This workbook is a companion to Clinical Ethics Consultation: A Practical Guide to Changing Culture, Building Capacity and Solving Problems Case by Case. The Toolkit lays out the process for clinical ethics consultation in a series of steps within five phases: Pre-Consult, Interviews, Mid-Consult, Consult meeting(s), and Post-Consult. For each step, the Toolkit provides directions for how to complete it, tips for success, and worksheets for capturing data and analysis. The Clinical Ethics Consultation Toolkit is the playbook from which clinical (...) ethics consultants can draw methods and strategies for effectively delivering ethics consultation. (shrink)

This book provides a careful and comprehensive, step-by-step method for providing clinical ethics consultation. This Guide can be applied in almost any healthcare setting and takes the reader from establishing an intake process and developing strategies for interviewing those involved in the situation, to undertaking a consultation meeting and following up on a clinical consult. The book is an invaluable resource to any clinical ethicist, or committee or consult team member who is seeking to provide their service with rigour and (...) quality. Written in simple language, the book explores ideas and concepts that will help the reader to understand, think through, and ultimately offer useful ethical consultation when facing ethically challenging issues. (shrink)

Health care providers’ interpretation of law can have intended and unintended effects on health care delivery in Canada. At times, health care providers encounter situations where they perceive the law to conflict with their sense of what is most ethically justified. In many cases, these health care providers feel especially torn because they assume that the legal requirements must dictate the decision, and cannot be explored or questioned. We challenge this assumption: the law is not as cut-and-dried as some assume; (...) therefore, its significance to health care decisions should be carefully considered. Within a systematic ethics process, legal considerations can be a source of values and information and can create opportunities for further dialogue. This approach is justified because it appropriately reflects the relationship of the law to ethics. This way of thinking about the law and ethics also avoids potentially harmful consequences of legalistic approaches to decision-making, such as breakdowns in communication, adversarial relationships, and a reduction of ethically complex decisions to simple rule following. (shrink)

It is urgent that we address the causes and harmful effects of racism in health care. We propose that building diversity competence in the way we deliver health care services is key to this effort....

ABSTRACT Objective: To contrast relief efforts for the 26 December 2004 tsunami with current global HIV/aids relief efforts and analyse possible reasons for the disparity. Methods: Literature review and ethical analysis. Results: Just over 273,000 people died in the tsunami, resulting in relief efforts of more than US$10 bn, which is sufficient to achieve the United Nation’s long‐term recovery plan for South East Asia. In contrast, 14 times more people died from HIV/aids in 2004, with UNAIDS predicting a US$8 bn (...) funding gap for HIV/aids in developing nations between now and 2007. This disparity raises two important ethical questions. First, what is it that motivates a more empathic response to the victims of the tsunami than to those affected by HIV/AIDS? Second, is there a morally relevant difference between the two tragedies that justifies the difference in the international response? The principle of justice requires that two cases similarly situated be treated similarly. For the difference in the international response to the tsunami and HIV/aids to be justified, the tragedies have to be shown to be dissimilar in some relevant respect. Are the tragedies of the tsunami disaster and the HIV/aids pandemic sufficiently different, in relevant respects, to justify the difference in scope of the response by the international community? Conclusion: We detected no morally relevant distinction between the tsunami and the HIV/aids pandemic that justifies the disparity. Therefore, we must conclude that the international response to HIV/aids violates the fundamental principles of justice and fairness. (shrink)

Study of the philosophy of ethics introdued by noted ancient philosophers, reformers and moralists.

Ranging from miniaturized biological robots to organoids, multi-cellular engineered living systems (M-CELS) pose complex ethical and societal challenges. Some of these challenges, such as how to best distribute risks and benefits, are likely to arise in the development of any new technology. Other challenges arise specifically because of the particular characteristics of M-CELS. For example, as an engineered living system becomes increasingly complex, it may provoke societal debate about its moral considerability, perhaps necessitating protection from harm or recognition of positive (...) moral and legal rights, particularly if derived from cells of human origin. The use of emergence-based principles in M-CELS development may also create unique challenges, making the technology difficult to fully control or predict in the laboratory as well as in applied medical or environmental settings. In response to these challenges, we argue that the M-CELS community has an obligation to systematically address the ethical and societal aspects of research and to seek input from and accountability to a broad range of stakeholders and publics. As a newly developing field, M-CELS has a significant opportunity to integrate ethically responsible norms and standards into its research and development practices from the start. With the aim of seizing this opportunity, we identify two general kinds of salient ethical issues arising from M-CELS research, and then present a set of commitments to and strategies for addressing these issues. If adopted, these commitments and strategies would help define M-CELS as not only an innovative field, but also as a model for responsible research and engineering. (shrink)

The use of platelet rich plasma as a novel treatment is discussed in the context of a qualitative research study comprising 38 interviews with sports medicine practitioners and other stakeholders working within the English Premier League during the 2013–16 seasons. Analysis of the data produced several overarching themes: conservatism versus experimentalism in medical attitudes; therapy perspectives divergence; conflicting versions of appropriate evidence; subcultures; community beliefs/practices; and negotiation of medical decision-making. The contested evidence base for the efficacy of PRP is presented (...) in the context of a broader professional shift towards evidence based medicine within sports medicine. Many of the participants while accepting this shift are still committed to casuistic practices where clinical judgment is flexible and does not recognize a context-free hierarchy of evidentiary standards to ethically justifiable practice. We also discuss a tendency in the data collected to consider the use of deceptive, placebo-like, practices among the clinician participants that challenge dominant understandings of informed consent in medical ethics. We conclude that the complex relation between evidence and ethics requires greater critical scrutiny for this emerging specialism within the medical community. (shrink)

Is God's foreknowledge compatible with human freedom? One of the most attractive attempts to reconcile the two is the Ockhamistic view, which subscribes not only to human freedom and divine omniscience, but retains our most fundamental intuitions concerning God and time: that the past is immutable, that God exists and acts in time, and that there is no backward causation. In order to achieve all that, Ockhamists distinguish ‘hard facts’ about the past which cannot possibly be altered from ‘soft facts’ (...) about the past which are alterable, and argue that God's prior beliefs about human actions are soft facts about the past. (shrink)

Feminist Geneaologies, Colonial Legacies, Democratic Futures provides a feminist anaylsis of the questions of sexual and gender politics, economic and cultural marginality, and anti-racist and anti-colonial practices both in the "West" and in the "Third World." This collection, edited by Jacqui Alexander and Chandra Talpade Mohanty, charts the underlying theoretical perspectives and organization practices of the different varieties of feminism that take on questions of colonialism, imperialism, and the repressive rule of colonial, post-colonial and advanced capitalist nation-states. It provides a (...) comparative, relational, historically grounded conception of feminist praxis that differs markedly from the liberal pluralist, multicultural understanding that sheapes some of the dominant version of Euro-American feminism. As a whole, the collection poses a unique challenge to the naturalization of gender based in the experiences, histories and practices of Euro-American women. (shrink)

In “Imposing Risks,” Judith Thomson gives a case in which, by turning on her stove, she accidentally causes her neighbor’s death. She claims that both the following are true: (1) she ought not to have caused her neighbor’s death; (2) it was permissible for her to turn her stove on. In this paper it is argued that it cannot be that both (1) and (2) are true, that (2) is true, and that therefore (1) is false. How this is so (...) is explained, and the implications of this position regarding the relation between rights and duties is explored. (shrink)

Plato's Timaeus contains a powerful and influential myth, of the construction of the universe by a divine craftsman. A god imposes reason on necessity, to bring order from a primeval 'receptacle' of disordered matter. There results the 'child' that is the cosmos - a copy of an eternally-existing perfect model. Here eight new essays from a distinguished international cast, explore aspects of this challenging work: the principles of the mythical narrative, how the world soul and human body are formed, implications (...) for illness - mental and physical, the importance of music and harmonious proportion. Later developments are also treated: Aristotle's theory of generation, the commentary of Proclus and elements of modern evolutionary theory. (shrink)

This is the first of two companion articles drawn from a larger project, provisionally entitled Undisciplining Moral Epistemology. The overall goal is to understand how moral claims may be rationally justified in a world characterized by cultural diversity and social inequality. To show why a new approach to moral justification is needed, it is argued that several currently influential philosophical accounts of moral justification lend themselves to rationalizing the moral claims of those with more social power. The present article explains (...) how discourse ethics is flawed just in this way. The article begins by identifying several conditions of adequacy for assessing reasoning practices designed to achieve moral justification and shows that, when used in contexts of cultural diversity and social inequality, discourse ethics fails these conditions. It goes on to argue that the failure of discourse ethics is rooted in its reliance on a broader conception of moral epistemology that is invidiously idealized. It concludes by pointing to the need to rethink both the mission and the method of moral epistemology. (shrink)

According to the standard analysis of degree questions, the logical form of a degree question contains a variable that ranges over individual degrees and is bound by the degree question operator how. In contrast with this, we claim that the variable bound by the degree question operator how does not range over individual degrees but over intervals of degrees, by analogy with Schwarzschild and Wilkinson's proposal regarding the semantics of comparative clauses. Not only does the interval-based semantics predict the existence (...) of certain readings that are not predicted under the standard view, it is also able, together with other natural assumptions, to account for the sensitivity of degree questions to negative islands, as well as for the fact, uncovered by Fox and Hackl, that negative islands can be obviated by some properly placed modals. Like Fox and Hackl, we characterize negative island effects as arising from the fact that the relevant question, due to its meaning alone, can never have a maximally informative answer. Contrary to Fox and Hackl, however, we do not need to assume that scales are universally dense, nor that the notion of maximal informativity responsible for negative islands is blind to contextual parameters. (shrink)

This paper examines the deontic logic of the Talmud. We shall find, by looking at examples, that at first approximation we need deontic logic with several connectives: O T A Talmudic obligation F T A Talmudic prohibition F D A Standard deontic prohibition O D A Standard deontic obligation. In classical logic one would have expected that deontic obligation O D is definable by $O_DA \equiv F_D\neg A$ and that O T and F T are connected by $O_TA \equiv F_T\neg (...) A$ This is not the case in the Talmud for the T (Talmudic) operators, though it does hold for the D operators. We must change our underlying logic. We have to regard {O T , F T } and {O D , F D } as two sets of operators, where O T and F T are independent of one another and where we have some connections between the two sets. We shall list the types of obligation patterns appearing in the Talmud and develop an intuitionistic deontic logic to accommodate them. We shall compare Talmudic deontic logic with modern deontic logic. (shrink)

J. M. Shorter; X*—Personal Identity, Personal Relationships, and Criteria, Proceedings of the Aristotelian Society, Volume 71, Issue 1, 1 June 1971, Pages 165–1.

Recently two distinct forms of rule-utilitarianism have been introduced that differ on how to measure the consequences of rules. Brad Hooker advocates fixed-rate rule-utilitarianism, while Michael Ridge advocates variable-rate rule-utilitarianism. I argue that both of these are inferior to a new proposal, optimum-rate rule-utilitarianism. According to optimum-rate rule-utilitarianism, an ideal code is the code whose optimum acceptance level is no lower than that of any alternative code. I then argue that all three forms of rule-utilitarianism fall prey to two fatal (...) problems that leave us without any viable form of rule-utilitarianism. (shrink)

Considerable methodological difficulties abound in neuroimaging, and several philosophers of science have recently called into question the potential of neuroimaging studies to contribute to our knowledge of human cognition. These skeptical accounts suggest that functional hypotheses are underdetermined by neuroimaging data. I apply Mayo’s error-statistical account to clarify the evidential import of neuroimaging data and the kinds of inferences it can reliably support. Thus, we can answer the question “What can we reliably learn from neuroimaging?” and make sense of how (...) this knowledge can contribute to novel construals of cognition. (shrink)

Peckham claims that my "behavior" in dealing with the quotations in Natural Supernaturalism is the same, in methodology and validity, as the interpretative behavior of Booth's waiter. But the great bulk of the utterances in my quotations—and no less, of the utterances constituting Peckham's own essay—do not consist of orders, requests, or commands. Instead, they consist of assertions, descriptions, judgments, exclamations, approbations, condemnations, and many other kinds of speech-acts, the meanings of which are not related to my interpretative behavior, even (...) in the indirect way in which the meaning of Booth's order is related to the future behavior of his waiter. M. H. Abrams, author of Natural Supernaturalism and The Mirror and the Lamp and Class of 1916 Professor of English at Cornell University, responds in this essay to Morse Peckham's "The Infinitude of Pluralism" . Morse Peckham, in his Critical Response, was commenting on issues raised by the forum on "The Limits of Pluralism" , to which M. H. Abrams contributed. Previous contributions to Critical Inquiry are "Rationality and Imagination in Cultural History: A Reply to Wayne Booth" and "The Deconstructive Angel". (shrink)

In retrospect, I think I was right to compose Natural Supernaturalism by relying on taste, tact, and intuition rather than on a controlling method. A book of this kind, which deals with the history of human intellection, feeling, and imagination, employs special vocabularies, procedures, and modes of demonstration which, over many centuries of development, have shown their profitability when applied to matters of this sort. I agree with Booth that these procedures, when valid, are in a broad sense rational, and (...) subject to analysis and some degree of definition. But the rules underlying such a discourse are complex, elusive, unsystematic, and subject to innovative modification; they manifest themselves in the intuitive expertise of the historian; and the specification of these rules should not precede, but follow practice. . . . After the fact, nevertheless, a book like Natural Supernaturalism is subject to close critical inquiry about its methods and rationale. I am grateful to Booth for opening up such an inquiry, and for doing so in a way that is not only disarming, but seems to me to be the most promising of useful results. That is, instead of adopting a prosecutorial stance, demanding: "Justify the rationality and probative force of what you have done; it looks dammed suspicious to me," he has adopted the friendly tactic of saying: "Your book, in my experience of it, has yielded discoveries that I want to call knowledge, by methods, however deviant from standard rubrics of valid reasoning, that it seems irrational to call non-rational. Let's set out to clarify what these methods are, and to see what grounds we can find for the claim that they provide warranted knowledge." M.H. Abrams' contributions to Critical Inquiry are "The Deconstructive Angel" and "Behaviorism and Deconstruction: A Comment on Morse Peckham's 'The Infinitude of Pluralism'". (shrink)

Ukraine in our time is characterized by a high level of saturation by various educational institutions. Now there are 14 classical and 45 technical universities, 30 academies, 72 institutes and 740 other educational institutions of different levels of accreditation, which are in state ownership. At the same time, 90 higher private educational institutions were created, which were licensed by the Ministry of Education of Ukraine. Except for this, various religious churches and religious organizations reorder 50 religious educational institutions. About 5,000 (...) future clerics and preachers learn about them. More than 4,000 Sunday Schools are organized in religious communities of different denominations, which are visited by almost 60 thousand children of the faithful. Education in Ukraine is based on democratic principles, the requirements of the Constitution and the current legislation. (shrink)

In this paper, I will discuss why in some circumstances people express their intentions indirectly: the use of Indirect Speech Acts. Based on Parikh’s games of partial information and Franke’s IBR model, I develop game-theoretic models of ISAs, which are divided into two categories, namely non-conventional ISAs and conventional ISAs. I assume that non-conventional ISAs involve two types of communication situations: communication under certain cooperation and that under uncertain cooperation. I will analyse the cases of ironical request and implicit bribery (...) as typical instances of non-conventional ISAs of each situation type, respectively. I then apply the models to analyse the use of conventional ISAs from an evolutionary perspective, which is inspired by Lewisian convention theory. The models yield the following predictions: the use of non-conventional ISAs under certain cooperation relies on the sympathy between interlocutors, which blocks their evolution towards conventional ISAs; in unc... (shrink)

Curiosity and creativity are expressions of the trade-off between leveraging that with which we are familiar or seeking out novelty. Through the computational lens of reinforcement learning, we describe how formulating the value of information seeking and generation via their complementary effects on planning horizons formally captures a range of solutions to striking this balance.

Objectives The objective of this research was to develop ethics accreditation standards for hospitals. Research design Our research methods included a literature review, an expert focus group, the Delphi technique and a hospital survey. The entire process was separated into two stages: (1) the development of a draft of hospital ethics accreditation standards; and (2) conducting a nationwide hospital survey of the proposed standards. Results This study produced a tentative draft of hospital ethics accreditation standards comprised of six chapters and (...) 62 standards based on the expert focus group and Delphi technique. The six chapters are: Medical ethics policies, regulations and leadership; The establishment and operation of a medical ethics committee; The establishment and operation of research-related ethics committees; Medical ethics education; Organisational ethical climate; and Respect for patients' rights and establishment of good hospital-patient relationships. The hospital survey indicated that the concept of an organisational ethical climate was new to most hospital managers, most hospitals disliked the idea of having a separate hospital ethics accreditation system, and small hospitals were concerned about their ability to comply with all of the standards. Conclusions Regardless of whether hospital ethics accreditation can be a stand-alone accreditation or just part of existing hospital accreditation programmes, we hope this draft can serve as a good reference for future endeavours by hospital accreditation authorities. (shrink)