BackgroundDecision-making in end-stage dementia is a complex process involving medical, social, legal and ethical issues. In ESD, the person suffers from severe cognitive problems leading to a loss of capacity to decide matters regarding health and end-of-life issues. The decisional responsibility is usually passed to clinicians and relatives who can face significant difficulty in making moral decisions, particularly in the presence of life-threatening swallowing problems.AimThis study aimed to understand the decision-making processes of clinical teams and relatives in addressing life-threatening swallowing (...) difficulties in ESD in long-term care in Malta.MethodThe study followed a qualitative approach where six case studies, involving six different teams and relatives of six different patients, were interviewed retrospectively to understand their decision-making in connection with the management of swallowing difficulties in ESD. Data were collected through semistructured interviews with each stakeholder. All data were transcribed and subjected to thematic analysis.ResultsFour themes were identified: the vulnerability of patients in dementia decision-making; the difficult role of relatives in decision-making; the decisional conflict between aggressive care through tube feeding versus oral comfort feeding; a consensus-building decision-making process as ideal to facilitate agreement and respect for patient’s dignity.ConclusionDecision-making to manage swallowing difficulties in ESD is a challenging process, which involves an interpretation of personal values, beliefs, patient preferences, care needs and clinical practice. Better communication between clinicians and relatives in dementia helps promote agreement between stakeholders leading to a care plan that respects the dignity of patients at their end of life. (shrink)

The COVID-19 pandemic has inspired numerous opportunities for telehealth implementation to meet diverse healthcare needs, including the use of virtual communication platforms to facilitate the growth of and access to clinical ethics consultation (CEC) services across the globe. Here we discuss the conceptualization and implementation of two different virtual CEC services that arose during the COVID-19 pandemic: the Clinical Ethics Malaysia COVID-19 Consultation Service and the Johns Hopkins Hospital Ethics Committee and Consultation Service. A common strength experienced by both platforms (...) during virtual delivery included improved ability for local practitioners to address consultation needs for patient populations otherwise unable to access CEC services in their respective locations. Additionally, virtual platforms allowed for enhanced collaboration and sharing of expertise among ethics consultants. Both contexts encountered numerous challenges related to patient care delivery during the pandemic. The use of virtual technologies resulted in decreased personalization of patient-provider communication. We discuss these challenges with respect to contextual differences specific to each service and setting, including differences in CEC needs, sociocultural norms, resource availability, populations served, consultation service visibility, healthcare infrastructure, and funding disparities. Through lessons learned from a health system in the United States and a national service in Malaysia, we provide key recommendations for health practitioners and clinical ethics consultants to leverage virtual communication platforms to mitigate existing inequities in patient care delivery and increase capacity for CEC globally. (shrink)

This collection of essays, offered in honor of the distinguished career of prominent political philosophy professor Clifford Orwin, brings together internationally renowned scholars to provide a wide context and discuss various aspects of the virtue of “humanity” through the history of political philosophy.

A limiting factor in ethics education in medical training has been difficulty in assessing competence in ethics. This study was conducted to test the concept that content analysis of pediatric residents’ personal reflections about ethics experiences can identify changes in ethical sensitivity and reasoning over time. Analysis of written narratives focused on two of our ethics curriculum’s goals: 1) To raise sensitivity to ethical issues in everyday clinical practice and 2) to enhance critical reflection on personal and professional values as (...) they affect patient care. Content analysis of written reflections was guided by a tool developed to identify and assess the level of ethical reasoning in eight domains determined to be important aspects of ethical competence. Based on the assessment of narratives written at two times (12 to 16 months/apart) during their training, residents showed significant progress in two specific domains: use of professional values, and use of personal values. Residents did not show decline in ethical reasoning in any domain. This study demonstrates that content analysis of personal narratives may provide a useful method for assessment of developing ethical sensitivity and reasoning. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:uippraisals from the 'Past THE CLEAREST INTELLECT OF OUR AGEl H UGH MACLENNAN 19°7-199° R cently I have been rereading Bertrand Russell, and in so doing I suddenly realized that lowe to this man a good deal of such happiness as I enjoy. Over the years I had forgotten how great my debt was, but when I reread one of his books which I first read as a student, (...) I understood the extent to which he had liberated me from the psychological sadism of Calvin and Knox, to whom I had been unduly exposed when young. It is probably impossible for anyone entirely to escape once these two have got their hands around his throat, but Russell enabled me to escape a litde. 1 [This essay was recently discovered during the cataloguing for BRACERS of an obscure class of correspondence. Mr. Joseph w. Devine had sent Russell a clipping of the essay's appearance in' the Philadelphia Sunday But/etin, of 15 July 1962. I had long thought, from reading Elspeth Cameron's Hugh MacLennan: a Writers Life (1981), that he showed signs not only of having been influenced by Russell but of being the sOrt of person who is attracted to Russell's way of thinking. A promising tide in the same scholar's bibliography ofMacLennan turned out to be a fuller version of the clipping. "The Clearest Intellect of Our Age" is reprinted from The Montreal Star, 14 July 1962, "Entertainments" sec., p. 5. Russell did influence MacLennan. Neither the Russell Archives nor the inventory of the Maclennan papers at the Universiry of Calgary reveals personal contact berween the rwo. I wish I had asked MacLennan about contacts and influence seventeen years ago, when I sent him an early issue of Russell He commented: ''1 found your journal fascinating and never before had read that beautiful thing Russell wrote in his early days with Whitehead:" He is referring to the essay on the status of women in No.6, now in Papers 12.-Ed.] russell: the Journal ofthe Benrand Russell Archives McMaster Unive..ity Libraty Press noS. 11 (summer 1991): 83-5 ISSN 00,6-01631 84 HUGH MACLENNAN I suppose he really is the greatest man alive, in the sense that his teaching grows and his teaching is good, but it is pointless to argue the point between him and Churchill. It is wonderful, however, that many think he is our greatest man and that he has become an international hero to millions of the thoughtful youth. He must be the first pure logician who ever was that. Until he took his stand against nuclear war, he never appealed to the passions. He lacked the aggressions which youth admires. He never said: "Come live with me and I will be your master"; or, "Follow me and I will purge you of your sins." He had no use for self-sacrifice as such. He simply said, in effect: "Happiness is good. If you desire it, you must be reasonable." As he was intelligent enough to know that anyone who teaches that happiness is good, and teaches how to achieve it, is sute to be considered subversive to a Christian-commercial society, he bore no personal resentment when society persecuted him. The young know, of course, that Russell is now assumed by the experts to be the most important philosopher since Hume, but that is not why they love him. They love him for the sublime civilization of his courage, for his refusal to let an intensely kind nature blunt his respect for truth. They love him because he loves life even in the twentieth century; and they love him most of all because he is engage. And of course they also love the wit which refuses to be made tongue-tied by those who insist that whenever one speaks of sex or religion one must be solemn. Russell's wit is worth the study of any writer. It is based on mathematics, and Russell would agree, I think, with the remark Camillien Houde once made to me when I asked the famous mayor of Montreal how he was always able to make people laugh. Houde replied... (shrink)

Jennifer Hornsby has defended the Reasons-Knowledge Thesis : the claim that \-ing because p requires knowing that p, where the ‘because’ at issue is a rationalising ‘because’. She defends by appeal to the thought that it provides the best explanation of why the subject in a certain sort of Gettier case fails to be in a position to \ because p. Dustin Locke and, separately, Nick Hughes, present some modified barn-façade cases which seem to constitute counterexamples to and undermine Hornsby’s (...) way of motivating it by rendering their alternative Reasons-Explanation Thesis a better explanation of Hornsby’s datum. This paper defends and Hornsby’s argument for it against those objections. First, I point out that their supposedly intuitive verdict about the relevant barn-façade cases is not as intuitive as they think. Second, I point out that even if we share the intuition: we have strong reason to doubt the verdict anyway. And finally, I point out that since is independently implausible, the two problems can be tackled anyway. (shrink)

In November of 1050 Agnes of Poitou, wife of Emperor Henry III, gave birth to their first son. The birth of a son and heir was always an important event, and in this instance especially so. Henry had been seriously ill several times, including that very year. Although he had four daughters, there was a danger that he might die without male issue. Henry's ill health and lack of a male heir encouraged political instability and even conspiracy. When Henry was (...) seriously ill at Frankfurt in October 1045, ecclesiastical and lay magnates actually discussed whom they would choose as his successor. In 1047 at Xanten, perhaps in the presence of the emperor, Archbishop Hermann of Cologne exhorted his congregation that “along with him they should beg from the heavenly clemency that a son be given to the emperor in order to dispose properly the peace of the realm.”. (shrink)

The chief feature of Gadamer's philosophy is his claim that the humanities obey their own rules concerning reading texts and ensuring certitude. The promise of certitude is illusory, however, and the discourses on interpretation by him and his leading disciples are too confused to instruct the reader. His own sketch of his philosophy, published in his autobiographic Philosophical Apprenticeship, and its reflection in Gadamer and Hermeneutics (Hugh J. Silverman, ed.), shows this and reveals him as still too insensitive to (...) the national tragedy of the Third Reich, which he witnessed. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Minding Brain Injury, Consciousness, and Ethics: Discourse and DeliberationsJoseph J. Fins (bio) and James Giordano (bio)The annual John Collins Harvey Lecture at the Georgetown University’s Pellegrino Center for Clinical Bioethics is a forum for addressing contemporary topics at the intersection of medicine and bioethics. This year, in marking the decadal anniversary of the launch of the Brain Research through Advancing Innovative Neurotechnology (BRAIN) Initiative, the Harvey Lecture provided an (...) interactive discussion with renowned clinician, researcher, scholar, and author, Joseph J. Fins, MD—who is the E. William Davis, Jr., MD Professor of Medical Ethics, Chief of the Division of Medical Ethics, and a Professor of Medicine at Weill Cornell Medical College—conducted by James Giordano, PhD, MPhil—who is a Professor of Neurology and Biochemistry, and Chief of the Pellegrino Center’s Neuroethics Studies Program at the Georgetown University Medical Center. The discourse focused upon the topic of covert consciousness, and the ways in which current and developing brain science technologies, together with revised practices of medicine, in general, may afford new opportunities in patient care, but may also give rise to issues, questions, challenges, and opportunities for neuroethics.Prof. James GIORDANO:Prof. Fins, your most recent book, Rights Come to Mind: Brain Injury, Ethics, and the Struggle for Consciousness (Fins 2015), addresses your ongoing work to employ current and emerging neurological approaches to reveal conscious functions in patients with profound brain injury and disease. To be sure, the destination—if you will—is to talk about covert consciousness. But in commencing this discussion, I’d like to propose a route, which traces your professional journey to this point in your career, and how it led you on your search to reveal consciousness in those patients who lack expressive capability. You went into palliative care first, and that brought you to where you are today. [End Page 227]Prof. Joseph J. FINS:First, let me thank you and the Pellegrino Center for the honor of giving the John Harvey Collins Lecture in such an interactive manner. The forefront of neurological care—and the neuroethical issues and methods focal to such practice—wasn’t what I initially intended to do professionally, but I think that therein is a good lesson for young people’s career aspirations. Simply put, one doesn’t always know where they’ll end up at the beginning of the journey, and as Kierkegaard said, life is lived forward, but is understood backwards (Kierkegaard 1843).In the nineties and the early 2000s, I was trying to help improve the quality of care of people at the end of life, and I wrote a book, entitled The Palliative Ethic of Care: Clinical Wisdom at Life’s End (Fins 2006), in which I addressed notions of phronesis—practical wisdom—in integrating theory and practice toward improving how people die. I became interested in the Quinlan case (Quinlan 1976), and the right to die, and around the same time, I ran into a colleague of mine at Cornell: Dr. Nicholas D. Schiff. Dr. Schiff is a neurologist, who was a protégé of Fred Plum, who was the originator of the concept of the vegetative state with Bryan Jennett, back in 1972. Fred was both of our teachers here at Cornell. Niko (Dr. Schiff) was interested in patients with disorders of consciousness, and was beginning to envision doing work—that ultimately, we did—using deep brain stimulation (DBS) to try to treat patients in the minimally conscious state, a category that was subsequently codified in 2002.I realized that a whole population of people—with these disorders of consciousness—had been somewhat marginalized, and their neglect essentially devolves back to the considerations of the right to die. The right to die was established in the Quinlan case because Judge Hughes—the presiding chief judge of the New Jersey Supreme Court—talked about Ms. Quinlan’s loss of a cognitive, sapient state as being the moral warrant for her right to die, given the fact that it was viewed as a futile situation. I recognized, over the ensuing years—from my background in palliative and end-of-life care—[1] that we had over-generalized notions of futility... (shrink)

Menachem Fisch is the Joseph and Ceil Mazer Professor of History and Philosophy of Science and Director of the Center for Religious and Interreligious Studies at Tel Aviv University. He is also Senior Fellow of the Kogod Center for the Renewal of Jewish Thought at the Shalom Hartman Institute in Jerusalem.

The Irish antecedents of the struggle of Archbishop Hughes and his Irish emigrant flock against the Public School Society of the City of New York.

How do psychoanalysts explain human morality? _Guilt and Its Vicissitudes: Psychoanalytic Reflections on Morality_ focuses on the way Melanie Klein and successive generations of her followers pursued and deepened Freud's project of explaining man's moral sense as a wholly natural phenomenon. With the introduction of the superego, Freud laid claim to the study of moral development as part of the psychoanalytic enterprise. At the same time he reconceptualized guilt: he thought of it not only as conscious, but as unconscious as (...) well, and it was the unconscious sense of guilt that became a particular concern of the discipline he was founding. As Klein saw it, his work merely pointed the way. Judith M. Hughes argues that Klein and contemporary Kleinians went on to provide a more consistent and comprehensive psychological account of moral development. Hughes shows how Klein and her followers came to appreciate that moral and cognitive questions are complexly interwoven and makes clear how this complexity prompted them to extend the range of their theory. Hughes demonstrates both a detailed knowledge of the major figures in post-war British psychoanalysis, and a keen sensitivity to the way clinical experience informed theory-building. She writes with vigor and grace, not only about Freud and Klein, but also about such key thinkers as Riviere, Isaacs, Heimann, Segal, Bion and Joseph. _Guilt and Its Vicissitudes_ speaks to those concerned with the clinical application of psychoanalytic theory and to those interested in the contribution psychoanalysis makes to understanding questions of human morality. (shrink)

This theological treatise was condemned on March 20, 1985 by The Vatican Congregation for the Doctrine of the Faith (formerly known as The Holy Office). The statement of public notification approved by Pope John Paul II, declared that “the options of Leonardo Boff… endanger the sound doctrine of the faith which this congregation must promote and protect.” The central theme in the book is that today the practice and structure of the Catholic Church is an obstacle to the pursuit of (...) the Christian task in Latin America. A 35 year old Franciscan Friar, Boff is a renowned Catholic theologian in Brazil. Joseph Cardinal Ratzinger, head of the Congregation, had already launched an investigation of Boff's opinions and called him to Rome for questioning. (shrink)

The Heythrop Journal, Volume 63, Issue 1, Page 144-149, January 2022.

“Yet another book on Tocqueville!” This was the opening line of Delba Winthrop’s review of Sheldon Wolin’s Tocqueville between Two Worlds: The Making of a Political and Theoretical Life in 2002. In...

In lieu of an abstract, here is a brief excerpt of the content:Journal of the History of Ideas 62.2 (2001) 233-244 [Access article in PDF] Joseph Butler on Forgiveness: A Presupposed Theory of Emotion Paul A. Newberry "I forgive him as far as humanity can forgive. I would do him no injury." Mrs. Dale in Anthony Trollope's The Last Chronicle of Barset, 1867. In the recent philosophical literature on forgiveness, a topic of great concern is the proper characterization of (...) forgiveness or, said in another way, the proper definition of forgiveness. Forgiveness has been defined in a multitude of ways: among others, as the overcoming of resentment, the overcoming of moral hatred, as a speech act, and as forbearance. Of these definitions the one that enjoys anything close to a kind of consensus is that forgiveness is the overcoming of resentment. This position, with various qualifications and stipulations, is held by numerous philosophers, among them R. S. Downie, Kathleen Dean Moore, A. C. Ewing, Martin Hughes, and Jeffrie Murphy. 1 The progenitor of this view is widely acknowledged to be Joseph Butler, who wrote sermons on both resentment and forgiveness nearly three hundred years ago. 2In this paper I will demonstrate that the attribution of this definition of forgiveness to Butler is in error: he did not define forgiveness as the overcoming of resentment but rather as the checking of revenge, or forbearance. Aside from the goal of setting the historical record straight, I have a broader and more important purpose in this essay. One sees that such an interpretation of Butler must provoke two questions. First, why did Butler define forgiveness only in terms of how one is to act, therefore paying no attention, apparently, to how one feels? Second, how do Murphy and the others incorrectly attribute this view to Butler? [End Page 233] I contend that these answers can be addressed if we take a close look at the role of emotions and theories of emotion in the definitions offered by Butler and Murphy (as representative of the group). I will attempt to establish that Butler's definition of forgiveness as the checking of revenge presupposes a feeling theory of emotions which is distinct from and in conflict with--in many ways pertinent to forgiveness--the cognitive theory of emotions presupposed by Murphy's definition. If I am successful in showing this claim to be plausible, then I will also have demonstrated that more attention needs to be paid to theories of emotion underlying work on forgiveness. But since the misinterpretation of Butler is widespread among contemporary writers on forgiveness and not peculiar to Murphy, my claim is a gesture toward what I take to be a problem greater than mere misinterpretation. Given the fact that a feeling theory of emotions was the predominant theory among philosophers in Butler's day until the end of the nineteenth century and that cognitive theory is currently a dominant philosophical theory, I fear that what has happened is that modern commentators on Butler are unaware that they are imposing their own presupposed theories of emotion onto a text from an earlier historical period.The plan of the paper is first to show by careful exegesis how Butler characterizes forgiveness and then, after a brief sketch of the difference between feeling theory and cognitive theory, to demonstrate how Butler's definition presupposes the former and Murphy's the latter. I will conclude with a few remarks about the import of these findings.Joseph Butler's treatment of forgiveness is found in a collection of his sermons first published as Fifteen Sermons in 1726. 3 Included in this collection are two sermons of primary importance to the topic of forgiveness: a sermon on resentment (Sermon VIII) and a subsequent sermon on forgiveness (Sermon IX). An understanding of Butler's definition of forgiveness properly begins with his sermon on resentment in which he distinguishes between two different kinds of resentment. One kind he calls "hasty and sudden" resentment, the other "settled and deliberate" resentment. 4 Hasty and sudden resentment is generally (and naturally) the result of sudden hurt or violence. 5... (shrink)

I develop a broadly reliabilist theory of non-ideal epistemic rationality and argue that if it is correct we should reject the recently popular idea that the standards of non-ideal epistemic rationality are mere social conventions.

The seventh edition of this pragmatic guide to determining right and wrong in the workplace is updated with new case studies and ancillary materials to combine stakeholder perspectives with a deep dive on workplace ethics issues. Using a unique stakeholder-based approach, this book takes business ethics out of the theory realm and provides practical ways to analyze any business decision. Including dozens of cases, Joseph Weiss looks beyond the impacts of ethical lapses on share price and profit to focus (...) on relationships between stakeholders, including individuals, groups, corporations, and governments. The new seventh edition includes seven new cases and ten new Point/Counterpoint exercises, which challenge students to argue both sides of a contemporary issue. It incorporates the latest research as well as updated cases dealing with recent scandals at organizations such as Boeing, Facebook, and Uber. Professors will have access to online support, including teaching notes, PowerPoint slides, and sample tests. The book is equipped with a step-by-step guide to implementing stakeholder analysis, tips to help students apply ethical principles in their personal and professional lives, and comprehensive coverage of employee workplace issues. Addressing relevant topics such as risk management, preferential hiring, and sexual harassment in conjunction with the digital divide, bribery, the environment, and more, Business Ethics, seventh edition explores ethical implications in today's increasingly interconnected global business environment. (shrink)

(2013). Life, the Unhistorical, the Suprahistorical: Nietzsche on History. International Journal of Philosophical Studies: Vol. 21, No. 1, pp. 64-91. doi: 10.1080/09672559.2012.744532.

Nietzsche was a philosopher who prided himself, in deliberate contradistinction with previous philosophers, on his ‘historical sense’. But this leaves many questions unanswered about the precise role of the historical in Nietzsche’s philosophy. Perhaps most importantly, can the conception of genealogy in Nietzsche’s later philosophy, as a revised historical method, be taken to represent his mature philosophical methodology in general? I argue, firstly, that there is considerable continuity between Nietzsche’s conceptions of history in the early essay ‘On the uses and (...) disadvantages of history for life’ and those of his later philosophy. The former can therefore be used as a resource for understanding the latter. Through a reading of the early history essay I demonstrate that Nietzsche’s conception of the historical here is intimately bound up with the notion of the ‘unhistorical’ and that it is precisely renewed access to the unhistorical which is required in order for history to be conducive to the flourishing of humanity. I go on to contend that this holds for Nietzsche’s later writings as well, and that genealogy, being purely historical, must therefore be seen as one subsidiary part of a broader philosophy in which the unhistorical will play, literally, a vital role. (shrink)

"'There is only one thing that is certain, namely that we can have nothing certain; and therefore it is not certain that we can have nothing certain,' Samuel Butler once said, expressing in that mindbloggler all the elements required to form a classical paradox. Throughout the ages wise men and jesters alike have been intrigued by such mental twists and riddles which defy common sense and yet appear to be true." -- Dust jacket.

The late Joseph Grange is perhaps the most sharply focused and elegantly lucid of the group of North American philosophers to build new aesthetic metaphysical visions from the legacies of process philosophy and pragmatism. His peers include, among others, George Allan,1 Roger Ames,2 Chung-ying Cheng,3 Robert Corrington,4 Frederick Ferre,5 Warren Frisina,6 David L. Hall,7 Judith Jones,8 Elizabeth Kraus,9 Hugh P. McDonald,10 Steve Odin,11 Sandra Rosenthal,12 Robert Smid,13 David Weissman,14 and myself, along with our many students and colleagues. This (...) group has widely variant systems, yet what unites us is an emphasis on the aesthetic and a lack of the fear to enter deeply into metaphysics when relevant.. (shrink)