Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

The draft Code of Conduct for Research is an important initiative towards assisting the scientific community in complying with the provisions of the Protection of Personal Information Act 4 of 2013 (POPIA). However, its approach towards cross-border data sharing should be reconsidered to clarify the ambiguities inherent in the legal requirements for the cross-border sharing of health data in the POPIA. These ambiguities include the concept of ‘transfer of information’, the application of adequacy as a legal mechanism for transfer, the (...) nature of consent for cross-border sharing and the scope of the recipient third party. We suggest that the draft Code of Conduct for Research can be improved by: Explaining or defining the concept of ‘transfer of information’ and when it applies to cross-border sharing in research Clarifying the application of adequacy as a legal mechanism for transfer vis-à-vis the other alternatives Expanding on the interpretation and application of consent as a legal mechanism for cross-border transfers Expanding the category of persons who may be recipients of personal information in a third country. (shrink)

A substantial portion of Adam Smith's discussion of Stoicism in TMS VII is dedicated to the Stoic “principle of suicide,” according to which suicide is sometimes morally required. While scholars agree that Stoicism exercised considerable influence over Smith, no recent work has explored his views on suicide, despite the central role it plays in his treatment of Stoicism. I argue that Smith opposes the principle of suicide on both epistemic and moral grounds, providing an important critique of Stoicism. I also (...) show how Smith departs from other early modern accounts of suicide by offering a notably humane analysis of this tragic act. I conclude by considering what Smith's discussion of Stoicism and suicide tells us about his moral theory, and I forward a reading of Smith as a skeptic. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 8.4 (2001) 317-322 [Access article in PDF] On Wolfgang Blankenburg, Common Sense, and Schizophrenia Aaron L. Mishara Introduction In its increasing openness to neuroscience (Cowan, Harter, and Kandel 2000) and other of its neighboring disciplines, mainstream biological psychiatry has allowed psychopathology, philosophy, and philosophical approaches to psychopathology to play an increased role in current research interests. Given this new openness, and the acknowledgment of the (...) severity of one of psychiatry's most debilitating, costly, and intractable disorders, 1 the translation of W. Blankenburg's 1969 article concerning the psychopathology of common sense does not merely serve historical interest. It is an exceptional example of a not well-known trend in German- and French-speaking psychiatry to apply philosophical phenomenology and existentialism to psychopathological research. This trend, which reached a peak in the late 1950s and was strong well into the 1970s, has dwindling, but nevertheless, current representatives in Heidelberg and Zurich and is scattered in a few other places in Europe, Japan, the United States, and South America. The view of the Zeitgeist—which may sound astonishing, even antiquated to contemporary readers—was highly ambitious: Conceptual approaches, such as philosophical ("transcendental") phenomenology, were expected to supply knowledge about the structure of consciousness and its disturbance in various mental disorders.Following the lead of Binswanger and Szilasi, who viewed schizophrenia as an "experiment of nature" that enables us to view underlying processes otherwise hidden to "natural, everyday consciousness," Blankenburg believed that it may be possible to map the formal properties of the psychopathology of schizophrenia—precisely in the loss of common sense—as a disturbance to the basic organization of conscious experience. Any attempt to summarize this rather abstract and complex approach in a brief commentary would be ill advised. In passing, rather, I will remark that such efforts could have profound relevance to the current research of schizophrenia and its underlying neurobiology. This research has gradually acknowledged the importance of taking the patient's subjective experience of the disorder into account (Mishara, Parnas, and Naudin 1998). In this commentary, I will first give an account of the biographical and clinical reasons that led Blankenburg to turn to the problem of common sense and its relevance for schizophrenia. I will then explore what implications [End Page 317] his work may have for more recent findings concerning schizophrenia. Blankenburg's Intellectual Development Born in 1928, W. Blankenburg, the son of a Lufthansa pilot who pioneered transatlantic commercial flights, began his studies in Freiburg im Breisgau in 1947. While at Freiburg, Blankenburg heard lectures in philosophy given by E. Fink (the former assistant to Husserl) and Max Mueller, and in psychology, by R. Heiss and others. After three years, Blankenburg turned to the study of medicine, producing a dissertation in 1956 on an application of Daseinsanalysis (Heidegger and Binswanger) to a case of paranoid schizophrenia. Binswanger wrote the forward to the publication. Between 1956 and 1958, Blankenburg studied internal medicine in Heidelberg with the accomplished phenomenologist of bodily experience (Leibphaenomenologer) and student of V. von Weizsaecker Herbert Pluegge. He spent one semester in Goettingen where he attended lectures by the ontological philosopher Nicolai Hartmann, who provided for Blankenburg a more useful approach to the problem of nature and natural science than Heidegger's primary emphasis on the question of Being. During his Freiburg years, Blankenburg attended small seminars led by Heidegger in the Schwarzwald forest. (Heidegger had been forbidden to teach after the end of World War II.) Blankenburg recalls that the participants would sit on logs in an open field as if to invoke Heidegger's concept of the clearing (Lichtung) of Being. While not entirely sympathetic with Heidegger's philosophy, Blankenburg learned to carefully "listen"—as Heidegger would repeatedly emphasize—to language, not merely poetic or philosophical language, but the language of the patients he would meet in clinical practice.During this time, Blankenburg heard lectures by W. Szilasi, the philosopher-scientist who held Husserl's and Heidegger's chair in the department of philosophy. Szilasi collaborated with the phenomenological psychiatrist, L. Binswanger. Their effort to apply concepts from Husserl's... (shrink)

It is widely agreed among broadly Anselmian theists that God is in some sense the 'delimiter of possibilities.' In other words, the scope of possibility is explained by the manner in which the universe emanates from God. However, existing accounts of God's role here—in terms of freedom, choice, or power—face serious difficulties. The present paper provides a new account of God's role as the delimiter of possibilities in terms of the different manner in which the non-actuality of non-actual states of (...) affairs is explained. Intuitively and metaphorically, we can think of the menu of states of affairs being 'whittled down' in successive stages of a process of divine decision-making, with the different species of impossibility corresponding to when and how the states of affairs are ruled out. I argue that this approach provides genuine contingency while also preserving the Principle of Sufficient Reason. (shrink)

There is a prima facie conflict between the values of love and autonomy. How can we bind ourselves to a person and still enjoy the fruits of self-determination? This chapter argues that the solution to this conflict lies in recognizing that love is the basis of autonomy: one must love a person in order to truly appreciate their autonomy. To make this case, this chapter defends a minimalist account of love, according to which love is an agreeable sensation that is (...) experienced when considering the existence of another person. On this view, the lover does not desire anything from the beloved but works to attend to their presence. Love, then, puts us in a position to appreciate the beloved in their particular way of being. By accepting the presence of the beloved we gain a sense of their autonomy. The roots of this account of love are found in the writings of Damaris Cudworth Masham. This chapter draws on the work of Kieran Setiya, David Velleman, and Kyla Ebels-Duggan to elaborate on and defend Masham’s views. (shrink)

? The author wishes to acknowledge the help he has received from Mr R. S. Easterby of the Applied Psychology Department, University of Aston in Birmingham, in completing this research.

Allocating scarce organs to transplant candidates is only one stage in the long process of organ transplantation. Before being listed, all candidates must undergo a rigorous assessment by a multidisciplinary transplant team. The Department of Health and NHS Blood and Transplant (NHSBT) are responsible for the development of detailed strategies to ensure a fair and objective assessment experience for all transplant candidates. Difficulties arise when particularly vulnerable candidates, such as candidates with psychiatric illnesses, are assessed. NHSBT has already developed unique (...) assessment guidelines for alcoholic and substance-abusing liver transplant candidates to allow for a more comprehensive evaluation, but candidates with psychiatric illnesses are still assessed against general criteria. Should these candidates be assessed against their own criteria? On what clinical grounds do transplant teams justify excluding such candidates from transplantation? Is redress available for candidates who feel they have been unfairly refused a liver transplant simply because of their psychiatric illness? This essay will critically examine the provisions published by the Department of Health and NHSBT for the assessment of liver transplant candidates with psychiatric illnesses, and will provide a commentary as to whether enough is being done to protect these particularly vulnerable candidates from inconsistent assessment decisions. (shrink)

OBJECTIVES: To determine the epidemiology and the underlying pathological conditions of natural deaths among motor vehicle drivers. Sudden death while driving may cause damage to properties, other vehicles or road users. Although the Medical Commission on Accident Prevention recommended restrictions to drivers at risk of sudden death due to their medical conditions, these restrictions are useless if they do not result in greater safety to the public. DESIGN: A retrospective study of natural deaths of motor vehicle drivers. SETTING: Natural deaths (...) of motor vehicle drivers reported to the coroner for Birmingham and Solihull. SUBJECTS: 86 consecutive natural deaths of motor vehicle drivers in a five-year period between 1984 and 1988. RESULTS: Of the 86 fatalities reviewed, 80 (93%) sudden deaths were caused by ischaemic heart disease. Fifty vehicles were involved in collision with 32 properties, 20 other vehicles and six pedestrians. Fifty-one out of 80 cardiac deaths had past cardiac history and three had reported chest pain prior to the sudden death. CONCLUSION: An applied normative ethical assessment based on the basic moral principles of autonomy, justice, beneficence and non-maleficence are discussed. We conclude that medical screening of drivers has little benefit for the drivers or other persons. (shrink)

The political media discourse and its pragmalinguistic peculiarities are analyzed in the paper. The choice of the subject matter for the analysis is determined by the interest to media communication. It is noted that the political discourse is one of the effective means of influence on the collective consciousness. Various definitions of the concept ‘discourse‘ are given; special attention is paid to the presidential discourse. Discourse as a communicative event taking place in a social context is based on pragmatic situations (...) and is studied taking into account such factors as a communicative situation, the addresser and the addressee of speech, the content of the communication, the pragmatic meaning of language units. The author analyses compositional, stylistic, and lexico-grammatical means used to create a pragmatic effect in the annual New Year addresses of the President of Russia Vladimir Putin. The effectiveness of presidential discourse is achieved due to the choice of words with positive connotation, the use of repetition, use of personal and possessive pronouns in the first person plural, the use of parallel syntactic constructions, and the use of both formal and informal styles. The author concludes that pragmatic means are of great importance for media discourse studies and presidential public addresses play an important role in shaping the moral values of the nation. (shrink)

The author of the article discusses a political discourse of the US president Donald Trump. The political discourse is considered to be a type of discourse based on views and beliefs, the purpose of which is to manipulate the consciousness of the addressee using strategies in order to form certain beliefs. The strategy in this case means the plan of implementation of the communicative task, necessary for effective achievement of the addressee’s goal, realized with the help of certain tactics. The (...) choice of the subject matter is determined by the interest to political communication. The author analyses discourse strategies and markers, stylistic and lexico-grammatical means used as manipulative means in Donald Trump’s Acceptance Speech, Victory Speech, and Inaugural Address. Special attention is given to the strategy of improvement, strategy of enhancement, and strategy for evaluation of alternatives. It is known that presidential public addresses are of great importance, therefore communicative skills of politicians and ability to speak in public play a great role in their political career. The analysis of D. Trump’s presidential discourse has revealed the use of discursive manipulative strategies and manipulative markers, numerous repetitions, calls for joint action, the use of ‘unifying vocabulary‘, slogans, inversion. It is noted that the presidential political discourse is an effective means of manipulating the consciousness of the nation and the formation of its outlook. The author concludes that speech manipulation is a complex phenomenon, the effectiveness of which depends on linguistic, psychological, extralinguistic, and social factors. (shrink)

The article deals with the role of public addresses delivered by the US first lady Michelle Obama in forming the presidential image. Special attention is paid to communicative strategies, stylistic and lexico-grammatical means used in public addresses for influencing the electorate. It is shown that both Obama and his spouse’s speeches play an important role in the electorate consciousness manipulation in the USA.

In the article various means that are used for creating the image of Elizabeth II are studied. The choice of the subject matter for the analysis is determined by the interest to the British royal family. The author considers various definitions of the concept ‘image‘ and analyzes its characteristic features. It is noted that image can be positive and negative, controlled and uncontrolled, desired and actual. The image helps to show particular traits of a personality. It is based on the (...) person’s appearance, his or her manners, hobbies, interests, speech peculiarities. It is known that such factors as family environment, sports, pets and hobbies play a great role in the creation of the image. There are the following aspects of the image: professional, social and portrait. Special attention is paid to verbal and non-verbal means of creating an image. The main lexical, phonetic and stylistic characteristic features of the monarch’s Christmas Broadcasts have been singled out. A positive image of the monarch is created with the help of verbal and nonverbal means. The Queen’s public addresses and Christmas broadcasts may serve as an example of verbal means used for image creation. Patriotism, sense of duty, loyalty to traditions, adherence to the rules of Royal etiquette is evident in the communicative behavior of the Queen. It is noted that public addresses play a certain role in the creation of a positive image of the English Queen. (shrink)

Comment by Aaron L. Mackler on “‘Through Her I Too Shall Bear a Child’: Birth Surrogates in Jewish Law” by Elie Spitz Reply by Elie Kaplan Spitz Research Note by G. Scott Davis.

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Wilhelm Griesinger”Aaron L. Mishara (bio)Arens situates Wilhelm Griesinger in a historical context with which we are no longer familiar. In doing so, she has performed an important task for contemporary clinicians, philosophers, and historians. We find ourselves working and thinking (both in everyday clinical practice and in the construction of our models of mental disorder) with the same categories that Griesinger struggled to sort out and redefine; (...) we often do so, however, without awareness of their history or lack of permanence. Ackerknecht writes that all the dominant trends in modern psychiatry can be traced back to Griesinger; he states that Griesinger is the “founder of neuropsychiatry,” a “merging of the two disciplines” neurology and psychiatry. Griesinger presents us with a “systematic synthesis of the anatomical, physiological, psychological and clinical points of view” (Ackerknecht 1959, 63). Somewhat contrarily, Karl Jaspers, in his General Psychopathology, groups Griesinger with the great observers and describers of clinical experience rather than among the systematic analyzers (Jaspers 1963, 849–50). Although Griesinger is best known for his identification of mental disorders as a subset of brain diseases, Karl Bonhoeffer, a successor to Griesinger as director of the Charité Clinic in Berlin, cautions that Griesinger “continued to see in psychological causes the most frequent and abundant source of mental disorders” (Bonhoeffer 1911, 53). Kales, Kales, and Vela-Bueno, however, write, “Griesinger was representative of a clinical movement that minimized the value of psychological concepts in the understanding of mental diseases” (Kales, Kales, and Vela-Bueno 1990, 15). Precisely because of his importance, contention surrounds his legacy.If Griesinger is the pioneer of empirical approaches in biological neuropsychiatry (as Ackerknecht and others claim), he is also precursor to philosophical criticisms of their limits. It is not so easy to lump Griesinger to one side of the oppositions with which we think today: Griesinger’s scientific psychiatry (formed on the basis of the newly emergent empirical physiology) was meant to steer between the Scylla of the previously reigning overspeculative romantic medicine and the Charybdis of the antitheoretical and “positivistic” materialism of Magendie. As Arens suggests, even during the same generation of university psychiatry which Griesinger was critical in forming, he was posthumously denounced as belonging to the Hegelian idealists; later, he was proclaimed to be an empiricist. Griesinger’s work contained both idealism and empiricism in a fragile synthesis that soon broke asunder.Hermeneutic theory points out that we inevitably interpret an author, in this case, Griesinger, in terms of the prejudices of our own present context of understanding and our current problems of application to clinical practice (Gadamer 1993). On the one hand, we benefit from the advantage of seeing all that follows Griesinger’s work and are able to “understand the author [End Page 165] better than he understood himself.” We are able to see what he only anticipates but is still not able to explicitly articulate as the unpredicted effects of his work. On the other hand, our interpretations are encumbered by the sedimentations of the views of his successors: his work lies buried under the subsequent interpretations and vicissitudes of a reception with its own agendas, contexts of interpretation, and realms of application. It would be easier if we could simply assign him to one side of our current debates concerning mind/body, individual/culture, and explanation/understanding rather than seeing that our present quandaries in understanding, classifying, and treating mental disorder result precisely from a reading of Griesinger that is not careful enough. It is here that Arens can help us develop our present views further by reviewing their past.Although Griesinger is heralded as the pioneer of an empirical physiological approach which employs a natural scientific concept of mechanism (Ackerknecht, O. Marx, Verwey), Arens situates him in the tradition of Kant and German idealism. It is perhaps this solution of being both philosophical and empirical which seems hard for us, today, to understand. We have come to view these directions as contradictory, to be necessarily in a mutually exclusive relationship. (But that is rather the expression of the present impasse and not the way that Griesinger originally approached these problems.) Arens ambitiously retraces the genealogy of Griesinger’s model... (shrink)