Donation after cardiac death (DCD) is associated with many problems, including ischemic injury, high rates of delayed allograft function, and frequent organ discard. Furthermore, many potential DCD donors fail to progress to asystole in a manner that would enable safe organ transplantation and no organs are recovered. DCD protocols are based upon the principle that the donor must be declared dead prior to organ recovery. A new protocol is proposed whereby after a donor family agrees to withdrawal of life-sustaining treatments, (...) premortem nephrectomy is performed in advance of end-of-life management. Since nephrectomy should not cause the donor's death, this approach satisfies the dead donor rule. The donor family's wishes are best met by organ donation, successful outcomes for the recipients, and a dignified death for the deceased. This proposal improves the likelihood of achieving these objectives. (shrink)

Advances in DNA sequencing technology open new possibilities for public health genomics, especially in the form of general population preventive genomic sequencing. Such screening programs would sit at the intersection of public health and preventive health care, and thereby at once invite and resist the use of clinical ethics and public health ethics frameworks. Despite their differences, these ethics frameworks traditionally share a central concern for individual rights. We examine two putative individual rights—the right not to know, and the child’s (...) right to an open future—frequently invoked in discussions of predictive genetic testing, in order to explore their potential contribution to evaluating this new practice. Ultimately, we conclude that traditional clinical and public health ethics frameworks, and these two rights in particular, should be complemented by a social justice perspective in order adequately to characterize the ethical dimensions of general population PGS programs. (shrink)

Scientists, humanists, and art lovers alike value art not just for its beauty, but also for its social and epistemic importance; that is, for its communicative nature, its capacity to increase one's self-knowledge and encourage personal growth, and its ability to challenge our schemas and preconceptions. However, empirical research tends to discount the importance of such social and epistemic outcomes of art engagement, instead focusing on individuals' preferences, judgments of beauty, pleasure, or other emotional appraisals as the primary outcomes of (...) art appreciation. Here, we argue that a systematic neuroscientific study of art appreciation must move beyond understanding aesthetics alone, and toward investigating the social importance of art appreciation. We make our argument for such a shift in focus first, by situating art appreciation as an active social practice. We follow by reviewing the available psychological and cognitive neuroscientific evidence that art appreciation cultivates socio-epistemic skills such as self- and other-understanding, and discuss philosophical frameworks which suggest a more comprehensive empirical investigation. Finally, we argue that focusing on the socio-epistemic values of art engagement highlights the important role art plays in our lives. Empirical research on art appreciation can thus be used to show that engagement with art has specific social and personal value, the cultivation of which is important to us as individuals, and as communities. (shrink)

A 55-year-old man, admitted to the hospital after an episode of aphasia due to transient ischemic attack, underwent ultrasound imaging that showed near occlusion of the left carotid artery. A carot...

While bioethics as a field has concerned itself with methodological issues since the early years, there has been no systematic examination of how ethics is incorporated into research on the Ethical, Legal and Social Implications of the Human Genome Project. Yet ELSI research may bear a particular burden of investigating and substantiating its methods given public funding, an explicitly cross-disciplinary approach, and the perceived significance of adequate responsiveness to advances in genomics. We undertook a qualitative content analysis of a sample (...) of ELSI publications appearing between 2003 and 2008 with the aim of better understanding the methods, aims, and approaches to ethics that ELSI researchers employ. We found that the aims of ethics within ELSI are largely prescriptive and address multiple groups. We also found that the bioethics methods used in the ELSI literature are both diverse between publications and multiple within publications, but are usually not themselves discussed or employed as suggested by bioethics method proponents. Ethics in ELSI is also sometimes undistinguished from related inquiries. (shrink)

Background: Discussion of the influence of money on bioethics research seems particularly salient in the context of research on the ethical, legal, and social implications (ELSI) of human genomics, as this research may be financially supported by the ELSI Research Program. Empirical evidence regarding the funding of ELSI research and where such research is disseminated, in relation to the specific topics of the research and methods used, can help to further discussions regarding the appropriate influence of specific institutions and institutional (...) contexts on ELSI and other bioethics research agendas. Methods: We reviewed 642 ELSI publications (appearing between 2003 and 2008) for reported sources of funding, forum for dissemination, empirical and nonempirical methods, and topics of investigation. Results: Most ELSI research is independent of direct grant-based funding sources; 66% reported no such sources of funding. The National Human Genome Research Institute (NHGRI) is the most dominant source of funding; 16% of publications acknowledged at least one source of NHGRI grant funding. Funding is acknowledged more frequently in empirical than nonempirical publications and more frequently in publications in public health journals than in any other ELSI research dissemination forums. Dominant research topics vary by publication forum and by reported funding. Conclusions: ELSI research is surprisingly independent of direct grant-based funding, yet correlations are apparent between this type of funding and publication placement, topics addressed, and methods used, implying a not insignificant influence on ELSI research agenda setting. However, given the relatively low percentage of publications acknowledging external grant-based funding, as well as other significant correlations between publication placement and topics addressed, additional institutional contexts, perhaps related to professional advancement or valuation, may shape research agendas in ways that potentially exceed the direct influences of grant-based funding in this area. In some cases, grant-based funding may actually counter other potentially problematic institutional influences. (shrink)

This article reflects on the implications of the concept of health and the questions it poses for moral philosophy, psychology, and the panoply of professions that are involved in the practices of care and in the ethics of individual rights, dignity, and autonomy. Significant among these questions is what we call “the predicament of agency.” The predicament involves the ethical tensions—arising within the broad concept of health and flourishing, but also in concrete everyday practices and relationships—between supporting individual health outcomes (...) and supporting health and flourishing through respect for autonomy and self-direction. Three ways of addressing the predicament of agency are discussed: by reinterpreting the nature and requirements of autonomy (a) by appeal to reason, (b) by designing or curating contextual conditions influencing choice (often called “choice architecture” or “nudging”) in ways that constrain autonomy but do not violate its core value, and (c) by appeal to relational judgment and reflective professional practice. The article argues that each of these lines of thought is important, but none is a panacea, and none is free from conceptual confusions and ethical pitfalls of its own. The relational approach is the most promising in pointing beyond the predicament of agency—not so much by resolving it as by showing how it can be worked through without either turning our back on caring or turning caring into management and manipulation. (PsycINFO Database Record (c) 2016 APA, all rights reserved). (shrink)

The breaking of bad news in a hospital setting, particularly to patients in a terminal condition, highlights some complex and often emotive ethical issues for nurses. One theory that examines the way in which individuals react to bad news such as a terminal illness, is the theory of awareness contexts. However, this theory may be limited by failing to recognize the complexity of the situation and the ethical issues involved for nurses caring for terminally ill patients. Furthermore, contexts of awareness (...) are influenced to a much greater extent by relationships with nurses than simply by the delivery of medical information. Even when information is given to the client and the family, the nurse is involved in helping them to know the meaning of this information. In a hospital, the nurse is faced with emotional demands by clients, families and colleagues, complex issues of advocacy, and professional boundaries and responsibilities. It is the author’s wish to examine the reality of clinical practice for nurses, thus further extending the theory of awareness contexts. (shrink)

Purpose: We sought to examine the ethical, legal, and social implications (ELSI) literature research and scholarship types, topics, and contributing community fields of training as a first step to charting the broader ELSI community’s future priorities and goals. Methods: We categorized 642 articles and book chapters meeting inclusion criteria for content in both human genetics or genomics and ethics or ELSI during a 5-year period (2003–2008) according to research and scholarship types, topics, and the area of advanced training of the (...) first-listed author. Research and scholarship type categories were developed and characterized through in-depth review of 95 randomly sampled publications from the larger group. Results: There is a single dominant approach to ELSI, which focuses on ethical and other social issues “downstream” of advances in genomics, the contributors to which predominately have advanced training in medicine or science fields other than social science. A comparatively low percentage of publications primarily offer policy recommendations, and these are much more likely to be written by those with advanced training in law than is the case for the literature as a whole. Social science studies predominately employ qualitative methods and vary significantly with respect to the extent and types of recommendations offered. Two further types of ELSI research and scholarship offer alternative models for so-called “normative” work in this field. Conclusion: Considering topics, training, and types of ELSI research and scholarship from the most recent past allows for a baseline perspective that is sorely needed in charting this field’s future course. (shrink)

This analysis explores the phenomenology of suffering and temporal, genetic and social developmental aspects of suffering for seriously ill older adults. A phenomenological account of suffering is advanced using oral history data from in-depth interviews with a seriously ill, frail elderly woman. The analysis evaluates how a phenomenological account of suffering may inform ethics in end-of-life decision making, and may provide a further basis for an integrated ethical and gerontological response to suffering in palliative social work practice with seriously ill (...) older adults at the end of life. Levinas’s ethical philosophy and conceptualizations of the non-totalizing relation of self to other, disinterest, and radical passivity are employed to help reframe an approach to the ethical relation and the nature of obligation in end-of-life care, expanding consciousness of suffering and its meanings in an intersubjectively experienced world. Differences in Husserl’s account of the other and the concept of alterity in Levinas’s ethics are explored in the context of phenomenology as a descriptive science that respond directly to the pragmatic concerns of the analysis. (shrink)

Preparing the Next Generation of Oral Historians is an invaluable resource to educators seeking to bring history alive for students at all levels. Filled with insightful reflections on teaching oral history, it offers practical suggestions for educators seeking to create curricula, engage students, gather community support, and meet educational standards. By the close of the book, readers will be able to successfully incorporate oral history projects in their own classrooms.

The Politics of the Soul: Eric Voegelin on Religious Experience includes eight essays examining one of the most profound studies of religious experience to appear in the last century: that of the political philosopher Eric Voegelin. Voegelin is increasingly recognized as a political theorist of exceptional scope and erudition and the most important philosopher of his time since Toynbee, and his treatment of religious experience is a crucial part of his overall analysis of existence and history. This collection of essays (...) by prominenet Voegelin scholars is the first book to explore the relevance of that analysis to the contemporary understanding of political theory, theology, history, and philosophy of consciousness, and as such it constitutes a significant contribution not only to Voegelin scholarship but to the current quest for theoretical foundations. (shrink)

Thanks to a helpful tetradic diagram found in the expanded fifth edition of John Deely’s Basics of Semiotics, in which the context and circumstances of a sign’s utterance (in addition to the sign-vehicle itself and the immediate object of the sign) is distinguished from all that is explicit in the sign itself apart from the context and circumstances of its utterance, it is possible to bring Deely’s insights to bear upon the semiotically suggestive work of Marshall McLuhan. McLuhan’s implicitly semiotic (...) understanding of analogy is structurally present in his efforts to visually articulate the “laws of media” with his own “tetrad” diagrams. Deely’s discussion of the irreducible triadicity of signs therefore illuminates McLuhan’s attempt to understand how analogical thought actually works on the most fundamental structural level in the cognition of the semiotic animal. There is a unique cognitive syntax to analogy, which is operative in the animal that Deely has most appropriately identified as “the semiotic animal”. This article discusses McLuhan’s understanding of analogy in terms of its figure/ground structure, by using the example of the thermometer from Deely’s Basics of Semiotics. In relating this example to McLuhan’s tetrad, it is shown how McLuhan’s implicitly semiotic analysis can also increase our semiotic understanding of other technological tools, such as Skype videoconferencing. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Model for the Many Senses of ScriptureFrom the Literal to the Spiritual in Genesis 22 with Thomas AquinasChristopher S. Morrissey (bio)Introduction: Many Senses Require Many TranslationsOn the mountain the Lord appeared (NETS, Gen. 22:14b)On the mount of the LORD it shall be provided (RSV)1In the mount of the LORD it shall be seen (KJV)On the mountain the LORD will see (NAB)ἐν τῷ ὄρει κύριος ὤφθη (LXX)in monte Dominus (...) videtur (Nova Vulgata)in monte Dominus videbit (St. Jerome’s Vulgate)In his book Abraham’s Curse, Bruce Chilton argues that in Gen. 22:14b, “the Septuagint’s Greek renders the Hebrew text” correctly (i.e., “with Yahweh as the subject of the verb”), whereas English translations like the King James Version (KJV) prefer to imply that the ram is the verbal subject. Chilton contends that “This is a case of translators caring more about doctrine than wording, and attempting to legislate what the Bible can say.”2Chilton’s textual exegesis does have some value. He notes that “Contextually [End Page 231] as well as grammatically, God is the subject: Yahweh ‘was seen’ on Moriah, liberating Isaac by means of divine intervention.”3 But with his polemics against the KJV, he fails to affirm the rich polysemy of the passage. He replaces one literal reading with another and then argues as if the two are at odds. But Scripture has many senses, a truth famously expressed in the medieval distich of Augustine of Dacia, best known in the version of Nicholas of Lyra: “The literal sense teaches what happened; what you believe, the allegorical; the moral, what you should do; where you are going, the anagogical.”4 Therefore Chilton is wrong to impute bad motives to anyone who would attempt to unfold the spiritual sense of a passage (“caring more about doctrine”), or even to anyone who would note that a passage has more than one literal meaning.Chilton’s own insistence on uncovering the univocal original meaning of a passage (through his preferred historical method of “generative exegesis”)5 is excessively literal, as if recourse to grammar would allow one “to legislate what the Bible can say.” When Chilton says “Yahweh ‘was seen’ on Moriah,” he is not contending that God was seen directly, literally, but rather interpreting the metaphorical or parabolical sense of the phrase “Yahweh was seen” (in Gen. 22:14b), because he glosses the meaning of the metaphor as “liberating Isaac by means of divine intervention”;6 that is, God is seen indirectly, cognitively, rather than literally with the eyes. Because literally seeing a ram is not opposed to cognitively understanding God’s action, the KJV, pace Chilton, can be defended contextually. To my mind, the Revised Standard Version (RSV), echoing the KJV, does the best job of rendering the Hebrew text literally, with “On the mount of the lord it shall be provided,” because this leaves open the many senses of the third person singular “it,” to be unfolded by exegesis. Thus more than one translation is required in order to appreciate all the significations being deployed in the treatment of “seeing” in Gen. 22:8 and 22:14. “It shall be provided”: More than one univocal sense of the “it” has to be uncovered by exegesis in this Scripture, in order to see what “it” is all about.To justify my opinion that the RSV most felicitously translates the Hebrew, I would like to prepare the way to a conclusion in which I compare the Septuagint’s translation (which follows Chilton’s preferred rendering of the context) with the Vulgate Latin translations. The path toward this conclusion will show that Chilton’s polemics, indicative of an exegetical attitude that is hostile to an appreciation of the many senses of Scripture, fail to see how the RSV translation is also defensible as keeping the reader’s mind open to the many senses of the Scriptural passage. But first things first. With the help of St. Thomas Aquinas, let me distinguish the various senses of Scripture and then point out how they are all exemplified here, all being signified by the text. [End Page 232] Click for larger view View... (shrink)

While much has been written about Islam, particularly over the twenty-five years, few books have explored the full range of the ideas that have defined the faith over a millennium and a half. Fitzroy Morrissey provides a clear and concise introduction to the origins and sources of Islamic thought, from its beginnings in the 7th century to the current moment. He explores the major ideas and introduces the major figures--those who over the centuries have broached life's major questions, from the (...) nature of God and the existence of free will to gender relations and the ordering of society, and in the process defined Islam. Drawing on Arabic and Persian primary texts, as well as the latest scholarship, A Short History of Islamic Thought explains the key teachings of the Qur'an and Hadith, the great books of Islamic theology, philosophy, and law, as well as the mystical writings of the Sufis. It evaluates the impact of foreign cultures-Greek and Persian, Jewish and Christian-on early Islam, accounts for the crystallization of the Sunni and Shi'i forms of the faith, and accounts for the rise of such trends as Islamic modernism and Islamism. Above all, it reveals the fundamental principles of Islamic thought, both as a source of inspiration for Muslims today and as illuminating and rewarding in their own right. (shrink)

This critical essay responds to the COVID-19 pandemic and subsequent lockdown in Victoria from the perspective of a retired Aboriginal academic and reflects on personal responsibility, Indigenous history, and resilience.

This analysis explores the phenomenology of suffering and temporal, genetic and social developmental aspects of suffering for seriously ill older adults. A phenomenological account of suffering is advanced using oral history data from in-depth interviews with a seriously ill, frail elderly woman. The analysis evaluates how a phenomenological account of suffering may inform ethics in end-of-life decision making, and may provide a further basis for an integrated ethical and gerontological response to suffering in palliative social work practice with seriously ill (...) older adults at the end of life. Levinas’s ethical philosophy and conceptualizations of the non-totalizing relation of self to other, disinterest, and radical passivity are employed to help reframe an approach to the ethical relation and the nature of obligation in end-of-life care, expanding consciousness of suffering and its meanings in an intersubjectively experienced world. Differences in Husserl’s account of the other and the concept of alterity in Levinas’s ethics are explored in the context of phenomenology as a descriptive science that respond directly to the pragmatic concerns of the analysis. (shrink)

This paper describes a novel approach to teaching introductory-level students how to engage with philosophical texts, developed in the context of a philosophy of art course. We aimed to enhance students’ motivation to read philosophy well by cultivating habits of active reading. To this end we created a structured set of three assignments: instructor created digitally annotated reading assignments, a student digital annotation assignment, and required student participation in a collective GoogleDoc “repository of artworks, examples, ideas, and questions.” Student feedback (...) suggests that this set of teaching tools enhanced their sense of agency in approaching philosophical texts. (shrink)

European Journal of Political Theory, Ahead of Print. Deliberative democrats have abandoned the ideal of consensus in favour of a range of different, more realistic alternatives. But these alternatives provide little anchorage to guide or even evaluate deliberative practice – something acutely problematic given the contemporary context of accelerating polarization in many advanced liberal democracies. In this article, we turn to Stalnaker’s account of the ‘common ground’ – the shared pool of information that is agreed upon by the parties to (...) a discourse – to reassert a distinct ideal standard for democratic deliberation which remains malleable enough to apply across messy contexts of real-world political contestation and debate. Our account offers an appropriate normative yardstick by which to assess deliberative practices across different discursive contexts, as well as impetus for further experimentation and innovation in efforts towards democratic renewal and reform. (shrink)

Deliberative democrats have abandoned the ideal of consensus in favour of a range of different, more realistic alternatives. But these alternatives provide little anchorage to guide or even evaluat...

We suggest a fuller understanding of the obligation to respect patient autonomy can be gained by recognizing patients as historically and socially situated agents, whose values are developed, challenged, and changed, rather than merely applied, in their decision-making about their use of preimplantation genetic diagnosis or preimplantation genetic screening (PGD/PGS). We ground this discussion in empirical research on the patients experiences with PGD/PGS, and conclude by suggesting that promoting patients’ self-respect is a useful ethical standard for providers and practices to (...) recognize. (shrink)