Whole eye transplantation (WET) remains experimental. Long presumed impossible, recent scientific advances regarding WET suggest that it may become a clinical reality. However, the ethical implications of WET as an experimental therapeutic strategy remain largely unexplored. This article evaluates the ethical considerations surrounding WET as an emerging experimental treatment for vision loss. A thorough review of published literature pertaining to WET was performed; ethical issues were identified during review of the articles.

Organic crosstalk or intercommunication among different organs is an interesting medical concept based on the biosemiotic perspective which considers the organism as a process maintained by the vital information flow between structural plane and biosemiotic plane, both with their different layers of biological complexity. From this point of view the organ is not merely the structure which produces crosstalk but just as much its product. The crosstalk perspective seeks two main goals: to investigate the characteristic serum biosemiotic patterns of pathogenic (...) organic crosstalk in order to achieve early diseases diagnosis, and to learn how to correct it. These achievements could allow physicians to evolve from a medical practice that focuses on misbiosemiotic effects, diagnosing and treating damaged organs, to a medical practice that focuses on misbiosemiotic processes, in this way diagnosing and treating pathogenic organ crosstalk before it culminates in organ damage. (shrink)

Communication and Conflict Management Training for Clinical Bioethics Committees Content Type Journal Article Pages 341-349 DOI 10.1007/s10730-009-9116-7 Authors Lauren M. Edelstein, Johns Hopkins Medicine’s Howard County General Hospital 5755 Cedar Lane Columbia MD 21044 USA Evan G. DeRenzo, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Elizabeth Waetzig, Change Matrix Inc. 485 Maylin St. Pasadena CA 91105 USA Craig Zelizer, Georgetown University Department of Government 3240 Prospect St. Washington, D.C. NW 20057 (...) USA Nneka O. Mokwunye, Washington Hospital Center Center for Ethics 110 Irving St Washington, D.C. NW 20010 USA Journal HEC Forum Online ISSN 1572-8498 Print ISSN 0956-2737 Journal Volume Volume 21 Journal Issue Volume 21, Number 4. (shrink)

Early last year, the GenEthics Consortium (GEC) of the Washington Metropolitan Area convened at George Washington University to consider a complex case about genetic testing for Alzheimer disease (AD). The GEC consists of scientists, bioethicists, lawyers, genetic counselors, and consumers from a variety of institutions and affiliations. Four of the 8 co-authors of this paper delivered presentations on the case. Supplemented by additional ethical and legal observations, these presentations form the basis for the following discussion.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Eternal Life and Human Happiness in Heaven: Philosophical Problems, Thomistic Solutions by Christopher M. BrownElizabeth C. Shaw and Staff*BROWN, Christopher M. Eternal Life and Human Happiness in Heaven: Philosophical Problems, Thomistic Solutions. Washington, D.C.: The Catholic University of America Press, 2021. xiii + 487 pp. Cloth, $75.00The contents of the book are straightforwardly announced by the title. Christopher Brown entertains four apparent problems about eternal life in (...) heaven considered by contemporary philosophers and theologians and offers solutions to them from the thought of St. Thomas Aquinas. The book consists of seventeen chapters together with an introduction and conclusion and is divided into four parts. In the first part Brown lays out the problems and the solutions to them proposed by contemporary philosophers and theologians. In the second part he explains St. Thomas's distinction between essential and accidental reward in heaven and goes on to treat of the former—which consists in the beatific vision, that is, our beholding of God—and its proper accidents—which are delight, joy, and charity. In the third part he then deals with the accidental reward, which has to do with the perfected condition of our glorified bodies, society with other persons, and so on. Finally, in the fourth part Brown, drawing on his expositions of St. Thomas's doctrine in the two previous parts, details Thomistic solutions to the four problems discussed in the first part and argues that these solutions are superior to those proposed by the contemporary philosophers and theologians he has engaged.So, what are the four problems that Brown addresses? Let's present them as questions. (1) Is heaven just a private communion between a human person and God, or is it a perfect community centered on God that also involves angels, other human persons, and other creatures? (2) Is heaven just a spiritual affair, or are our resurrected bodies a part of it? (3) Is heaven a static or dynamic reality? (4) Is heaven boring?The answers are as follows. Ad primum: Heaven is a perfect community centered on God that also involves angels, other human persons, and other creatures. Ad secundum: Heaven is a spiritual and physical affair that includes our souls and our resurrected bodies. Ad tertium: Heaven is a dynamic reality. Ad quartum: Heaven is not boring!I cannot cover here all of the specifics of the way Brown shows how St. Thomas arrives at these answers. People who know St. Thomas well, even if they have not reflected much on these problems before, probably will [End Page 135] not have great difficulty thinking through how he might get to the first and second answers, at least in general terms. But the third and fourth, I think, call for further comment. My comments will necessarily be brief.If I understand Brown correctly, he wants to say (and contends that St. Thomas holds) that heaven is dynamic insofar as in heaven we are in act. But we can be in act in two senses: We can be in act in an unchanging way or in a changing way. In heaven my capacities to know God and to love him are both fully perfected, that is, they are fully actualized and undergo no change. But in heaven we will enjoy our resurrected bodies as well, and our bodies will also be active and interacting with other bodies. This activity will entail change. So, either way we will be active in heaven and, therefore, heaven will be something dynamic.What, then, about the problem of boredom? Because we will be perfectly happy in heaven, argues Brown (interpreting St. Thomas), heaven won't be boring. But the matter doesn't end there. Brown points out that Brian Ribeiro, developing an idea of Bernard Williams, objects that a person who is perfectly happy in the way that we are supposed to be in heaven, cannot be personally identical with any person in this life because the conditions of the beatified person and the nonbeatified person are just too radically different for there to be continuity between the two. Brown replies that St. Thomas convincingly shows that God can, by grace, prepare persons in this... (shrink)

Knowledge of the ethical and legal basis of medicine is as essential to clinical practice as an understanding of basic medical sciences. In the UK, the General Medical Council requires that medical graduates behave according to ethical and legal principles and must know about and comply with the GMC’s ethical guidance and standards. We suggest that these standards can only be achieved when the teaching and learning of medical ethics, law and professionalism are fundamental to, and thoroughly integrated both vertically (...) and horizontally throughout, the curricula of all medical schools as a shared obligation of all teachers. The GMC also requires that each medical school provides adequate teaching time and resources to achieve the above. We reiterate that the adequate provision and coordination of teaching and learning of ethics and law requires at least one full-time senior academic in ethics and law with relevant professional and academic expertise. In this paper we set out an updated indicative core content of learning for medical ethics and law in UK medical schools and describe its origins and the consultative process by which it was achieved. (shrink)

Next SectionFollowing the influential Gifford and Reith lectures by Onora O’Neill, this paper explores further the paradigm of individual autonomy which has been so dominant in bioethics until recently and concurs that it is an aberrant application and that conceptions of individual autonomy cannot provide a sufficient and convincing starting point for ethics within medical practice. We suggest that revision of the operational definition of patient autonomy is required for the twenty first century. We follow O’Neill in recommending a principled (...) version of patient autonomy, which for us involves the provision of sufficient and understandable information and space for patients, who have the capacity to make a settled choice about medical interventions on themselves, to do so responsibly in a manner considerate to others. We test it against the patient–doctor relationship in which each fully respects the autonomy of the other based on an unspoken covenant and bilateral trust between the doctor and patient. Indeed we consider that the dominance of the individual autonomy paradigm harmed that relationship. Although it seems to eliminate any residue of medical paternalism we suggest that it has tended to replace it with an equally (or possibly even more) unacceptable bioethical paternalism. In addition it may, for example, lead some doctors to consider mistakenly that unthinking acquiescence to a requested intervention against their clinical judgement is honouring “patient autonomy” when it is, in fact, abrogation of their duty as doctors. (shrink)

In _Violence and Civility_, Étienne Balibar boldly confronts the insidious causes of violence, racism, nationalism, and ethnic cleansing worldwide, as well as mass poverty and dispossession. Through a novel synthesis of theory and empirical studies of contemporary violence, the acclaimed thinker pushes past the limits of political philosophy to reconceive war, revolution, sovereignty, and class. Through the pathbreaking thought of Derrida, Balibar builds a topography of cruelty converted into extremism by ideology, juxtaposing its subjective forms and its objective manifestations. Engaging (...) with Marx, Hegel, Hobbes, Clausewitz, Schmitt, and Luxemburg, Balibar introduces a new, productive understanding of politics as antiviolence and a fresh approach to achieving and sustaining civility. Rooted in the principles of transformation and empowerment, this theory brings hope to a world increasingly divided even as it draws closer together. (shrink)

In this paper we consider an intuitionistic variant of the modal logic S4 (which we call IS4). The novelty of this paper is that we place particular importance on the natural deduction formulation of IS4— our formulation has several important metatheoretic properties. In addition, we study models of IS4— not in the framework of Kirpke semantics, but in the more general framework of category theory. This allows not only a more abstract definition of a whole class of models but also (...) a means of modelling proofs as well as provability. (shrink)

Many proteins responsible for genome maintenance interact with one another via short sequence motifs. The best known of these are PIP motifs, which mediate interactions with the replication protein PCNA. Others include RIR motifs, which bind the translesion synthesis protein Rev1, and MIP motifs, which bind the mismatch repair protein Mlh1. Although these motifs have similar consensus sequences, they have traditionally been viewed as separate motifs, each with their own target protein. In this article, we review several recent studies that (...) challenge this view. Taken together, they imply that these different motifs are not distinct entities. Instead, there is a single, broader class of motifs, which we call “PIP‐like” motifs, which have overlapping specificities and are capable of binding multiple target proteins. Given this, we must reassess the role of these motifs in forming the network of interacting proteins responsible for genome maintenance. (shrink)

The Organ Donation Act 2019 has introduced an opt-out organ donor register in England, meaning that consent to the donation of organs upon death is presumed unless an objection during life was actively expressed. By assessing the rights of the dead over their organs, the sick to those same organs, and the role of consent in their requisition, this paper interrogates whether such paradigms for deceased organ donation are ethically justifiable. Where legal considerations are applicable, I focus on the recent (...) changes in England as a case in point; however, this paper ultimately challenges the justifiability of opt-out systems in any form, concluding that ethical solutions to organ shortage do not lie in opt-out systems of deceased organ procurement. (shrink)

Aristotle argued that you need some wealth to live well. The Stoics argued that you could live well with or without wealth. But the Cynics argued that wealth is a hinderance. For the Cynics, a good life consists in self-sufficiency, or being able to rule and help yourself. You accomplish this by living simply and naturally, and by subjecting yourself to rigorous philosophical exercises. Cynics confronted people to get them to abandon extraneous possessions and positions of power to live better. (...) And while the Cynics were experts in living in this way, their ascetic lifestyles made their message curious to some audiences. This paper reflects on Cynic ascetic practices and the ways others perceived them. (shrink)

The aim of this paper is to defend a famous quotation from Martin Luther King, stating that “The arc of the moral universe is long, but it bends toward justice.” The quotation is inscribed on the King Memorial in Washington, D.C. and President Obama had it woven into a rug for the Oval Office in the White House. The quotation has become something of a contemporary proverb, and is certainly worthy of our close attention. In order to evaluate the (...) dictum, questions concerning its meaning will first be addressed and clarified, and various possible misinterpretations will be set aside. It will be argued that the appeal, and an effective defense of this moral claim, depend upon the pre-existing values of the people to whom the claim is addressed. The dictum is clearly intended to support hopes of social change and to encourage support for ideals of racial equality, but we want to know whether it is true or false and exactly what it means. King’s dictum can easily be taken as involving a doctrine of “divine Providence” or “historical inevitability.” But many are skeptical of these ideas and hold that we cannot be sure that the future will eventuate in desired moral outcomes. But, if so, what would it possibly mean to claim that the “moral universe” or the human world “bends toward justice”? On the other hand, holding that the moral universe “bends toward justice” claims more than saying that we can now act or organize to support justice; instead, it tells us that there is some pre-existing support for our related activities. What, then, is this pre-existing bend of the moral universe? (shrink)

In an old paper of our group in Milano a formalism was introduced for the continuous monitoring of a system during a certain interval of time in the framework of a somewhat generalized approach to quantum mechanics. The outcome was a distribution of probability on the space of all the possible continuous histories of a set of quantities to be considered as a kind of coarse grained approximation to some ordinary quantum observables commuting or not. In fact the main aim (...) was the introduction of a classical level in the context of QM, treating formally a set of basic quantities, to be considered as beables in the sense of Bell, as continuously taken under observation. However the effect of such assumption was a permanent modification of the Liouville-von Neumann equation for the statistical operator by the introduction of a dissipative term which is in conflict with basic conservation rules in all reasonable models we had considered. Difficulties were even encountered for a relativistic extension of the formalism. In this paper I propose a modified version of the original formalism which seems to overcome both difficulties. First I study the simple models of an harmonic oscillator and a free scalar field in which a coarse grain position and a coarse grained field respectively are treated as beables. Then I consider the more realistic case of spinor electrodynamics in which only certain coarse grained electric and magnetic fields are introduced as classical variables and no matter related quantities. (shrink)

Research ethics committees are charged with providing an opinion on whether research proposals are ethical. These committees are overseen by a central office that acts for the Department of Health and hence the State. An advisory group has recently reported back to the Department of Health, recommending that it should deal with inconsistency in the decisions made by different RECs. This article questions the desirability and feasibility of questing for consistent ethical decisions.

“Free riding,” used as a descriptive term, refers to taking a jointly produced benefit without contributing towards its production. Used as a term of criticism, it refers to the wrongful failure to contribute towards the joint production of benefits that one receives. On either usage, the central interest of moral philosophy in free riding is the same: to specify the conditions under which not contributing towards the joint production of benefits that one receives is wrong, and to explain why.

This paper explores ethical issues relating to the management of patients who are terminally ill and unable to maintain their own nutrition and hydration. A policy of sedation without hydration or nutrition is used in palliative medicine under certain circumstances. The author argues that this policy is dangerous, medically, ethically and legally, and can be disturbing for relatives. The role of the family in management is discussed. This issue requires wide debate by the public and the profession.

Contemporary Western societies are obsessed with the “obesity epidemic,” dieting, and fitness. Fat people violate the Western conscience by violating a thinness norm. In virtue of violating the thinness norm, fat people suffer many varied consequences. Is their suffering morally permissible, or even obligatory? In this paper, I argue that the answer is no. I examine contemporary philosophical accounts of oppression and draw largely on the work of Sally Haslanger to generate a set of conditions sufficient for some phenomena to (...) count as oppression, and I illustrate the account’s value using the example of gender oppression. I then apply the account to fat people, examine empirical evidence, and argue that the suffering of fat people counts as oppression. (shrink)

Traditionally clinicians have determined their patients' resuscitation status without consultation. This has been condemned as morally indefensible in cases where not for resuscitation (NFR) orders are based on quality of life considerations and when the patient's true wishes are not known. Such instances would encompass most resuscitation decisions in elderly patients. Having previously involved patients in CPR decision-making, we chose formally to explore the reasons behind the choices made. Although the patients were not upset, and readily decided at the time (...) of initial consultation, on later analysing the decision-making we found poor understanding of the procedure, poor recall of information given and in some cases evidence of harm. This may be attributed to impaired decision-making capacity of elderly hospitalised patients as previously shown, or to the discomfort precipitated by having to contemplate the apparent immediacy of cardiac arrest by these patients. We propose that subscribing to autonomy as a general principle needs to be balanced against particular cases where distress may be caused by, or result in, diminished competence and limited autonomy. (shrink)

An Address delivered to the Seattle G. K. Chesterton Society at the University of Washington Newman Center, May 2, 2013.

The classical Athenian philosopher Socrates was tried in 399 BCE on the basis of two notoriously ambiguous charges: corrupting the youth and impiety (in Greek, asebeia). A majority of the 501 dikasts (Athenian citizen-jurors) voted to convict him. Socrates was ultimately sentenced to death by drinking a hemlock-based liquid. This well-known account of the trial is by Plato, one of Socrates' students and a famous philosopher in his own right. Whether Socrates was punished unjustly is a contested issue which to (...) this day inspires discussions about the nature and meaning of justice. (shrink)

To speak of ‘the real subject’ or ‘the primary aim’ of a Platonic dialogue usually means to magnify one aspect of it at the expense of other aspects as important. Such is not my intention. It is quite clear, however, without prejudice to the philosophic value of any of the topics discussed, that the Protagoras is an attack upon the sophists as represented by Protagoras, the greatest of them. Hippias and Prodicus are present and some of the great man's glory (...) is reflected upon them; they are also no doubt to some extent implicated in his defeat, though they seem quite unaware of the fact. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Driven from Home: Protecting the Rights of Forced Migrants Edited by David Hollenbach, SJ, and: Kinship across Borders: A Christian Ethic of Immigration by Kristen HeyerRené M. Micallef SJDriven from Home: Protecting the Rights of Forced Migrants EDITED BY DAVID HOLLENBACH, SJ Washington DC: Georgetown University Press, 2010. 296 pp. $20.46Kinship across Borders: A Christian Ethic of Immigration KRISTEN HEYER Washington DC: Georgetown University Press, 2012. (...) 210 pp. $29.23Although based on a conference held at Boston College in November 2008, Driven from Home is no less timely today, given the context of current debates on immigration in the United States, the European Union, Australia, and the Middle East. David Hollenbach’s introduction explains how the book brings together Christian (mostly Catholic) theologians, human rights activists, humanitarian practitioners, and legal scholars to help us focus on a class of persons referred to as “forced migrants” or “persons needing protection.” These individuals are neither classical “convention refugees” (according to international law definitions) nor are they simply “migrant workers” (in the classical sense) since their basic human rights to security and subsistence cannot [End Page 230] be adequately guaranteed in their home country or region. They do not emigrate merely in search of a higher standard of living; rather, forced migrants enter and settle in foreign lands seeking some sort of “protection” similar to that afforded to “conventional” refugees. More concretely, the book focuses on persons on the move—individuals fleeing violence and the extreme poverty rampant in regions devastated by ecological degradation and natural disasters.Extending the logic of the 1952 Refugee Convention and adapting it to the realities of today, one can argue convincingly that the international community has a duty to protect such persons when their states of origin are structurally unable or unwilling to afford protection (as argued in Susan Martin’s essay). However, paternalistic approaches that diminish rather than augment the agency of local governments and migrants are to be avoided (as maintained in M. Brinton Lykes’ essay). The book helps us reflect on what can be done to guarantee the basic rights of forced migrants not only at the level of international law and institutions but also through domestic and regional policymaking spurred and inspired by both Christian and secular global-humanitarian values. Such values are eminently compatible when applied to this particular issue (see Silvano Tomasi’s contribution). Agbonkhianmeghe Orobator’s essay—which offers insightful reflections (albeit rather general ones) from Christian ethics, ecclesiology, and biblical theology—likewise points to the need for a truly interdisciplinary approach to the issue. The other authors help the book achieve precisely this. Theological ethics finds its own distinctive place and voice in dialogue with a range of perspectives: legal and political sciences and case studies (Frank Brennan, Daniel Kanstroom); philosophical approaches (Arash Abizadeh); and sociological research on particular migrant populations (M. Brinton Lykes, Maryanne Loughry). The book includes essays that integrate case studies, technical reflections, useful summaries of theological principles and doctrines (J. Bryan Hehir, Mary M. DeLorey, and Tomasi), and philosophical stances (Abizadeh, Thomas G. Weiss), and present practical and legal proposals (see Martin’s essay). A stimulating read for scholars and for the general public, the volume provides good training material for faith-based activists and practitioners.The argumentation strategy in many of the essays in Driven from Home is to appeal to the reader’s sense of solidarity with the needy or suffering neighbor. It promotes the virtues of hospitable citizenship and hospitable disciple-ship while carefully trying to convince national and international policymakers to reinforce and expand the international protection regime. Emboldened by the 2005 “Responsibility to Protect” breakthrough at the United Nations, the authors seek to remain acceptable to a wide audience in an atmosphere of resurgent nationalism, nativism, and protectionism. The authors generally avoid harsh critiques of Westphalian models of sovereignty and do not dwell [End Page 231] on the Catholic doctrines of the universal destination of created goods and the (circumscribed) right to immigrate (and not only to emigrate). Rather, they seek to introduce a new protection niche without fundamentally challenging the prevailing ideology of sovereignty, gently proposing new legal instruments as though they... (shrink)

A significant proportion of conservationists' work is directed towards efforts to save disappearing species. This relies upon the belief that species extinction is undesirable. When justifications are offered for this belief, they very often rest upon the assumption that extinction brought about by humans is different in kind from other forms of extinction. This paper examines this assumption and reveals that there is indeed good reason to suppose current anthropogenic extinctions to be different in kind from extinctions brought about at (...) other times or by other factors. Having considered – and rejected – quantity and rate of extinction as useful distinguishing factors, four alternative arguments are offered, each identifying a way in which anthropogenic extinction is significantly different from other forms of extinction, even mass extinction: (1) Humans are a different kind of natural cause from other causes of extinction; (2) Extinctions brought about by humans are uniquely persistent; (3) Anthropogenic extinctions are effectively random whereas past mass extinctions are rule-bound; (4) The impact of the current anthropogenic extinction event differs from the impact of other extinction events of the past, such that future recovery may not follow past patterns. Together, these four arguments suggest that the present-day extinction event brought about by humans may be unprecedented and that we cannot clearly extrapolate from past to present recovery from extinctions. Although insufficient as justification for the claim that present-day extinctions are undesirable, the arguments provide some ammunition for conservationists' conviction that species extinction – in which humans play an accelerating role – ought to be prevented. (shrink)

Grote's powerful defence of Thrasyllus' canon should have taught us at least not to reject lightly any dialogue which, like the Hippias Maior, is there classed as genuine. The burden of proof lies with those who attack our dialogue. Raeder, Ritter, and Apelt consider it to be genuine, while Ast, Jowett, Horneffer, and Röllig declare against it, as also Gomperz, Zeller, and Lutoslawski.

The author reviews and continues the debate initiated by her recent paper in this journal. The paper was critical of certain aspects of palliative medicine, and caused Ashby and Stoffell to modify the framework they proposed in 1991. It now takes account of the need for artificial hydration to satisfy thirst, or other symptoms due to lack of fluid intake in the terminally ill. There is also a more positive attitude to the emotional needs and ethical views of the patient's (...) family and care-givers. However, clinical concerns about the general reluctance to use artificial hydration in terminal care remain, and doubts persist about the ethical and legal arguments used by some palliative medicine specialists and others, to justify their approach. Published contributions to the debate to date, in professional journals, are reviewed. Key statements relating to the care of sedated terminally ill patients are discussed, and where necessary criticised. (shrink)

Traditionally, surgical practice has been experiential and based on the contemporary understanding of basic mechanisms of disease. It was both a science and an art and depended to far too great an extent on the individualism and self belief of its main exponents. “Evidence based medicine” emerged in the 1980s and a new gospel of “Rules of Evidence” was introduced. There is no doubt that the net effect of EBM has been beneficial, but over reliance on randomised controlled trials and (...) the lack of generalisability of scientific evidence to individual patients has perhaps led to less enthusiasm for its tenets among surgeons. There are valid and spurious reasons for this that are discussed. The situation is improving but inevitable tensions remain between the surgeon committed to the individual patient here and now, and the clinical researcher whose focus is the benefit of future patients in the larger community. (shrink)