Decision-making for the incompetent: Exemplars and questions from Siebert.

This book is the result of a three-year study undertaken by a multidisciplinary working party of the Institute of Medical Ethic (UK). The group was chaired by a moral theologian, and its members included biological and ethological scientists, toxicologists, physicians, veterinary surgeons, an expert in alternatives to animal use, officers of animal welfare organizations, a Home Office Inspector, philosophers, and a lawyer. Coming from these different backgrounds, and holding a diversity of moral views, the members produced the agreed report as (...) a result of detailed and rigorous discussions. The book sets out facts about animal experiments and about animal abilities to experience pain, distress and anxiety. There is a detailed examination of the moral claims related to the benefits likely to accrue from animal research, and of strategies for weighing these benefits against the harm caused to animals, in order to decide whether particular research projects ought or ought not to proceed. This leads to consideration of the statutory and non-statutory controls which safeguard standards in such research. The final section explores a variety of philosophical arguments about the use of animals in research, and offers a philosophical justification for the Working Party's more practical conclusions. Written in clear, nontechnical language, this book is accessible to lay people as well as to scientists. It is the first such document to emerge from a meeting of people with such widely differing views on this highly controversial subject, and represents a major contribution towards informing and raising the quality of contemporary debate. The book is unique in drawing together material and ideas never before found in one volume. It will interest a broad spectrum of readers, from ethicists and animal rights advocates to scientific researchers and laboratory administrators, along with general readers concerned about this compelling issue. (shrink)

I begin my comments with a first-person narrative. I know Octavio, Erotildes, and Nuria from the time I worked at the Institute of Psychiatry and was very close to the field of mental health. They are people whose work I admire and appreciate. I comment on this text from the point of view of someone who has never worked directly in mental health assistance and whose knowledge about severe mental illness therapy has occurred mostly from a third-person perspective. My comments (...) are based on parallels with situations and experiences that I have been studying lately.First of all, I want to say that I fully agree with the authors’ argument that “experiences and narratives about illness, treatment, and recovery are... (shrink)

Jane Grant's book explores the need to redefine the social compact in twenty-first century America. It proposes a new compact that would honor the expansion of civil, political, and social rights in America, and would integrate these rights within a new civic procedural ethos, clarifying our obligations to each other, future generations, other nations, and other species.

After retirement, older people often find themselves far from their children and grandchildren, and many spend their last years isolated and alone. As traditional concepts of family and social institutions fragment, social networks weaken, leading to an epidemic of loneliness, and substance abuse and suicide in developed countries. In fact, life expectancy in the US has dropped for the past few years, in large part due to a dramatic increase in suicide and drug overdose. None of these social problems is (...) likely to be solved by metformin. They point to a crisis of identity and meaning, an existential crisis. In this context, one might wonder if we are already seeing the effects of tinkering with our lifespan. There are many more conclusions one could draw about the implications of longevity, many of which have been elegantly described in Beyond Therapy: Biotechnology and the Pursuit of Happiness, published by the President’s Council on Bioethics, which I used as a reference for this talk. I hope I have been successful in providing a 10,000-foot view of the questions of efforts to extend human longevity and its implications that will provoke thought and discussion. I would like to end these reflections by turning back to my favorite transhumans. The reason we love superheroes is not for their superior strength or intelligence, but their characters. They use their powers to protect and serve humanity rather than dominate or annihilate it. It is not their gadgetry that makes them great, but how they use it to save the vulnerable. Even as a small child I knew that if everyone acted the way they did, the world would be a better place. The moral of every story was that the “enhancement” humanity needed would not come as the fruit of technology, but of virtue. (shrink)

Eduard Pernkopf’s Atlas of Topographical and Applied Human Anatomy is a four-volume anatomical atlas published between 1937 and 1963, and it is generally believed to be the most comprehensive, detailed, and accurate anatomy textbook ever created. However, a 1997 investigation into “Pernkopf’s Atlas,” raised troubling questions regarding the author’s connection to the Nazi regime and the still unresolved issue of whether its illustrations relied on Jewish or other political prisoners, including those executed in Nazi concentration camps. Following this investigation, the (...) book was removed from both anatomy classrooms and library bookshelves. A debate has ensued over the book’s continued use, and justification for its use has focused on two issues: there is no definitive proof the book includes illustrations of concentration camp prisoners or Jewish individuals in particular, and there is no contemporary equivalent to this text. However, both points fail to address the central importance of the book, not simply as part of anatomy instruction, but also as a comprehensive historical narrative with important ethical implications. Having encountered a first edition copy, these authors were given a unique opportunity to engage with the text through the respective humanities lenses of history, ethics, and narrative. In doing so, an instructive and profound irony has surfaced: Nazis, including Pernkopf, viewed specific groups of people as less than human, giving rise to unthinkable atrocities perpetuated against them. However, these same individuals became the sources for the creation of the Atlas, which served as the model for primary instruction on the human form for more than half of the twentieth century. In this article, we recount the difficult and somewhat opaque provenance of this book, engage the ethical questions surrounding both its creation and its use, and ultimately propose a pedagogical methodology for its continued use in medical education. (shrink)

The recently revised Common Rule requires that donors of biospecimens for research be informed if their specimens might be used for commercial profit. The Common Rule, however, does not apply to sharing or selling de-identified biospecimens that are “leftover” from clinical uses. As a result, many medical researchers remain uncertain of their legal and ethical obligations when a commercial entity expresses interest in these specimens.

Backround Education in ethics and professionalism should reflect the realities medical students encounter in the hospital and clinic. Method We performed content analyses on Case Observation and Assessments (COAs) written by third-year medical students about ethical and professional issues encountered during their internal medicine and paediatrics clinical clerkships. Results A cohort of 141 third-year medical students wrote 272 COAs. Content analyses identified 35 subcategories of ethical and professional issues within 7 major domains: decisions regarding treatment (31.4%), communication (21.4%), professional duties (...) (18.4%), justice (9.8%), student-specific issues (5.4%), quality of care (3.8%), and miscellaneous (9.8%). Conclusions Students encountered a wide variety of ethical and professional issues that can be used to guide pre-clinical and clinical education. Comparison of our findings with results from similar studies suggests that the wording of an assignment (specifying “ethical” issues, “professional” issues, or both) may influence the kinds of issues students identify in their experience-based clinical narratives. (shrink)

[Michael Tye] Externalism about thought contents has received enormous attention in the philosophical literature over the past fifteen years or so, and it is now the established view. There has been very little discussion, however, of whether memory contents are themselves susceptible to an externalist treatment. In this paper, I argue that anyone who is sympathetic to Twin Earth thought experiments for externalism with respect to certain thoughts should endorse externalism with respect to certain memories. /// [Jane Heal] Tye (...) claims that an externalist should say that memory content invoking natural kind concepts floats free of the setting where the memory is laid down and is at later times determined by the context in which the memory is revived. His argument assumes the existence of 'slow switching' of the meaning of natural kind terms when a person is transported from Earth to Twin Earth. But proper understanding of natural kind terms suggests that slow switching is likely never to be completed. Hence the situation of a person unknowingly transported to Twin Earth is not that his memories switch content but rather that he gets two natural kinds confused. (shrink)

When everyone can be a publisher, what distinguishes the journalist? This article considers contemporary challenges to institutional roles in a digital media environment and then turns to three broad journalistic normative values - authenticity, accountability, and autonomy - that affect the credibility of journalists and the content they provide. A set of questions that can help citizens determine the trustworthiness of information available to them emerges from the discussion.

This paper reports on the development of a research instrument designed to explore ethical reasoning in a tax context. This research instrument is a version of the Defining Issues Test originally developed by Rest [1979a, Development in Judging Moral Issues ; 1979b, Defining Issues Test ], but adapted to focus specifically on the environment encountered by tax practitioners. The paper explores reasons for developing a context- specific test, and details the manner in which this was undertaken. The study on which (...) it is based aims to compare the reasoning of tax practitioners in the taxspecific context and in the general social context covered by the original DIT, and to compare this with the reasoning of non-specialists in these two contexts. The paper therefore also considers the issues that arise when using such tests to compare reasoning in different domains or to compare groups. The focus on instrument development to measure ethical reasoning in a specific domain will contribute to the literature on research methods in the area of the DIT and will facilitate cross-study comparisons. (shrink)

_Strange Wonder_ confronts Western philosophy's ambivalent relationship to the Platonic "wonder" that reveals the strangeness of the everyday. On the one hand, this wonder is said to be the origin of all philosophy. On the other hand, it is associated with a kind of ignorance that ought to be extinguished as swiftly as possible. By endeavoring to resolve wonder's indeterminacy into certainty and calculability, philosophy paradoxically secures itself at the expense of its own condition of possibility. _Strange Wonder_ locates a (...) reopening of wonder's primordial uncertainty in the work of Martin Heidegger, for whom wonder is first experienced as the shock at the groundlessness of things and then as an astonishment that things nevertheless _are_. Mary-Jane Rubenstein traces this double movement through the thought of Emmanuel Levinas, Jean-Luc Nancy, and Jacques Derrida, ultimately thematizing wonder as the awesome, awful opening that exposes thinking to devastation as well as transformation. Rubenstein's study shows that wonder reveals the extraordinary in and through the ordinary, and is therefore crucial to the task of reimagining political, religious, and ethical terrain. (shrink)

_Strange Wonder_ confronts Western philosophy's ambivalent relationship to the Platonic "wonder" that reveals the strangeness of the everyday. On the one hand, this wonder is said to be the origin of all philosophy. On the other hand, it is associated with a kind of ignorance that ought to be extinguished as swiftly as possible. By endeavoring to resolve wonder's indeterminacy into certainty and calculability, philosophy paradoxically secures itself at the expense of its own condition of possibility. _Strange Wonder_ locates a (...) reopening of wonder's primordial uncertainty in the work of Martin Heidegger, for whom wonder is first experienced as the shock at the groundlessness of things and then as an astonishment that things nevertheless _are_. Mary-Jane Rubenstein traces this double movement through the thought of Emmanuel Levinas, Jean-Luc Nancy, and Jacques Derrida, ultimately thematizing wonder as the awesome, awful opening that exposes thinking to devastation as well as transformation. Rubenstein's study shows that wonder reveals the extraordinary in and through the ordinary, and is therefore crucial to the task of reimagining political, religious, and ethical terrain. (shrink)

When attempting to determine which of our acts affect future generations and which affect the identities of those who make up such generations, accounts of personal identity that privilege psychological features and person affecting accounts of morality, whilst highly useful when discussing the rights and wrongs of acts relating to extant persons, seem to come up short. On such approaches it is often held that the intuition that future persons can be harmed by decisions made prior to their existence is (...) mistaken as identity is a most fragile thing with even the smallest differences in the conditions under which we procreate affecting not the interests of distinct future persons, but the identities of those who will come to exist in the future. Within this paper I reject this view, holding that a subscription to these two accounts need not result in the conclusion that virtually all acts relating to possible persons are permitted. Further, I argue that such accounts may in fact allow a great deal more scope for the determination of prenatal harms than accounts of personal identity that privilege physical features. Finally, by interpreting claims regarding causal identity such as Parfit’s Time Dependence Claim in terms of Counterpart Theory I suggest that a solution to the non-identity problem can be found in the acceptance of, as relevant in prenatal cases, three kinds of objective similarity relations: Biological, Environmental and Decisional counterpart relations. (shrink)

Since Oregon implemented its Death with Dignity Act, many additional states have followed suit demonstrating a growing understanding and acceptance of aid in dying processes. Traditionally, the patient has been the one to request and seek this option out. However, as Death with Dignity acts continue to expand, it will impact the role of physicians and bring up questions over whether physicians have the ethical obligation to facilitate a conversation about AID with patients during end of life discussions. Patients have (...) the right to make informed decisions about their health, which implies that physicians have an obligation to discuss with and inform patients of the options that will accomplish the patients’ goals of care. We will argue that physicians have an ethical obligation to inform certain patients about AID during end of life care discussions. We will also address what this obligation encompasses and explore guidelines of when and how these conversations should occur and proceed. Earlier guidelines, presented by various palliative care and ethics experts, for proceeding with such conversations have mostly agreed that the discussion of hospice and end of life care with patients should be initiated early and that the individual goals of a patient during the remaining duration of life should be thoroughly examined before discussion of appropriate options. In discussing AID, physicians should never recommend but inform patients about the basics so that they can make an informed decision. If patients express further interest in AID, the physician should open up the dialogue to address the reasoning behind this decision versus other possible treatments to ensure that patients clearly comprehend the process and implications of their decision. Ultimately, any end of life choice should be made by patients with the full capacity to express what they envision for the remaining duration of life and to comprehend the advantages and disadvantages of all the possible options. (shrink)

Machine generated contents note: -- Acknowledgements -- Introduction: Points of Departure -- Chapter 1: Instructions for Traveling -- Chapter 2: Reflections on Travel -- Chapter 3: Imagined Travelers -- Conclusion: Homecomings -- Notes -- Index.

The subject of this book is young children's emotional-social learning and development within early childhood care and education settings in Aotearoa-New Zealand. The focus on emotional complexity fills a gap in early childhood care and education research where young children are frequently framed narrowly as 'learners,' ignoring the importance of emotional functioning and the feelings with which children make sense of themselves and the world. This book draws on original data in the form of narrative-like framed events to creatively illustrate (...) the complexities in children's diverse ways of feeling, thinking, playing, being, and becoming. Events illuminate the feelings and meanings of observed experiences in holistic and contextualised gestalts. Awareness of unconscious processes, the feeling of feelings, and cultural dimensions of development and meaning-making are addressed. The book emphasises the emergent and psychodynamic nature of children's development and learning with strong links to the role of play and playfulness in the events, drawing on two ethnographically inspired research projects that present theory, experience and practice in real-life events. (shrink)

BackgroundSuicide research aims to contribute to a better understanding of suicidal behaviour and its prevention. However, there are many ethical challenges in this research field, for example, regarding consent and potential risks to participants. While studies to-date have focused on the perspective of the researchers, this study aimed to investigate the views and experiences of members of Human Research Ethics Committees (HRECs) in dealing with suicide-related study applications.MethodsThis qualitative study entailed a thematic analysis using an inductive approach. We conducted semi-structured (...) interviews with a purposive sample (N = 15) of HREC Chairs or their delegates from Australian research-intensive universities. The interview guide included questions regarding the ethical concerns and challenges in suicide-related research raised by HREC members, how they dealt with those challenges and what advice they could give to researchers.ResultsThe analysis identified four main themes: (1) HREC members’ experiences of reviewing suicide-related study applications, (2) HREC members’ perceptions of suicide, suicide research, and study participants, (3) Complexity in HREC members’ decision-making processes, and (4) HREC members’ relationships with researchers.ConclusionsReliance on ethical guidelines and dialogue with researchers are crucial in the assessment of suicide-related study applications. Both researchers and HREC members may benefit from guidance and resources on how to conduct ethically sound suicide-related studies. Developing working relationships will be likely to help HRECs to facilitate high quality, ethical suicide-related research and researchers to conduct such research. (shrink)

While dominant management thinking is steered by profit maximisation, this paper proposes that sustained organisational growth can best be stimulated by attention to the common good and the capacity of corporate leaders to create commitment to the common good. The leadership thinking of Kautilya and Ashoka embodies this principle. Both offer a common good approach, emphasising the leader's moral and legal responsibility for people's welfare, the robust interaction between the business community and the state, and the importance of moral training (...) of leaders in identifying and promoting the common good. We argue that the complex process of re‐orientating corporate priorities towards the common good requires alertness and concerted effort if both business and society are to truly benefit. As Ashoka said: ‘A good deed is a difficult thing’. (shrink)

Studies with captive fowl have revealed that they possess greater cognitive capacities than previously thought. We now know that fowl have sophisticated cognitive and communicative skills, which had hitherto been associated only with certain primates. Several theories have been advanced to explain the evolution of such complex behavior. Central to these theories is the enlargement of the brain in species with greater mental capacities. Fowl present us with a conundrum, however, because they show the behaviors anticipated by the theories but (...) do not have the expected changes in the brain. Consequently fowl present two challenges of interest to us here. One is a scientific challenge to explain their remarkable capabilities. The other is an ethical challenge regarding our treatment of animals with higher cognitive skills. (shrink)

Telepolitics, the politics of the electronic media, is a new reality, an order of existence that has radically transformed man's relationship with his fellow man.

First published in 1918, this volume was partly based on lectures delivered by Dorothea Jane Stephen at and near Bangalore and was intended to illustrate the considerable influence exercised by the early literature of India on later Indian philosophy and culture. Examining themes of divinity and religion together with morality and human nature, the essays in this book combine to offer a fitting introduction to the importance and far-reaching effects of early Indian thought.

_Mothers and Daughters and the Origins of Female Subjectivity_ challenges the theory of the Oedipus complex, which permeates psychoanalytic theory, psychology, semiotics and cultural studies. The book focuses on the re-examination of women’s development through the theories of primitive mental states. Women’s subjectivity has been profoundly limited by continuing anxieties about the mother’s body. Jane Van Buren describes how women are gradually escaping the curse of inferiority and finding a voice, enabling the mother to provide their daughters with a (...) legacy of rightful agency over their bodies and minds. Drawing on the theories of Klein, Bion and Winnicott, and incorporating recent developments in psychobiology, this book provides a novel approach to subjects including the dreams, myths and phantasies of individuals, the nature of mother and daughter relationships, sexuality, pregnancy, menstruation and the idea of the mother’s body as problematic and dangerous. This interdisciplinary investigation into curtailed female subjectivity and its many ramifications in society, culture and individual mental growth will be of great interest to all practising psychoanalysts, and those studying psychoanalytic theory and gender studies. (shrink)

We completely characterize the simple majority weighted voting game achievable hierarchies, and, in doing so, show that a problem about representative government, noted by J. Banzhaf [Rutgers Law Review 58, 317–343 (1965)] cannot be resolved using the simple majority quota. We also demonstrate that all hierarchies achievable by any quota can be achieved if the simple majority quota is simply incremented by one.