OBJECTIVES: To study the resuscitation preferences, choice of decision-maker, views on the seeking of patients' wishes and determinants of these of elderly hospital in-patients. DESIGN: Questionnaire administered on admission and prior to discharge. SETTING: Two acute geriatric medicine units (Southampton and Poole). PARTICIPANTS: Two hundred and fourteen consecutive consenting mentally competent patients admitted to hospital as emergencies. RESULTS: Resuscitation was wanted by 60%, particularly married and functionally independent patients and those who had not already considered it. Not wanted resuscitation was (...) associated with lack of social contacts. Sixty-seven per cent welcomed enquiry about their preferences and 78% wanted participation in decision, 43% as sole decision-maker. Wishing to choose oneself was associated with not wanting resuscitation, prior knowledge of it, and lack of a spouse. Patients' opinions remained stable during their admission. CONCLUSIONS: Discussion of resuscitation is practical on hospital admission without causing distress and the views expressed endure through the period of hospitalisation. Elderly patients' attitudes depend partly on personal health and social circumstances. This may assist doctors when patients are unable to participate themselves. (shrink)

Decisions about cardiopulmonary resuscitation may be based on medical prognosis, quality of life and patients' choices. Low survival rates indicate its overuse. Although the concept of medical futility has limitations, several strong predictors of non-survival have been identified and prognostic indices developed. Early results indicate that consideration of resuscitation in the elderly should be very selective, and support "opt-in" policies. In this minority of patients, quality of life is the principal issue. This is subjective and best assessed by the individual (...) in question. Patients' attitudes cannot be predicted reliably and surrogate decision-making is inadequate. Lay knowledge is poor. However, patients can use prognostic information to make rational choices. The majority welcome discussion of resuscitation and prefer this to be initiated by their doctors; many wish to decide for themselves. There is little evidence that this causes distress. The views of such patients, if competent, should be sought actively. (shrink)

Keith Thomas: Gerald Edward Aylmer, 1926-2000 Adrian Hollis: William Spencer Barrett, 1914-2001 Bruce Williams: Charles Frederick Carter, 1919-2002 Malcolm Mackintosh: John Erickson, 1929-2002 J. H .R. Davis: Raymond William Firth, 1901-2002 F. M. L. Thompson: Hrothgar John Habakkuk, 1915-2002 A. W. Price: Richard Mervyn Hare, 1919-2002 Hugh Lloyd-Jones: Geoffrey Stephen Kirk, 1921-2003 Michael Lapidge and Peter Matthews: Vivien Anne Law, 1954-2002 Ann Moss: John Lough, 1913-2000 Terence Cave: Ian Dalrymple McFarlane, 1915-2002 Ludwig Paul: David Neil MacKenzie, 1926-2001 Peter (...) Birks: John Kieran Barry Moylan Nicholas, 1919-2002 Jonathan Shepard: Dimitri Dimitrievich Obolensky, 1918-2001 David Cannadine: John Harold Plumb, 1911-2001 Daniel Waley: Nicolai Rubinstein, 1911-2002 Ian Wood: John Michael Wallace-Hadrill, 1916-1985 R. G. M. Nisbet: William Smith Watt, 1913-2002 G. W. Bernard: Richard Bruce Wernham, 1906-1999. (shrink)

The idea for our paper began with a practical problem. As curricularists dedicated to an aesthetic approach to teaching, curriculum, and learning, we regularly provide workshops on this topic for teachers in K–12 schools. Our own work is based on Dewey’s aesthetic ideas1 and we have developed a theory called CRISPA2 that teachers may employ to create what we might call “wow” experiences in their own classrooms.3 That is, they can set up the conditions for students to have aesthetic experiences (...) with the material they are learning. When conducting such workshops for teachers, we often hear the observation, “This is like flow,” or we get the question, “How is this different from a spiritual experience?”Thus, this... (shrink)

Concern about the ethics of clinical drug trials research on patients and healthy volunteers has been the subject of significant ethical analysis and policy development—protocols are reviewed by Research Ethics Committees and subjects are protected by informed consent procedures. More recently attention has begun to be focused on DNA banking for clinical and pharmacogenetics research. It is, however, surprising how little attention has been paid to the commercial nature of such research, or the unique issues that present when subjects are (...) asked to consent to the storage of biological samples. Our contention is that in the context of pharmacogenetic add-on studies to clinical drug trials, the doctrine of informed consent fails to cover the broader range of social and ethical issues. Applying a sociological perspective, we foreground issues of patient/subject participation or ‘work’, the ambiguity of research subject altruism, and the divided loyalties facing many physicians conducting clinical research. By demonstrating the complexity of patient and physician involvement in clinical drug trials, we argue for more comprehensive ethical review and oversight that moves beyond reliance on informed consent to incorporate understandings of the social, political and cultural elements that underpin the diversity of ethical issues arising in the research context. (shrink)

We offer a formal account of the English past tenses. We see the perfect as having reference time at speech time and the preterite as having reference time at event time. We formalize four constraints on reference time, which we bundle together under the term ‘perspective’. Once these constraints are satisfied at the different reference times of the perfect and preterite, the contrasting functions of these tenses are explained. Thus we can account formally for the ‘definiteness effect’ and the ‘lifetime (...) effect’ of the perfect, for the fact that the perfect seems to ‘explain’ something about the present, and that the perfect cannot presuppose a past time point. We explain why perfect and preterite can sometimes be interchangeable, and we offer a solution to the ’present perfect puzzle’. We explain the unacceptability of notorious examples of the perfect such as * Gutenberg has discovered the art of printing . We give greater definition to the familiar notions of ‘current relevance’ and ‘extended now’. (shrink)

Rapid advances in the domain of science and technology are having an unprecedented effect upon the provision of higher education in universities throughout the world, the pace of change often being so fast as to make planning for the development of the “classroom of the future” an extremely difficult task. The Mobile Multimedia University (MMU) project, a collaborative action between four leading UK based research facilities, has been established to investigate these issues. Included amongst its aims is the use of (...) novel research methodologies to determine the factors which will influence the shape and form of future education provision, and thus the distribution of knowledge to society, such as mobility, telecommunications and multimedia services. This paper describes the use of a Delphi survey in predicting the technological trends and innovations which will affect university education in the near future. It describes the theory underpinning the Delphi method, illustrating this with examples of how such a technique has been successfully used in the past. It then details the specific application of the Delphi approach within the current MMU research project, detailing the preliminary results and discussing the implications of these findings for the future of universities and other institutes of higher education. (shrink)

Concern about the ethics of clinical drug trials research on patients and healthy volunteers has been the subject of significant ethical analysis and policy development—protocols are reviewed by Research Ethics Committees and subjects are protected by informed consent procedures. More recently attention has begun to be focused on DNA banking for clinical and pharmacogenetics research. It is, however, surprising how little attention has been paid to the commercial nature of such research, or the unique issues that present when subjects are (...) asked to consent to the storage of biological samples. Our contention is that in the context of pharmacogenetic add-on studies to clinical drug trials, the doctrine of informed consent fails to cover the broader range of social and ethical issues. Applying a sociological perspective, we foreground issues of patient/subject participation or ‘work’, the ambiguity of research subject altruism, and the divided loyalties facing many physicians conducting clinical research. By demonstrating the complexity of patient and physician involvement in clinical drug trials, we argue for more comprehensive ethical review and oversight that moves beyond reliance on informed consent to incorporate understandings of the social, political and cultural elements that underpin the diversity of ethical issues arising in the research context. (shrink)

In comparative studies, Confucian teaching and learning have multiple meanings. On the one hand, they refer to contemporary educational practices and contexts in Asian countries and regions such as mainland China, Hong Kong, Taiwan, Japan, South Korea, and Singapore. Comparative researchers contend that Confucian heritage Culture, a mixed and blended cultural tradition of Confucianism, Taoism, and Buddhism, has heavily influenced these countries and regions.1 As a result, their educational practices and contexts are different from those in Western countries.2 One indication (...) of this point is that, although teachers in Confucian teaching and learning environments conduct lectures, the learning tasks are... (shrink)

Early versions of satellite and radiosonde datasets suggested that the tropical surface had warmed more than the troposphere, while climate models consistently showed tropospheric amplification of surface warming in response to human-caused increases in greenhouse gases. We revisit such comparisons here using new observational estimates of surface and tropospheric temperature changes. We find that there is no longer a serious discrepancy between modeled and observed trends in the tropics. Our results contradict a recent claim that all simulated temperature trends in (...) the tropical troposphere are inconsistent with observations. This claim was based on the use of older radiosonde and satellite datasets and on two methodological errors: the neglect of observational trend uncertainties introduced by interannual climate variability and application of an inappropriate statistical “consistency test”.This emerging reconciliation of models and observations has two primary explanations. First, because of changes in the treatment of buoy and satellite information, new surface temperature datasets yield slightly reduced tropical warming relative to earlier versions. Second, recently developed satellite and radiosonde datasets now show larger warming of the tropical lower troposphere. In the case of a new satellite dataset from remote sensing systems, enhancedRSS warming is due to an improved procedure of adjusting for inter-satellite biases. When the RSS-derived tropospheric temperature trend is compared with four different observed estimates of surface temperature change, the surface warming is invariably amplified in the tropical troposphere, consistent with model results. Even if we use data from a second satellite dataset with smaller tropospheric warming than in remote sensing systems RSS, observed tropical lapse rates are not significantly different from those in all model simulations.Our results contradict a recent claim that all simulated temperature trends in the tropical troposphere and in tropical lapse rates are inconsistent with observations. This claim was based on the use of older radiosonde and satellite datasets and on two methodological errors: the neglect of observational trend uncertainties introduced by interannual climate variability and application of an inappropriate statistical “consistency test”. (shrink)

Presents a plethora of approaches to developing human potential in areas not conventionally addressed. Organized in two parts, this international collection of essays provides viable educational alternatives to those currently holding sway in an era of high-stakes accountability.

Astronauts often report experiences of awe and wonder while traveling in space. This paper addresses the question of whether awe and wonder can be scientifically investigated in a simulated space travel scenario using a neurophenomenological method. To answer this question, we created a mixed-reality simulation similar to the environment of the International Space Station. Portals opened to display simulations of Earth or Deep Space. However, the challenge still remained of how to best capture the resulting experience of participants. We could (...) use psychological methods, neuroscientific methods or philosophical methods. Each of these approaches offer many benefits, but each is also limited. Neurophenomenology capitalises on and integrates all three methods. We employed questionnaires from psychology, electroencephalography, electrocardiography, and functional near-infrared spectroscopy from neuroscience, and a phenomenological interview technique from philosophy. This neurophenomenological method enabled extensive insight in experiencers and non-experiencers of awe and wonder in a simulated space scenario that otherwise would not have been possible. Traditional empirical analyses were completed, followed by individual differences analyses using interview transcriptions paired with physiological responses. Experiencers of AW showed differences in theta and beta activity throughout the brain compared to non-experiencers. Questionnaires indicated that non-experiencers of AW gave more positive responses of religious and spiritual practices than experiencers of AW. Interviews showed that awe and wonder were more likely to occur when watching the simulated Earth view instead of the Deep Space view. Our study is a successful example of neurophenomenology, a powerful and promising interdisciplinary approach for future studies of complex states of experience. (shrink)

A substantial proportion of human embryos spontaneously abort soon after conception, and ethicists have argued this is problematic for the pro-life view that a human embryo has the same moral status as an adult from conception. Firstly, if human embryos are our moral equals, this entails spontaneous abortion is one of humanity’s most important problems, and it is claimed this is absurd, and a reductio of the moral status claim. Secondly, it is claimed that pro-life advocates do not act as (...) if spontaneous abortion is important, implying they are failing to fulfill their moral obligations. We report that the primary cause of spontaneous abortion is chromosomal defects, which are currently unpreventable, and show that as the other major cause of prenatal death is induced abortion, pro-life advocates can legitimately continue efforts to oppose it. We also defend the relevance of the killing and letting die distinction, which provides further justification for pro-life priorities. (shrink)

It is widely agreed that possession of consciousness contributes to an entity’s moral status, even if it is not necessary for moral status (Levy and Savulescu 2009). An entity is considered to have...

A child poverty rate of ten percent could mean that every tenth child is always poor, or that all children are in poverty for one month in every ten. Knowing where reality lies between these extremes is vital to understanding the problem facing many countries of poverty among the young. This unique study goes beyond the standard analysis of child poverty based on poverty rates at one point in time and documents how much movement into and out of poverty by (...) children there actually is, covering a range of industrialised countries - the USA, UK, Germany, Ireland, Spain, Hungary and Russia. Five main topics are addressed: conceptual and measurement issues associated with a dynamic view of child poverty; cross-national comparisons of child poverty rates and trends; cross-national comparisons of children's movements into and out of poverty; country-specific studies of child poverty dynamics; and the policy implications of taking a dynamic perspective. (shrink)

In his recent article Perry Hendricks presents what he calls the impairment argument to show that abortion is immoral. To do so, he argues that to give a fetus fetal alcohol syndrome is immoral. Because killing the fetus impairs it more than giving it fetal alcohol syndrome, Hendricks concludes that killing the fetus must also be immoral. Here, I claim that killing a fetus does not impair it in the way that giving it fetal alcohol syndrome does. By examining the (...) reason why giving a fetus this condition is wrong, I conclude that the same reasoning, on common pro‐choice accounts, does not apply to killing the fetus. Accordingly, Hendricks's argument does not succeed in showing abortion is immoral. (shrink)

Rob Lovering has developed an interesting new critique of views that regard embryos as equally valuable as other human beings: the moral argument for frozen human embryo adoption. The argument is aimed at those who believe that the death of a frozen embryo is a very bad thing, and Lovering concludes that some who hold this view ought to prevent one of these deaths by adopting and gestating a frozen embryo. Contra Lovering, we show that there are far more effective (...) strategies for preserving the lives of frozen embryos than adoption. Moreover, we point out that those who regard the deaths of frozen embryos as a very bad thing will generally regard the deaths of all embryos as a very bad thing, whether they are discarded embryos, aborted embryos or embryos that spontaneously abort. This entails these other embryos must be taken into account when considering moral obligations, as well as other human lives at risk from preventable causes. (shrink)

Ectogenesis, or the use of an artificial womb to allow a foetus to develop, will likely become a reality within a few decades, and could significantly affect the abortion debate. We first examine the implications for Judith Jarvis Thomson’s violinist analogy, which argues for a woman’s right to withdraw life support from the foetus and so terminate her pregnancy, even if the foetus is granted full moral status. We show that on Thomson’s reasoning, there is no right to the death (...) of the foetus, and abortion is not permissible if ectogenesis is available, provided it is safe and inexpensive. This raises the question of whether there are persuasive reasons for the right to the death of the foetus that could be exercised in the context of ectogenesis. Eric Mathison and Jeremy Davis have examined several arguments for this right, doubting that it exists, while Joona Räsänen has recently criticized their reasoning. We respond to Räsänen’s analysis, concluding that his arguments are unsuccessful, and that there is no right to the death of the foetus in these circumstances. (shrink)

Perry Hendricks has recently presented the impairment argument for the immorality of abortion, to which I responded and he has now replied. The argument is based on the premise that impairing a fetus with fetal alcohol syndrome is immoral, and on the principle that if impairing an organism is immoral, impairing it to a higher degree is also—the impairment principle. If abortion impairs a fetus to a higher degree, then this principle entails abortion is immoral. In my reply, I argued (...) that abortion does not impair an organism in the way fetal alcohol syndrome does, and showed that interest theorists can avoid the argument. Hendricks has responded to my criticisms by demonstrating how abortion does impair an organism. In this reply, I acknowledge Hendricks’ point, but proceed to criticise the application of the impairment principle to abortion, showing that it is invalid if we accept his explanation for why inflicting fetal alcohol syndrome is immoral. I also argue that counter-examples show the impairment principle itself to be dubitable, concluding that the impairment argument remains unpersuasive. (shrink)

In their target article, “Proposed Principles for International Bioethics Conferencing: Anti-Discriminatory, Global, and Inclusive,” Jecker et al. (2024) highlight the growing international scope o...

William Simkulet has recently criticised Colgrove et al’s defence against what they have called inconsistency arguments—arguments that claim opponents of abortion (OAs) act in ways inconsistent with their underlying beliefs about human fetuses (eg, that human fetuses are persons at conception). Colgrove et al presented three objections to inconsistency arguments, which Simkulet argues are unconvincing. Further, he maintains that OAs who hold that the fetus is a person at conception fail to act on important issues such as the plight of (...) frozen embryos, poverty and spontaneous abortion. Thus, they are morally negligent. In response, we argue that Simkulet has targeted a very narrow group of OAs, and so his criticisms are inapplicable to most OAs. We then explain why his responses to each of Colgrove et al’s objections do not succeed, even for this restricted group. Finally, we note that Simkulet fails to provide evidence for his claims regarding OAs’ supposed failures to act, and we show that OAs veritably do invest resources into these important issues. We conclude that Colgrove et al’s reasons for rejecting inconsistency arguments (en masse) remain intact. (shrink)

One of the most influential philosophical arguments in favour of the permissibility of abortion is Judith Jarvis Thomson’s violinist analogy, presented in ‘A Defense of Abortion’. Its appeal for pro-choice advocates lies in Thomson’s granting that the fetus is a person with equivalent moral status to any other human being, and yet demonstrating—to those who accept her reasoning—that abortion is still permissible. In her argument, Thomson draws heavily on the parable of the Good Samaritan, arguing that gestating a fetus in (...) some circumstances is what she calls a Good Samaritan act, and claiming that we are not morally required to be Good Samaritans. Here, I argue that Thomson has subverted the parable to justify an action that is the antithesis of its meaning. I contend that Christians are required to be Good Samaritans, and explain that for Christians, this entails abortion is impermissible in all circumstances. Further, I argue that the parable shows the fetus is our neighbour in need of our mercy and assistance, and consequently Christians should be actively involved in helping to ensure the unborn are protected, whether they are fetuses in danger of induced abortion or miscarriage, or surplus frozen embryos. (shrink)

The substance view is an account of personhood that regards all human beings as possessing instrinsic value and moral status equivalent to that of an adult human being. Consequently, substance view proponents typically regard abortion as impermissible in most circumstances. The substance view, however, has difficulty accounting for certain intuitions regarding the badness of death for embryos and fetuses, and the wrongness of killing them. Jeff McMahan’s time-relative interest account is designed to cater for such intuitions, and so I present (...) a proposal for strengthening the substance view by incorporating McMahan’s account – the Dual-Aspect Account of the morality of killing. I show that it resolves some important issues for the substance view while preserving its central premise of moral equality for all human beings. I then compare the Dual-Aspect Account with McMahan’s Two-Tiered Account of the morality of killing, which he derives from his time-relative interest account. (shrink)

In ’Abortion and deprivation: a reply to Marquis’, Anna Christensen contends that Don Marquis’ influential ’future like ours’ argument for the immorality of abortion faces a significant challenge from the Epicurean claim that human beings cannot be harmed by their death. If deprivation requires a subject, then abortion cannot deprive a fetus of a future of value, as no individual exists to be deprived once death has occurred. However, the Epicurean account also implies that the wrongness of murder is also (...) not grounded in the badness of death, which is strongly counterintuitive. There is an alternative: we can save our intuitions by adopting a more moderate Epicurean account such as that proposed by David Hershenov, who grounds the wrongness of killing in the prevention of the benefit of further good life rather than in the badness of death. Hershenov’s account, however, is equally applicable to Marquis’ argument: abortion similarly prevents a fetus from enjoying the benefit of a future like ours. Consequently, we conclude that Christensen’s criticism of Marquis’ argument fails to undermine his reasoning. (shrink)

Opponents of abortion are commonly said to be inconsistent in their beliefs or actions, and to fail in their obligations to prevent the deaths of embryos and fetuses from causes other than induced...

According to the psychological account of personal identity, our identity is based on the continuity of psychological connections, and so we do not begin to exist until these are possible, some months after conception. This entails the psychological account faces a challenge from the non-identity problem—our intuition that someone cannot be harmed by actions that are responsible for their existence, even if these actions seem clearly to cause them harm. It is usually discussed with regard to preconception harms, but in (...) the context of the psychological account, it is also applicable to prenatal harms. Inflicting prenatal injury is widely thought to be morally impermissible, but if the injury is identity-determining on the psychological account, then no-one seems to be harmed—rather, the injury is responsible for bringing them into existence. Here, I argue that identity-determining injuries can routinely occur on the psychological account, and that this undermines the account. I assess Nicola Williams’ proposal to salvage the account based on a trans-world account of personal identity, and show that it is unsuccessful. I then show that Jeff McMahan’s embodied mind account of personal identity is also susceptible. I conclude that identity-determining prenatal injuries pose a significant challenge for the psychological account and its variants, and provide a reason for supporting alternative accounts that fix personal identity at conception. (shrink)

Don Marquis’ future-like-ours account argues that abortion is seriously immoral because itdeprives the embryo or fetus of a valuable future much like our own. Marquis was mindful ofcontraception being reductio ad absurdum of his reasoning, and argued that prior tofertilisation, there is not an identifiable subject of harm. Contra Marquis, Tomer Chaffercontends that the ovum is a plausible subject of harm, and therefore contraception deprives theovum of a future-like-ours. In response, I argue that being an identifiable subject of harm is (...) notsufficient for Marquis’ argument to succeed. In addition, we must also share our identity withan ovum. I show that on the account of personal identity utilised by Marquis’ defenders, weare not identical with an ovum. As a result, Chaffer’s reductio fails. (shrink)

According to the psychological account of personal identity, our identity is based on the continuity of psychological connections, and so we do not begin to exist until these are possible, some months after conception. This entails the psychological account faces a challenge from the non-identity problem—our intuition that someone cannot be harmed by actions that are responsible for their existence, even if these actions seem clearly to cause them harm. It is usually discussed with regard to preconception harms, but in (...) the context of the psychological account, it is also applicable to prenatal harms. Inflicting prenatal injury is widely thought to be morally impermissible, but if the injury is identity-determining on the psychological account, then no-one seems to be harmed—rather, the injury is responsible for bringing them into existence. Here, I argue that identity-determining injuries can routinely occur on the psychological account, and that this undermines the account. I assess Nicola Williams’ proposal to salvage the account based on a trans-world account of personal identity, and show that it is unsuccessful. I then show that Jeff McMahan’s embodied mind account of personal identity is also susceptible. I conclude that identity-determining prenatal injuries pose a significant challenge for the psychological account and its variants, and provide a reason for supporting alternative accounts that fix personal identity at conception. (shrink)

Recently, the substance view of persons has been heavily criticized for the counterintuitive conclusions it seems to imply in scenarios such as embryo rescue cases and embryo loss. These criticisms...

Benjamin Zolf, in his recent paper ‘No conscientious objection without normative justification: Against conscientious objection in medicine’, attempts to establish that in order to rule out arbitrary conscientious objections, a reasonability constraint is necessary. This, he contends, requires normative justification, and the subjective beliefs that ground conscientious objections cannot easily be judged by normative criteria. Zolf shows that the alternative of using extrinsic criteria, such as requiring that unjustified harm must not be caused, are likewise grounded on normative criteria. He (...) concludes that conscientious objection is therefore untenable. Here, I present an alternative account, based on the value we are willing to place on conscientious objection as an expression of freedom of conscience and religion. Using an extrinsic criterion such as harm, we can make a judgement of what degree of harm should be tolerated as the cost of permitting conscientious objection. A normative criterion for judging individual claims is therefore not required. (shrink)

This article evaluates the effect of different human resource management (HRM) practices on organizations’ environmental performance. We develop a model to evaluate the influence of a broad range of HRM practices, including environmental performance criteria in managers’ performance evaluations and two types of internal corporate social responsibility (CSR) practices: socially responsible employee benefits and corporate volunteering practices. To this end, we analyze a sample of 142 manufacturing companies that have completed B Lab’s Impact Assessment process to certify their environmental performance. (...) The results show that including environmental criteria in a higher proportion of managers’ performance evaluations directly impacts organizations’ environmental performance and strengthens the positive effect of other environmental management practices. The findings also demonstrate the direct effects of both types of CSR practices on an organization’s environmental performance. Our study advances recent work on Green HRM and CSR by identifying the specific HRM practices that allow organizations to move from being part of the world’s environmental problem to being part of the solution. (shrink)