the Abstrusa glossary. The conclusions reached there are repeated, though perhaps not so positively, in the article under discussion. I hold with Professor Rand that we have in Servius auctus substantially the voice of Donatus, though in a fragmentary form, due to the work of a compiler who, with Servius as a basis, has worked in with more or less success explanatory matter which departed from, or was an addition to, the information supplied by an interpreter who himself derived most of his material from Donatus. (shrink)

Retrospective rule-making has few supporters and many opponents. Defenders of retrospective laws generally do so on the basis that they are a necessary evil in specific or limited circumstances, for example to close tax loopholes, to deal with terrorists or to prosecute fallen tyrants. Yet the reality of retrospective rule making is far more widespread than this, and ranges from ’corrective’ legislation to ’interpretive regulations’ to judicial decision making. The search for a rational justification for retrospective rule-making necessitates a reconsideration (...) of the very nature of the rule of law and the kind of law that can rule, and will provide new insights into the nature of law and the parameters of societal order. This book examines the various ways in which laws may be seen as retrospective and analyses the problems in defining retrospectivity. In his analysis Dr Charles Sampford asserts that the definitive argument against retrospective rule-making is the expectation of individuals that, if their actions today are considered by a future court, the applicable law was discoverable at the time the action was performed. The book goes on to suggest that although the strength of this ’rule of law’ argument should prevail in general, exceptions are sometimes necessary, and that there may even be occasions when analysis of the rule of law may provide the foundation for the application of retrospective laws. (shrink)

A Lost Book from J. Oswald Sanders Now Re-Released with a Beautiful New Cover "The complex strains and problems which the Christian encounters in the contemporary world find their answer, not in tranquilizers or stimulants, but in a correct understanding and application of scriptural principles." -J. Oswald Sanders, from the introduction J. Oswald Sanders (best known for his book Spiritual Leadership, which has sold over a million copies), touched hundreds of thousands of lives in his lifetime and continues to inspire (...) Christians today. His books Spiritual Leadership, Spiritual Maturity, and The Incomparable Christ are beloved and well-read to this day. But there are two of his books that readers haven’t had access to in over 30 years. A Spiritual Clinic is one of them. Life wears on us, we go through seasons of fatigue, strain and tension that take their toll, and we can easily fall into apathy. Sanders prescribes a powerful tonic of scriptural principles that lead to recovery and growth. For anyone who feels worn out from their Christian life and could use a little spiritual doctoring, A Spiritual Clinic is for you. (shrink)

The papers of Burley and Harris, and Draper and Chadwick, in this issue, raise a problem: what should doctors do when patients request an option which is not the best available? This commentary argues that doctors have a duty to offer that option which will result in the individual affected by that choice enjoying the highest level of wellbeing. Doctors can deviate from this duty and submaximise--bring about an outcome that is less than the best--only if there are good reasons (...) to do so. The desire to have a child which is genetically related provides little, if any, reason to submaximise. The implication for cloning, preimplantation diagnosis and embryo transfer is that doctors should only produce a clone or transfer embryos expected to enjoy a level of wellbeing which is less than that enjoyed by other children the couple could have, if there is a good reason to employ that technology. This paper sketches what might constitute a good reason to submaximise. (shrink)

On its first appearance in 1960, J.O. Urmson's Concise encyclopedia of Western philosophy and philosophers established itself as a classic. Its contributors included many of the leading philosophers of the English-speaking world: Ryle, Hare, Strawson, Ayer, Dummett, Williams and many others. They wrote with an authority and individuality which made the Encyclopedia into a lively and engaging introduction to philosophy as well as a convenient reference work. For this edition, supervised by Jonathan Rée, the original articles have been revised and (...) updated, and eighty articles by thirty one new authors have been added. The additions take account of recent developments in philosophy, of literary, historical and political issues in philosophy, and of developments in continental thought, including in Marxism, psychoanalysis, phenomenology, existentialism, structuralism, post-structuralism and deconstruction. There is a clear, integral cross-referencing system which allows the reader to identify points of overlap between philosophical traditions and their personalities at a glance. (shrink)

We need to rethink our attitudes to the bodies of the dead in order to increase our willingness to donate organs and tissues My father died aged 87 on January 20, 1998. It was the day of his 42nd wedding anniversary. He been admitted to a major teaching hospital with jaundice of unknown origin. He died after a medical procedure and a delay in diagnosis and management of bleeding after the procedure. I believed it was important to understand why he (...) had died and what the underlying cause of his jaundice had been. I requested an autopsy. My father was not only the best father a person could have had, but my closest friend. The circumstances of his death were especially sad for me. I was on a plane while he was allowed to die of blood loss in intensive care over a period of hours, becoming progressively more delirious and experiencing the slow motion throes of death. I was told he had died while I was still in the air. My first thought was that I would never again see him or hear his deep chuckle. I would never again feel the gentle touch of his large hands. He would never see my daughter grow up as he had wanted to, playing, and laughing on the beach. I have witnessed many autopsies. As medical students, we had to attend autopsy each morning at 8.30 am as a part of pathology in fourth year medicine. Before this, we had two years of anatomy dissection, probing every crevice of the formalin fixed human body. I learnt an immense amount from these activities. But I also knew how gruesome the autopsy is. I knew that an autopsy would mean that my father would be dismembered. But I had no hesitation in requesting …. (shrink)

Despite its uniform appearance, the cerebellar cortex is highly heterogeneous in terms of structure, genetics and physiology. Purkinje cells (PCs), the principal and sole output neurons of the cerebellar cortex, can be categorized into multiple populations that differentially express molecular markers and display distinctive physiological features. Such features include action potential rate, but also their propensity for synaptic and intrinsic plasticity. However, the precise molecular and genetic factors that correlate with the differential physiological properties of PCs remain elusive. In this (...) article, we provide a detailed overview of the cellular mechanisms that regulate PC activity and plasticity. We further perform a pathway analysis to highlight how molecular characteristics of specific PC populations may influence their physiology and plasticity mechanisms. (shrink)

In recent years the issue of whether mysticism can be induced by drugs has been pursued by both scholars of mystical literature and psychological researchers. R. C. Zaehner is perhaps the best known among the scholars of religious literature who have addressed the issues of drug-induced mysticism. While on the side of empirical psychology investigators such as Walter N. Pahnke, R. E. L. Masters, and Jean Houston have pursued some of the same issues using the techniques of laboratory experimentation. Zaehner, (...) who was familiar with both Eastern and Western mysticism, argued that drug-induced experiences are not the same as religious mystical experiences of the theistic variety. It was farcical, he argued, for Aldous Huxley to posit a connection between his preternatural feeling of oneness with his chair and the Beatific Vision. The issue between Zaehner and Huxley was not over the veridicality of Huxley's mystical experience. It was over the significance of Huxley's experience: Was it or was it not a drug-induced mystical experience of the sort attained by mystics after heroic struggles of self-discipline? This was the issue again when Zaehner came to address himself to the claims of Timothy Leary, a chief proponent of ‘the LSD experience’, and, in general terms, this has been the central issue pursued by the psychological researchers. (shrink)

This paper describes the concept of a do-gooder: a person who does unwanted good. It illustrates why doing-good is a problem and argues that patients should not be compelled to do what is best. It shows the ways in which doctors covertly do-good and offers a critique of these. The discussion focuses on the example of the treatment of patients who attempt suicide.

In ‘Belief-In and Belief in God’ , J. N. Williams suggests that belief in God cannot be rational unless one has rational beliefs that God exists. While agreeing with his conclusion , I disagree at almost every step with his method of arriving at it. In particular I suggest that Williams goes astray concerning the dual aspect of belief in , the nature of performatives, the arousal of belief states, and the correct account of belief in God.