Background The expressions of a “wish to hasten death” or “wish to die” raise ethical concerns and challenges. These expressions are related to ethical principles intertwined within the field of medical ethics, particularly in end-of-life care. Although some reviews were conducted about this topic, none of them provides an in-depth analysis of the meanings behind the “wish to hasten death/die” based specifically on the ethical principles of autonomy, dignity, and vulnerability. The aim of this review is to understand if and (...) how the meanings behind the “wish to hasten death/die” relate to and are interpreted in light of ethical principles in palliative care. Methods We conducted a meta-ethnographic review according to the PRISMA guidelines and aligned with Noblit and Hare’s framework. Searches were performed in three databases, Web of Science, PubMed, CINAHL, with no time restrictions. Original qualitative studies exploring the meanings given by patients, family caregivers and healthcare professionals in any context of palliative and end-of-life care were included. A narrative synthesis was undertaken. PROSPERO registration CRD42023360330. Results Out of 893 retrieved articles, 26 were included in the analysis, accounting for the meanings of a total of 2,398 participants. Several factors and meanings associated with the “wish to hasten death” and/or “wish to die” were identified and are mainly of a psychosocial and spiritual nature. The ethical principles of autonomy and dignity were the ones mostly associated with the “wish to hasten death”. Ethical principles were essentially inferred from the content of included articles, although not explicitly stated as bioethical principles. Conclusions This meta-ethnographic review shows a reduced number of qualitative studies on the “wish to hasten death” and/or “wish to die” explicitly stating ethical principles. This suggests a lack of bioethical reflection and reasoning in the empirical end-of-life literature and a lack of embedded ethics in clinical practice. There is a need for healthcare professionals to address these topics compassionately and ethically, taking into account the unique perspectives of patients and family members. More qualitative studies on the meanings behind a wish to hasten death, their ethical contours, ethical reasoning, and implications for clinical practice are needed. (shrink)

In Brazil, abortion is only allowed in cases of rape, serious risk to a woman's life or fetal anecephaly. Legal abortion services cover less than 4% of the Brazilian territory and only 1,800 procedures are performed, in average, per year. During the COVID‐19 pandemic, almost half of the already few Brazilian abortion clinics shut down and women had to travel even longer distances, reaching abortion services at later gestational ages. In this paper, we describe three bottom‐up advocacy strategies that emerged (...) from difficulties deepened during the COVID‐19 pandemic at a single abortion service in Brazil, amidst anti‐gender policies from the federal government. Telemedicine abortion, outpatient surgical abortion and the provision of abortion after 20 weeks' gestation are important strategies that may reduce inequalities that impact the most vulnerable populations, such as black and indigenous women, children, adolescents and women experiencing domestic violence. (shrink)

ABSTRACT The presence of truth and honesty is a permanent demand, and becomes vital the more committed and intimate a relationship is. Medical practice is relevant to this discussion when one questions whether or not a physician should always tell their patient the truth in the face of a progressive or potentially fatal disease, regarding the diagnosis, outcome, therapy and evolution of the specific disease. From this discussion we aim, with the present report, to look at the truth applicable to (...) the patient‐physician relationship, and its ethical and moral implications; and also to look at where the Brazilian Code of Medical Ethics (BCME) and the medical literature stand regarding this issue. One concludes that there are only two moments not to tell a patient the truth: when the patient does not want to be informed, and when the truth could be iatrogenic. The question now is, when would the truth be iatrogenic? Physicians, in our opinion, would not be able to judge solitarily when the truth might be deleterious to their patient. Alternatively, we propose the appointment of a multidisciplinary commission to help the doctor with such a decision. (shrink)

Rationale Treatment guidelines recommend a more conservative surgical approach than mastectomy for early stage breast cancer and a stronger emphasis on adjuvant therapy. Registry data at South Australian teaching hospitals have been used to monitor survivals and treatment in relation to these guidelines.Aims and objectives To use registry data to: (1) investigate trends in survival and treatment; and (2) compare treatment with guidelines.Methods Registry data from three teaching hospitals were used to analyse trends in primary courses of treatment of breast (...) cancers during 1977–2003 (n = 4671), using univariate analyses and multiple logistic regression. Disease-specific survivals were analysed using Kaplan–Meier product limit estimates and multivariable Cox proportional hazards regression.Results The 5-year survival was 79.9%, but with a secular increase, reaching 83.6% in 1997–2003. The relative risk of death (95% confidence limits) was 0.74 (0.62, 0.88) for 1997–2003, compared with previous diagnoses, after adjusting for tumour node metastasis stage, grade, age and place of residence. Treatment changes included an increase in conservative surgery (as opposed to mastectomy) from 51.7% in 1977–1990 to 76.8% in 1997–2003 for stage I (P < 0.001) and from 31.1% to 52.2% across these periods for stage II (P < 0.001). Adjuvant radiotherapy also became more common (P < 0.001), with 20.6% of patients receiving this treatment in 1977–1990 compared with 60.7% in 1997–2003. Radiotherapy generally was more prevalent when conservative surgery was provided, although also relatively common in mastectomy patients when tumour diameters exceeded 50 mm or when there were four or more involved nodes. The proportion of patients receiving chemotherapy increased (P < 0.001), from 19.6% in 1977–1990 to 36.9% in 1997–2003, and the proportion having hormone therapy also increased (P < 0.001), from 34.3% to 59.4% between these periods.Conclusions Survivals appear to be increasing and treatment trends are broadly consistent with guideline directions, and the earlier research on which these recommendations were based. (shrink)

If we admit that Latin-American literature is a part of what is called Western culture, why, I ask myself, has it not been able to influence any of the great literatures of the West, outside of the Spanish? To be more precise, when I speak of influencing, I am not referring to the historico-cultural event that signifies Latin America, which has changed the West, but specifically to literature, that is, writing, the book, the language, the contents, the creative structure and (...) the symbols. From its origins until today, Latin-American literature, like Jugoslavian literature—in spite of the Nobel prize awarded to Ivo Andric—or Bulgarian or Icelandic, remains a marginal phenomenon. It is produced within a closed circuit, having no real resonance except in Spain. Furthermore, it struggles between two guilt feelings: one, that of being late with regard to renovating currents of fashions of the day and the other, that of not responding to its own reality. Because of those burdens of a guilty conscience, it often feigns innovation by following outside models or exalting a nationalist realism that has not produced the slightest new form but only a mediocre art of propaganda. It simulates and copies, or it lags behind. It either tries to be up to date or pretends to overcome this uneasiness by inventing an intransigent Americanism, behaving like a telluric barbarian or accepting traditional popular forms that may produce works such as Martin Fierro, whose value for the Latin-Americans cannot be denied but whose range is limited. (shrink)

Este artigo tem por objetivo apresentar as proposições de Martin Buber (1878-1965) no campo da Filosofia da Educação mediante a análise de um texto específico de sua vasta produção, a saber: uma conferência realizada em 1929, intitulada Educação para a comunidade, que integra o livro Sobre comunidade, uma coletânea de textos de Buber organizada por Marcelo Dascal e Oscar Zimmermann.

Em 1945, Otto Friedrich Bollnow publica uma recensão da obra fundamental de Ludwig Binswanger, aparecida em 1942, em que procura desenvolver uma concepção antropológica, tomando como ponto de partida e fundamento a Ontologia Fundamental de Martin Heidegger, tal como fora exposta em 1927, em Ser e Tempo. O presente trabalho consiste na tradução e apresentação desse texto de Bollnow, enquadrando-as numa hermenêutica da existência, desenvolvida por este autor ao longo da sua obra, e na tematização, por ambos os autores, (...) das tonalidades afectivas positivas, muito especialmente como o amor em Binswanger. (shrink)

La filosofía ha encontrado en la literatura de Jorge Luis Borges un ámbito único para reflexionar en torno de sus propios problemas. En este ensayo examinaré las tensiones y contradicciones que afloran dentro del paradigma metafísico de la inmediación y de la intuición. El cuento de «Funes, el memorioso» ofrece la ocasión para pensar en la imposibilidad del hombre de afirmar un sistema de signos o una facultad perceptiva que ignore el inexorable resto que guarde la diferencia entre lo real (...) y lo representado. Una vida humana que se afirme en el ideal de un saber absoluto, de una visión ininterrumpida, es finalmente funesta. El hombre vive de las mediaciones y de las interrupciones, recuerda porque olvida, despierta porque sueña, conoce porque ignora: mira porque tiene párpados. (shrink)

I examine Spinoza's claim in the Metaphysical Thoughts that the attributes of God are only distinguished by a distinction of reason. I contend that for Spinoza essential attributes, such as Thought or Extension, cannot be distinguished by Francisco Suarez's distinction of reasoning reason, as Martin Lin suggests, nor can he be using Suárez’ distinction of reasoned reason for this purpose, as Yitzhak Melamed believes. Since reasoning reason and the distinction of reasoned reason are the only two kinds of rational (...) distinction available to Spinoza, it follows that for him the distinction between God's essential attributes in the CM cannot be a distinction of reason. But I show that Spinoza is not mistakenly using Suarez's distinction in the CM. Rather, I argue, Spinoza consistently follows Suárez and uses reasoned reason to distinguish between God's necessary properties and not between God's essential attributes. (shrink)

The main theme of the article, which by genre falls into the area of semiotically influenced philosophy, is a reflection on the relationship between the human and the non-human, using two partial but parallel discourses. The first discourse is the perspective of general semiotics, which is defined in the article on the basis of two distinct forms of rationality that, in different guises, still intervene in debates about the nature of the humanities and social sciences today. The first form of (...) this rationality is semiological, which can be classified under the encyclopaedic rubric of structuralism, and which has its main source of inspiration in general linguistics and its continuation in philosophical anti-humanism. The second perspective has its origins in Peirce’s logicist theory of the sign and his pragmatist metaphysics, and opens up thinking about the sign, the human, and the non-human to a non-language-centric view of the world. Despite their demonstrable theoretical and methodological incompatibility, the present text treats them as incompatible but largely complementary perspectives. It is in their mutual exposition that one can see the moments in which the view of modern human as a semiological and semiotic animal takes shape. The text brings this fundamental and founding theoretical schism into focus by examining two images from post/modern art: Ted Chiang’s “The Great Silence” and Jorge Luis Borges’ “Averroës’s Search.”. (shrink)

The main theme of the article, which by genre falls into the area of semiotically influenced philosophy, is a reflection on the relationship between the human and the non-human, using two partial but parallel discourses. The first discourse is the perspective of general semiotics, which is defined in the article on the basis of two distinct forms of rationality that, in different guises, still intervene in debates about the nature of the humanities and social sciences today. The first form of (...) this rationality is semiological, which can be classified under the encyclopaedic rubric of structuralism, and which has its main source of inspiration in general linguistics and its continuation in philosophical anti-humanism. The second perspective has its origins in Peirce’s logicist theory of the sign and his pragmatist metaphysics, and opens up thinking about the sign, the human, and the non-human to a non-language-centric view of the world. Despite their demonstrable theoretical and methodological incompatibility, the present text treats them as incompatible but largely complementary perspectives. It is in their mutual exposition that one can see the moments in which the view of modern human as a semiological and semiotic animal takes shape. The text brings this fundamental and founding theoretical schism into focus by examining two images from post/modern art: Ted Chiang’s “The Great Silence” and Jorge Luis Borges’ “Averroës’s Search.”. (shrink)

RESUMO O presente artigo parte de várias considerações de Bakhtin a respeito do discurso romanesco a fim de compreender alguns aspectos discursivos do Dom Quixote, de Miguel de Cervantes. Procede-se, então, a uma comparação com o discurso de outra obra que reproduz parcialmente o Dom Quixote: o conto Pierre Menard, autor do Quixote, de Jorge Luis Borges. Por fim, discute-se brevemente o problema da quase ausência do Dom Quixote nas discussões de Bakhtin sobre o romance, apresentando-se a hipótese de Walter (...) Reed de que, tal como no conto de Borges, a própria teoria bakhtiniana também reproduz parcialmente o peculiar pensamento do Quixote. ABSTRACT This article discusses several of Bakhtin’s concepts regarding discourse in the novel genre as a way to understand some discursive aspects of Miguel de Cervantes’ Dom Quixote. We then proceed to a comparison with the discourse in another literary work that partially reproduces Dom Quixote: the short story “Pierre Menard, Author of the Quixote,” by Jorge Luis Borges. Finally, we briefly discuss the problem of Dom Quixote’s almost absence in Bakhtin’s work about the novel genre, while presenting the hypothesis by Walter Reed that, as in Borges’ short story, Bakhtin’s theory itself also partially reproduces the Quixote’s particular way of thinking. (shrink)

En este artículo se analiza cómo se manifiestan el post-humanismo y el trans-humanismo en la obra de Borges. Se postula aquí que en la narrativa breve de Borges no sólo se manifiesta una reacción post-humanista contra el antropocentrismo imperante en la modernidad. También aparecen destellos poderosos de un trans-humanismo en virtud del cual se piensa en la inmortalidad y en la ampliación de las facultades cognitivas y espirituales de los seres humanos de un modo sumamente original porque excluye la necesidad (...) de los avances tecnológicos más sorprendentes. (shrink)

To what extent does human reason apply to the mind-independent world according to Spinoza? Does he even believe that human reason applies to that world at all? Being and Reason answers these questi...

El tema aquí propuesto rebasa los límites de un ensayo por centrarse en un escritor tan erudito y enciclopédico como Borges. Pero no se trata de una excepción, en realidad cualquier propuesta sobre su obra suele afrontar el mismo riesgo. Con esta idea en mente, mi ensayo intenta dar un resumen de los puntos de encuentro que Borges mantiene con algunos representantes de la Ilustración, como Berkeley, Hume, Jonathan Swift, Kant y Leibniz. En este sentido mi enfoque bosqueja un derrotero (...) epistemológico al adentrarse en teorías del conocimiento que, refutando postulados metafísicos y teológicos, instalan la vida humana, como diría José Isaacson, en la pendiente interminable de la pregunta. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Borges Forgets NietzscheClancy MartinHow little moral would the world appear without forgetfulness! A poet could say that God has placed forgetfulness as a doorkeeper on the threshold of human dignity.—Nietzsche, Human, All-Too-HumanIn his short story "Funes, the Memorious," Jorges Luis Borges writes of his singular nineteen-year-old hero, Funes: "He was, let us not forget, almost incapable of general, platonic ideas. It was not only difficult for him to understand (...) that the generic term dog embraced so many unlike specimens of differing sizes and differing forms; he was disturbed by the fact that a dog at three-fourteen (seen in profile) should have the same name as the dog at three-fifteen (seen in front)." And he goes on to say that "... he was not very capable of thought. To think is to forget a difference, to generalize, to abstract. In the overly replete world of Funes there were nothing but details, almost contiguous details" (pp. 42–43).1 About a century earlier, in 1872, in a passage from his famous unpublished essay "On Truth and Lies in a Nonmoral Sense," Friedrich Nietzsche wrote: "Just as it is certain that one leaf is never totally the same as another, so it is certain that the concept "leaf" is formed by arbitrarily discarding these individual differences and by forgetting the distinguishing aspects... Every concept arises from the equation of unequal things... We obtain the concept, as we do the form, by overlooking what is individual and actual; whereas nature is acquainted with no forms and no concepts, and likewise with no species, but only with an X which remains inaccessible and undefinable for us."2 [End Page 265]From this and other passages, mostly in "On Truth and Lies," Nietzsche scholars have derived Nietzsche's much-debated (or so-called, depending on who you talk to) "theory of perspectivism." This is the idea that, roughly speaking, "truths" about the world are at best truths uttered from the perspective of some knower, who inevitably brings to world (and thus, to those truths) a particular way of looking at things, of seeing some details and excluding others, of valuing some aspects of the world more than others, etc.I will not be addressing the well-known problems of Nietzsche's theory of perspectivism (if indeed he had such a truth-theory).3 What interests me here is something most scholars have ignored about Nietzsche's perspectivism,4 and what Borges tries to illuminate in his strange little fable: the importance of forgetting to thinking and the difficulties memory may present to one who would think about "truth" as something more than "an impossible idiom in which each individual object, each stone, each bird and branch [has] an individual name" (p. 42). For Nietzsche, and for Borges writing under Nietzsche's influence, the human facts about forgetting and remembering illustrate that our epistemological projects are much more psychological than some philosophers would like to admit. Once we acknowledge the deeply psychological character of those projects, we see that they may not be "truth" projects at all, but rather psychologically valuable (perhaps even necessary) projects of strategic falsification.IThe "absent-minded" narrator of Borges's story tells us that he is adding his own tale to a collection of testimonials to Funes, as part of the project "that all those who knew him should write something about him" (pp. 35–36). Thus the play of words in the title: "Funes" is "memorious" not just because of the accident that results in his amazing and infallible memory, but also because this text is part of a larger memorial. A relationship between memory and knowing from a particular perspective is introduced immediately: Funes will be known and remembered through the gathering of many individual memorials to him. None of these testimonies will be "objective" or "impartial": all of them will necessarily preserve the perspective of the particular individual who is recalling Funes. As the narrator of our memorial confesses, his own efforts will be impoverished by "the deplorable fact of my being an Argentinian... when the theme is a Uruguayan" (p. 35). [End Page 266]Our narrator offers three... (shrink)

The influence and reputation of Pierre Menard, Author of the Quixote, is easily comparable to the impact of groundbreaking theoretical texts. Numerous philosophers, aestheticians and theorists of literature, music, or visual arts have been induced by this short story by J.L. Borges to reconsider the status of the literary work of art, to rethink the relationship between work and text. The essays collected here move from analyses of the identity of the literary work of art, as it is explicitly established (...) by Borges? narrator, to arguments that simply employ the Menard case as an opportunity for discussing broader issues of literary studies and the philosophy of literature. Selected essays even abandon the field of literature altogether, moving on to analogous issues in the theory of visual arts and music. (shrink)

There is an important part in Schopenhauer's bibliography dedicated to reflections on a good life. Between 1826 and 1829, the German philosopher started to think about a eudemonology, an unfinished project, which relied on the rescue of the thought of ancient philosophers. In his discussions there is a great appreciation for Stoic thinking in order to produce a life as little unhappy as possible. Therefore, it seems relevant to revisit Schopenhauer's ideas and compare them with Seneca, who focused on the (...) same topics: the appropriation of the concepts of praecepta and decreta and their connection with happiness. (shrink)

It is common in philosophy of language to recognise two different kinds of linguistic meaning: literal or conventional meaning, on the one hand, versus communicated or conveyed meaning, on the other. However, once we recognise these two types of meaning, crucial questions immediately emerge; for instance, exactly which meanings should we treat as the literal (semantic) ones, and exactly which appeals to a context of utterance yield communicated (pragmatic), as opposed to semantic, content? It is these questions and, specifically, how (...) we should model the relationship between semantic content and utterance context, that is the topic of this chapter. We explore five contemporary answers to this modelling question, considering the benefits and challenges of each, before closing by examining some potential new directions for debates in this area. (shrink)

O esquecimento é uma experiência incómoda da quotidianeidade. Marca de temporalidade e de finitude, tem carácter ontológico e alcance ôntico. Manifesta o caminho da verdade do ser à maneira humana e do ser no mundo de tudo quanto há. Heidegger define esse caminho ontológico incontornável como sendo o da metafísica ocidental, hoje culminante na época da técnica. Mas, numa abordagem meta-ontológica, o fenómeno ontológico de poder esquecer constitui uma possibilidade para o existir de cada um, enquanto projecto. O não-esquecimento compulsivo-obsessivo (...) inibe o a-vir, reduzindo-o a interpretações sedimentadas, pre-determinadas por situações hermenêuticas do sido, congeladas num não-passado. A presente abordagem pretende considerar esta duplicidade do possível e do não-possível, radicada no olvido e na abertura afectiva, ao encontro e ao seu novum, assim habilitado. Para tal, parte de um quadro de Klee e de uma narrativa de Borges, para orientar a leitura de textos de Heidegger, desde 1927 a 1945. (shrink)

Jorge Luis Borges is working for decades now on the execution of the nightmare. Perhaps his most celebrated instance is "Tlon, Uqbar, Orbis Tertius ". It would take much work to sift the fabricated references in Borges' works from the ones deliberately misread from the over-emphasis on an author's casual remark, etc.

This paper deals with the question of whether nature sports are to be counted among the (traditional) sports and Kevin Krein’s recent argument, based on sporting excellence, as to why they should. Krein argues that sports as such are ultimately about sporting excellence and because both so-called traditional sports and nature sports fulfil that criterion, nature sports belong in the sport domain. Here, I show that Krein’s argument rests on an equivocation between two concepts of sporting excellence. Sporting excellence in (...) traditional sports is connected to sporting success. Here agon (contest or competition) dictates or frames areté (striving for excellence). This is not the case for sporting excellence in nature sports, as these are not competitions. We are dealing with two different concepts of sporting excellence and Krein’s argument, based on sporting excellence, must be rejected. It gives no basis for including nature sports in the sport domain. (shrink)

relevant to the differences between the two speakings, Odile’s words in the first case said what was false, while in the second case they said what was true. Both spoke of the same state of the world, or the same refrigerator in the same condition. So, in the first case, the words said what is false of a refrigerator with but a milk puddle; in the second case they said what is true of such a refrigerator.

It is common in philosophy of language to recognise two different kinds of linguistic meaning: literal or conventional meaning, on the one hand, versus communicated or conveyed meaning, on the other. However, once we recognise these two types of meaning, crucial questions immediately emerge; for instance, exactly which meanings should we treat as the literal (semantic) ones, and exactly which appeals to a context of utterance yield communicated (pragmatic), as opposed to semantic, content? It is these questions and, specifically, how (...) we should model the relationship between semantic content and utterance context, that is the topic of this chapter. We explore five contemporary answers to this modelling question, considering the benefits and challenges of each, before closing by examining some potential new directions for debates in this area. (shrink)

Action, reason, and causes in Kant -- Can we act without feelings? Respect, sympathy and other forms of love -- A place for affects and passion in the Kantian system -- What can Kant teach us about emotions? -- Physiology and the controlling of affects in Kant's philosophy -- Virtue as a cure for affects and passions -- The beautiful and the good: refinement as an introduction to morality -- Women and emotion -- Evil and passion -- An emotional Kant?

A long-standing theme in discussion of perception and thought has been that our primary cognitive contact with individual objects and events in the world derives from our perceptual contact with them. When I look at a duck in front of me, I am not merely presented with the fact that there is at least one duck in the area, rather I seem to be presented withthisthing (as one might put it from my perspective) in front of me, which looks to (...) me to be a duck. Furthermore, such a perception would seem to put me in a position not merely to make the existential judgment that there is some duck or other present, but rather to make a singular, demonstrative judgment, that that is a duck. My grounds for an existential judgment in this case derives from my apprehension of the demonstrative thought and not vice versa. (shrink)