Palliative care is a recent branch of health care. The doctors, nurses, and other professionals involved in it took their inspiration from the medieval idea of the hospice, but have now extended their expertise to every area of health care: surgeries, nursing homes, acute wards, and the community. This has happened during a period when patients wish to take more control over their own lives and deaths, resources have become scarce, and technology has created controversial life-prolonging treatments. Palliative (...) care is therefore faced with more ethical problems that other areas of health care. This book, by a clinician, teacher, and writer on health care ethics, has been written to provide all those who care for the terminally ill--doctors, nurses, social workers, clergymen, physiotherapists--with the concepts and principles which will assist them with difficult decisions. It challenges many received doctrines of palliative care, but its well-illustrated central theme is that technical expertise must be controlled by humane, non-technical judgments. (shrink)

As palliative care develops across many of the countries of Europe, we find that it continues to raise important ethical challenges. Palliative care practice requires ethical sensitivity and understanding. At the same time the very existence of palliative care calls for ethical explanation. Ethics and palliative care meet over some vital issues: 'the good death', sedation at the end of life, requests for euthanasia, futile treatment, and the role of research. Yet (...) class='Hi'>palliative care appears uncertain about its goals and there is evidence that its ethical underpinnings are changing. Likewise, the moral problems of palliative care are only partly served by the four 'principles' of modern bioethics. This innovative book, with contributions by clinicians, ethicists, philosophers and social scientists, provides the first ever picture of palliative care ethics in the European context. It will be of interest to those involved in the delivery and management of palliative care services, as well as to students and researchers. (shrink)

It is a philosophy of patient care, and is therefore open to critique and evaluation.Using the Oxford Textbook of Palliative Medicine Third Edition as their ...

In Morality and Ethics of War, which includes a foreword by Major General Susan Coyle, ethicist Deane-Peter Baker goes beyond existing treatments of military ethics to address a fundamental problem: the yawning gap that exists between the diverse moral frameworks defining personal identity in a multicultural society on the one hand, and the professional military ethic on the other. Baker argues that overcoming this chasm is essential to minimising the ethical risks that can lead to operational and strategic (...) failure for military forces engaged in today's complex conflict environment. He contends that spanning the gap is vital in preventing moral injury from befalling the nation's uniformed servants. Drawing on a revised account of what he calls 'the Just War Continuum', Baker develops a bridging framework that combines conceptual clarity and rigour with insights from cutting edge psychological research and creates a practical means for military leaders to negotiate the moral chasm in military affairs. (shrink)

This book considers coercion within the healing and ethical framework of therapeutic relationships and partnerships at all levels, and addresses the universal ...

This interdisciplinary collection presents valuable discourse and reflection on the nature of a good death. Bringing together a leading judge and other legal scholars, philosophers, social scientists, practitioners and parents who present varying accounts of a good death, the chapters draw from personal experience as well as policy, practice and academic analysis.Covering themes such as patients' rights to determine their own good death, considering their best interests when communication becomes difficult and the role and responsibilities of health professionals, the book (...) outlines how ethical healthcare might be achieved when dealing with assisted suicide by organizations and how end of life services in general might be improved. It will be of interest to students and academics working the area of medical law and ethics as well as health professionals and policy-makers. (shrink)

Making particular use of Shale’s analysis, this paper discusses the notion of leadership in the context of palliative medicine. Whilst offering a critical perspective, I build on the philosophy of palliative care offered by Randall and Downie and suggest that the normative structure of this medical speciality has certain distinctive features, particularly when compared to that of medicine more generally. I discuss this in terms of palliative medicine’s distinctive morality or ethos, albeit one that should still be (...) seen in terms of medical morality or the ethos of medicine. I argue that, in the context of multi-disciplinary teamwork, the particular ethos of palliative medicine means that healthcare professionals who work within this speciality are presented with distinct opportunities for leadership and the dissemination of the moral and ethical norms that guide their practice. I expand on the nature of this opportunity by further engaging with Shale’s work on leadership in medicine, and by more fully articulating the notion of moral ethos in medicine and its relation to the more formal notion of medical ethics. Finally, and with reference to the idea of medical education as both on going and as an apprenticeship, I suggest that moral and ethical leadership in palliative medicine may have an inherently educational quality and a distinctively pedagogical dimension. The nature of palliative medicine is such that it often involves caring for patients who are still receiving treatment from other specialists. Whilst this can create tension, it also provides an opportunity for palliative care professionals to disseminate the philosophy that underpins their practice, and to offer leadership with regard to the moral and ethical challenges that arise in the context of End of Life Care. (shrink)

To fulfill their crucial duty of relieving suffering in their patients, physicians may have to administer palliative sedation when they implement treatment-limitation decisions such as the withdrawal of life-supporting interventions in patients with poor prognosis chronic severe brain injury. The issue of palliative sedation deserves particular attention in adults with serious brain injuries and in neonates with severe and irreversible brain lesions, who are unable to express pain or to state their wishes. In France, treatment limitation (...) decisions for these patients are left to the physicians. Treatment-limitation decisions are made collegially, based on the presence of irreversible brain lesions responsible for chronic severe disorders of consciousness. Before these decisions are implemented, they are communicated to the relatives. Because the presence and severity of pain cannot be assessed in these patients, palliative analgesia and/or sedation should be administered. However, palliative sedation is a complex strategy that requires safeguards to prevent a drift toward hastening death or performing covert euthanasia. In addition to the law on patients' rights at the end of life passed in France on April 22, 2005, a recent revision of Article 37 of the French code of medical ethics both acknowledges that treatment-limitation decisions and palliative sedation may be required in patients with severe brain injuries and provides legal and ethical safeguards against a shift towards euthanasia. This legislation may hold value as a model for other countries where euthanasia is illegal and for countries such as Belgium and Netherlands where euthanasia is legal but not allowed in patients incapable of asking for euthanasia but in whom a treatment limitation decision has been made. (shrink)

BackgroundDuring a commercial surrogacy arrangement, the event of embryo transfer can be seen as the formal starting point of the arrangement. However, it is common for surrogates to undergo a failed attempt at pregnancy conception or missed conception after an embryo transfer. This paper attempts to argue that such failed attempts can be understood as a loss. It aims to reconstruct the experiences of loss and grief of the surrogates and the intended parents as a consequence of their collective failure (...) to conceive a surrogate pregnancy.MethodsDrawing on a qualitative study conducted over a period of eight months between 2014 and 2015 at two fertility clinics in Delhi and two in Kolkata, India, this paper examines the experiences of the surrogates and the intended parents when faced with missed conceptions or failed conceptions during a surrogacy arrangement.ResultsWe argue that while the surrogate grieves the non-arrival of a ‘good news’ as an uncertain loss, the intended parents experience yet another, failure in addition to the losses they might have incurred during their previous fertility treatments. The body of the surrogate becomes a site of ‘a lost opportunity’. The surrogate embodies a loss in her quest to achieve social mobility and the intended parents experience a disembodied pregnancy loss. This very emotional experience stands in stark contrast to the conceptualisation of such failed attempts as non-events within the discourse of the surrogacy industry. The experience of loss of the intended parents is recognised but their grief is given no space. We argue that such ambiguity around the nature of losses resulting out of a missed or failed conception during surrogacy is an outcome of lack of interpersonal relationship between the surrogate and the intended parents.ConclusionsSince commercial surrogacy is a relational process, the only way in which the experiences of losses and failures of the actors at the preconception stage can be better addressed is through developing close sharing and understanding between each other through an ethics of care. Therefore, to nurture caring relationships, surrogacy needs to be understood as a moral commitment by –the surrogates and intended parents. To enable such a commitment, there is a need to reconsider the pre-defined and legally regulated professional duty of the doctors, agents and agencies. It cannot be a one-sided commitment, but has to have elements of mutuality. (shrink)

Resource added for the Nursing-Associate Degree 105431, Practical Nursing 315431, and Nursing Assistant 305431 programs.

Das Sterben wird längst nicht mehr verdrängt und verschwiegen, es gehört vielmehr zu den ausgiebig erörterten Themen unserer Zeit. Viele Debatten ranken sich um Sterbehilfe und um die Frage, was einen guten Tod ausmacht. Dabei scheinen wir uns bemerkenswert einig zu sein, dass gut stirbt, wer bis zuletzt er oder sie selbst bleibt. Wir wünschen uns, so die These dieses Buches, unseren 'eigenen Tod': ein Lebensende, wie es uns entspricht, ein authentisches Sterben. Dieses Ideal leitet in unterschiedlicher Weise die Palliativversorgung (...) und die Sterbehilfebewegung an. Doch Nina Streeck zeigt, dass sich das, was so erstrebenswert klingt, als anspruchsvoll entpuppt. Die Idee des 'eigenen Todes' droht sich in ihr Gegenteil zu verkehren: in einen Zwang zum authentischen Sterben."--Page 4 of cover. (shrink)

This guide accompanies the following article: Matthew Kieran, ‘Art, Morality and Ethics: On the (Im)moral Character of Art Works and Inter‐Relations to Artistic Value’. Philosophy Compass 1/2 (2006): pp. 129–143, doi: 10.1111/j.1747‐9991.2006.00019.x Author’s Introduction Up until fairly recently it was philosophical orthodoxy – at least within analytic aesthetics broadly construed – to hold that the appreciation and evaluation of works as art and moral considerations pertaining to them are conceptually distinct. However, following on from the idea that artistic (...) value is broader than aesthetic value, the last 15 years has seen an explosion of interest in exploring possible inter‐relations between the appreciative and ethical character of works as art. Consideration of these issues has a distinguished philosophical history but as the Compass survey article suggests (‘Art, Morality and Ethics: On the (Im)Moral Character of Art Works and Inter‐Relations to Artistic Value.’Philosophy Compass 1.2 (2006): 129–43), it is only very recently that figures in the field have returned to it to develop more precisely what they take the relationships to be and why. Consensus is, unsurprisingly, lacking. The reinvigoration of the issues has led sophisticated formalists or autonomists to mount a more considered defence of the idea that aesthetic and literary values are indeed conceptually distinct from the justification or otherwise of the moral perspective or views endorsed in a work (Topic I). The challenges presented by such a defence are many but amongst them are appeals to critical practice (Lamarque and Olsen), scepticism about whether or not art really can give us bona fide knowledge (Stolnitz) and the recognition that truth often seems to be far removed from what it is we value in our appreciation of works (Lamarque). One way to motivate consideration of the relevance of a work’s moral character to its artistic value concerns the phenomena of imaginative resistance. At least sometimes it would seem that, as Hume originally suggested, we either cannot or will not enter imaginatively into the perspective solicited by a work due to its morally problematic character (Topic II). In some cases, it would seem that as a matter of psychological fact, we cannot do so since it is impossible for us to imagine how it could be that a certain attitude or action is morally permissible or good (Walton). The question then is whether or not this is a function of morality in particular or constraints on imaginative possibility more generally and what else is involved. At other times, the phenomena seem to be driven by a moral reluctance to allow ourselves to enter into the dramatic perspective involved (Moran) or evaluation of the attitude expressed (Stokes). Nonetheless, it is far from obvious that this is so of all the attitudes or responses we judge to be morally problematic. After all, it looks like we can and indeed often do suspend or background particular cognitive and moral commitments in engaging with all sorts of works (Nichols and Weinberg). If the moral character of a work interacts with how we appreciate and evaluate them, then the pressing question is this: is there any systematic account of the relationship available to us? One way is to consider the relationship between our emotional responses to works and their moral character (Topic III). After all, art works often solicit various emotional responses from us to follow the work and make use of moral concepts in so doing (Carroll). Indeed, whether or not a work merits the sought for emotional responses often seems to be internally related to ethical considerations (Gaut). Yet, it is not obvious that we should apply our moral concepts or respond emotionally in our imaginative engagement with works as art as we should in real life (Kieran, Jacobson). A different route is via the thought that art can convey knowledge (Topic IV). There might be particular kinds of moral knowledge art distinctively suited to conveying (Nussbaum) or it may just be that art does so particularly effectively (Carroll, Gaut, Kieran). Either way where this can be tied to the artistic means and appreciation of a work it would seem that to cultivate moral understanding contributes to the value of a work and to betray misunderstanding is a defect. Without denying the relevance of the moral character of a work some authors have wanted to claim that sometimes the immoral aspect of a work can contribute to rather than lessen its artistic value (Topic V). One route is to claim that there is no systematic theoretical account of the relationship available and what the right thing to say is depends on the particular case involved (Jacobson). Another involves the claim that this is so when the defect connects up in an appropriate way to one of the values of art. Thus, it has been claimed, only where a work reveals something which adds to intelligibility, knowledge or understanding in virtue of its morally problematic aspect can this be so (Kieran). The latter position looks like it could in principle be held whilst nonetheless maintaining that the typical or standard relationship is as the moralists would have it. Yet perhaps allowing valence change for such reasons is less a mark of principled explanation and more a function of downright inconsistency or incoherence (Harold). The topics themselves and suggested readings given below follow the structure articulated above as further amplified in the Compass survey article. The design and structure given below can be easily compressed or expanded further. Author Recommends 1 Carroll, Noël. ‘Art, Narrative and Moral Understanding.’Aesthetics and Ethics: Essay at the Intersection. Ed. Jerrold Levinson. Cambridge: Cambridge UP, 1998. 126–60. 2 This article develops the idea that engaging with narrative art calls on moral concepts and emotions and can thereby clarify our moral understanding. 2 Carroll, Noël. Beyond Aesthetics: Philosophical Essays. Cambridge: Cambridge UP, 2009. 4 Part IV consists of six distinct essays on questions concerning the inter‐relations between art and morality including the essay cited above and the author’s articulation and defence of moderate moralism. 3 Gaut, Berys. ‘The Ethical Criticism of Art.’Aesthetics and Ethics: Essay at the Intersection. Ed. Jerrold Levinson. Cambridge: Cambridge UP, 1998. 182–203. 4 Gaut, Berys. Art, Emotion and Ethics. Oxford: Oxford UP, 2007. 7 This monograph provides the most exhaustive treatment of the issues and defends the claim that, where relevant, whenever a work is morally flawed it is of lesser value as art and wherever it is morally virtuous the work’s value as art is enhanced. Chapters 7 and 8 defend concern ethical knowledge and chapter 10 is a development of the article cited above concerning emotional responses. Chapter 3 also gives a useful conceptual map of the issues and options in the debate. 5 Jacobson, Daniel. ‘In Praise of Immoral Art.’Philosophical Topics 25 (1997): 155–99. 9 A wide ranging and extended treatment of relevant issues which objects to generalising moral treatments of our responses to art works and defends the idea that particular works can be better because of rather than despite their moral defects. 6 Kieran, Matthew. ‘Forbidden Knowledge: The Challenge of Cognitive Immoralism.’Art and Morality. Ed. Sebastian Gardner and José Luis Bermúdez. London: Routledge, 2003. 56–73. 11 A general argument for immoralism is elaborated by outlining when, where and why a work’s morally problematic character can contribute to its artistic value for principled reasons (through enhancing moral understanding). 7 Kieran, Matthew. Revealing Art. London: Routledge, 2005. Chapter 4. 13 This chapter argues against both aestheticism and straightforward moralism about art, elaborating a defence of immoralism in relation to visual art whilst ranging over issues from pornographic art to the nature and demands of different genres in art. 8 Lamarque, Peter. ‘Cognitive Values in the Arts: Marking the Boundaries.’ Contemporary Debates in Aesthetics and the Philosophy of Art. Ed. Matthew Kieran. Oxford: Blackwell, 2006, 127–39. 15 This article concisely outlines and defends a sophisticated aestheticism that denies the importance of truth to artistic value. 9 Stolnitz, Jerome. ‘On the Cognitive Triviality of Art.’British Journal of Aesthetics 32.3 (1992): 191–200. 17 This article articulates and defends the claim that no knowledge of any interesting or significant kind can be afforded by works appreciated and evaluated as art. 10 Walton, Kendall. ‘Morals in Fiction and Fictional Morality, I.’Proceedings of the Aristotelian Society, Suppl. 68 (1994): 27–51. 19 This article builds on some comments from Hume to develop the idea that when engaging with fictions it seems impossible imaginatively to enter into radically deviant moral attitudes. Online Materials ‘Aesthetics and Ethics: The State of the Art.’American Society of Aesthetics online (Jeffrey Dean):. ‘Art, Censorship and Morality’ downloadable podcast of Nigel Warburton interviewing Matthew Kieran at Tate Britain (BBC/ou Open2.net as part of the Ethics Bites series):. ‘Art, Morality and Ethics: On the (Im)Moral Character of Art Works and Inter‐Relations to Artistic Value.’Philosophy Compass 1.2 (2006): 129–43 (Matthew Kieran):. ‘Ethical Criticism of Art.’Internet Encyclopedia of Philosophy (Ella Peek):. ‘Fascinating Fascism.’New York Review of Books Piece Discussing Leni Riefenstahl (Susan Sontag):. ‘The Beheading of St. John the Baptist (1450s), Giovanni de Paolo’ (Tom Lubbock):. Vladimir Nabokov and Lionel Trilling discuss Lolita (CBS):. Sample Syllabus Topic I Autonomism/aestheticism • Anderson, James C. and Jeffrey T. Dean. ‘Moderate Autonomism.’British Journal of Aesthetics 38.2 (1998): 150–66. • Beardsley, Monroe. Aesthetics: Problems in the Philosophy of Criticism. New York: Harcourt, Brace and World, 1958. Chapter 12. • Kant, Immanuel. The Critique of Judgement.Trans. James Creed Meredith. Oxford: Oxford UP, 1952 [1790]. • Lamarque, Peter. ‘Cognitive Values in the Arts: Marking the Boundaries.’Contemporary Debates in Aesthetics and the Philosophy of Art. Ed. Matthew Kieran. Oxford: Blackwell, 2006, 127–39. • ——. ‘Tragedy and Moral Value.’Australasian Journal of Philosophy 73.2 (1995): 239–49. • Lamarque, Peter and Stein Olsen. Truth, Fiction and Literature. Oxford: Clarendon Press, 1994. Chapter 10. • Stolnitz, Jerome. ‘On the Cognitive Triviality of Art.’British Journal of Aesthetics 32.3 (1992): 191–200. Topic II Imaginative Capacities, Intelligibility and Resistance • Moran, Richard. ‘The Expression of Feeling in Imagination.’Philosophical Review 103.1 (1994): 75–106. • Nichols, Shaun. ‘Just the Imagination: Why Imagining Doesn’t Behave Like Believing’. Mind & Language 21.4 (2006): 459–74. • Stokes, Dustin. ‘The Evaluative Character of Imaginative Resistance’. British Journal of Aesthetics 46.4 (2006): 387–405. • Tanner, Michael. ‘Morals in Fiction and Fictional Morality, II’. Proceedings of the Aristotelian Society, Suppl. Vol. 68 (1994): 51–66. • Walton, Kendall (1994). ‘Morals in Fiction and Fictional Morality, I’. Proceedings of the Aristotelian Society, Suppl. Vol. 68 (1994): 27–51. • Weinberg, Jonathan. ‘Configuring the Cognitive Imagination.’New Waves in Aesthetics. Eds. K. Stock and K. Thomson‐Jones. London: Palgrave Macmillan, 2008. 203–23. Topic III Moralism and Emotions • Carroll, Noël. ‘Moderate Moralism.’British Journal of Aesthetics 36.3 (1996): 223–37. • Carroll, Noël. ‘Art, Narrative and Moral Understanding.’Aesthetics and Ethics: Essay at the Intersection. Ed. Jerrold Levinson. Cambridge: Cambridge UP, 1998.126–60. • Gaut, Berys. Art, Emotion and Ethics. Oxford: Oxford UP, 2007. Chapter 10. • ——. ‘The Ethical Criticism of Art.’Aesthetics and Ethics: Essay at the Intersection. Ed. Jerrold Levinson. Cambridge: Cambridge UP, 1998. 182–203. • Hume, David. ‘Of the Standard of Taste.’Selected Essays. Oxford: Oxford UP, 1993 [1757]. 133–53. • Kieran, Matthew. ‘Emotions, Art and Immorality.’Oxford Handbook to the Philosophy of Emotions. Ed. Peter Goldie. Oxford: Oxford UP, 2009. 681–703. • Tolstoy, Leo. What is Art?. London: Penguin, 2004. Chapters 5 and 15. Topic IV Moralism and Knowledge • Aristotle. Poetics. Trans. M. Heath. London: Penguin, 1996 [367–322 BC]. • Carroll, Noël. ‘The Wheel of Virtue: Art, Literature and Moral Knowledge.’Journal of Aesthetics and Art Criticism 60.1 (2002): 3–26. • Gaut, Berys. Art, Emotion and Ethics. Oxford: Oxford UP, 2007. Chapters 7 and 8. • Gaut, Berys. ‘Art and Cognition.’Contemporary Debates in Aesthetics and the Philosophy of Art. Ed. Matthew Kieran. Oxford: Blackwell, 2006. 115–26. • Kieran, Matthew. ‘Art, Imagination and the Cultivation of Morals.’Journal of Aesthetics and Art Criticism 54.4 (1996): 337–51. • Nussbaum, Martha. ‘Finely Aware and Richly Responsible: Literature and the Moral Imagination.’Love’s Knowledge. New York: Oxford UP, 1990. 148–68. • Plato. The Republic. Trans. D. Lee. Harmondsworth: Penguin, 1974. Book 10. Topic V Immoralist Contextualism • Harold, James. ‘Immoralism and the Valence Constraint.’British Journal of Aesthetics 48.1 (2008): 45–64. • Jacobson, Daniel. ‘In Praise of Immoral Art.’Philosophical Topics 25 (1997): 155–99. • ——. ‘Ethical Criticism and the Vices of Moderation.’Contemporary Debates in Aesthetics and the Philosophy of Art. Ed. Matthew Kieran. Oxford: Blackwell, 2006. 342–55. • John, Eileen. ‘Artistic Value and Moral Opportunism.’Contemporary Debates in Aesthetics and the Philosophy of Art. Ed. Matthew Kieran. Oxford: Blackwell, 2006. 331–41. • Kieran, Matthew. ‘Forbidden Knowledge:The Challenge of Cognitive Immoralism.’Art and Morality. Ed. Sebastian Gardner and José Luis Bermúdez. London: Routledge, 2003. 56–73. • Kieran, Matthew. Revealing Art. London: Routledge, 2005. Chapter 4. • Patridge, Stephanie. ‘Moral Vices as Artistic Virtues: Eugene Onegin and Alice.’Philosophia 36.2 (2008): 181–93. Focus Questions 1 What is the strongest argument for the claim that the moral character of a work is not relevant to its artistic value? Does artistic or literary criticism tend to concern itself with the truth or morality of works? If so, in what ways? If not, why do you think this is? 2 What different explanations might there be for difficulty with or resistance to imaginatively entering into attitudes you take to be immoral? How might this relate to the way our imaginings work as contrasted with belief? How might different literary or artistic treatments of the same subject matter make a difference? 3 How do narrative works draw on our moral concepts and responses? Can we suspend our normal moral commitments or application of moral concepts in responding emotionally to art works? Should we respond emotionally to art works as we ought to respond to real world events we witness? Why? Why not? 4 How, if at all, do art works convey moral understanding? How, if at all, is this related to the kinds of moral knowledge art works can teach or reveal to us? When, where and why might this be tied to the artistic value of a work? How can we tell where a work enhances our moral understanding as opposed to misleading or distorting it? 5 What art works do you value overall as art which commend or endorse moral values and attitudes that you do not? Is appreciation of them always marred or lessened by the morally dubious aspect? If not, what explains the differences in evaluation? What, if anything, might you learn by engaging with works which endorse moral attitudes or apply moral concepts different from those you take to be justified? How, if at all, might this connect up with what makes them valuable as art? (shrink)

Introduction: Decisions to withdraw or withhold curative or life-sustaining treatment can have a huge impact on the symptoms which the palliative-care team has to control. Palliative-care patients and their relatives may also turn to palliative-care physicians and nurses for advice regarding these treatments. We wanted to assess Indian palliative-care nurses and physicians’ attitudes towards withholding and withdrawal of curative or life-sustaining treatment. Method: From May to September 2008, we interviewed 14 physicians and 13 nurses (...) working in different palliative-care programmes in New Delhi, using a semi-structured questionnaire. For the interviews and analysis of the data we followed Grounded-Theory methodology. Results: Withholding a curative or life-sustaining treatment which may prolong a terminal cancer patient’s life with a few weeks but also has severe side-effects was generally considered acceptable by the interviewees. The majority of the interviewees agreed that life-sustaining treatments can be withdrawn in a patient who is in an irreversible coma. The palliative-care physicians and nurses were of the opinion that a patient has the right to refuse life-saving curative treatment. While reflecting upon the ethical acceptability of withholding or withdrawal of curative or life-sustaining treatment, the physicians and nurses were concerned about the whole patient and other people who may be affected by the decision. They were convinced they can play an important advisory role in the decision-making process. Conclusion: While deciding about the ethical issues, the physicians and nurses do not restrict their considerations to the physical aspects of the disease, but also reflect upon the complex wider consequences of the treatment decisions. (shrink)

Wish to die statements are becoming a frequent phenomenon in terminally ill patients. Those confronted by these statments need to understand the complexity of such wishes, so they can respond competently and compassionately to the requests. If misunderstood, the statements can be taken at face-value and the practitioner may not recognise that a patient is in fact experiencing ambivalent feelings at the end of life, or they may misinterpret the expressed wish to die as a sign of clinical depression. Public (...) debate about the morality and ethics of various end-of-life care options has exploded in recent years. However, it has never been sensitive to the finer aspects of clinical reality or the experiences of patients. The Patient's Wish to Die: Research, Ethics, and Palliative Care brings together that reality and the patient's voice, combining them with different research approaches. It presents the best available knowledge and research methodologies about patients' wishes at the end-of-life, together with a series of ethical views and a discussion about the clinical implications for palliative care. The book presents material in an open and unbiased manner whilst remaining sensitive to the spiritual and existential dimensions of dying, and to the different cultural views that provide meaning to the individual. Written by the best specialists and ethics scholars from around the world, including palliative care practitioners and end-of-life scholars from countries where assisted dying practices are legalized and from those where it isn't, The The Patient's Wish to Die: Research, Ethics, and Palliative Care will prove essential reading for all those working or studying in the field of palliative care. (shrink)

The article considers the issues of modern German political philosophy in accordance with its formation, institutionalization and development. Germany’s political philosophy is analyzed in terms of its interaction with social and practical philosophy. The text states that political philoso- phy belongs to both social philosophy and political science. As a political theory, it is a compo- nent of social theories institutionalized in the modern era. As a political philosophy, it appears as a metatheory of political theory. Political philosophy is also (...) part of practical philosophy, exploring the problems of interaction between ethics and politics and the moral reclamation of the political system of modern society. These issues are themed in the context of the institution- alization of this discipline in the early twentieth century, its transformation into a political reli- gion during National Socialism, the revival after World War II, as well as actualization in such areas of socio-humanitarian sciences as discourse philosophy, functional-system theory of so- ciety, etc. according to the political situation of modern Germany. (shrink)

In clinical practice, modern medicine, especially intensive medicine, has made outstanding technological progress that has changed diagnostic and therapeutic paradigms. Nowadays, some patients for whom there were no treatments in the past not only survive but return to active life thanks to intensive medicine. However, in some cases intensive care will not help patients in a critical condition and merely prolong death. In such situations, the treatment is terminated or not extended, and the patient is allowed to die in (...) dignity. In this specific situation all intensive procedures are terminated. Palliative care is the next stage. This is a sensitive issue that should be discussed with healthcare professionals and experts from other areas of life to ensure it is communicated appropriately to patients and their relatives. (shrink)

On the powerful qualities view, every fundamental property is both dispositional and qualitative. Identity theory is the standard account of the view, which makes the stronger claim that a property’s dispositionality and qualitativity are identical to each other, and identical to the property itself. Recent defences of the powerful qualities view have involved novel theories of powerful qualities which are not also variants of identity theory. Giannotti (Erkenntnis 86:603–621, 2021a) has suggested a novel theory of his own, the dual aspect (...) account, which makes use of a particular notion of aspects. For Giannotti, dispositionality and qualitativity are each an aspect of a property, and an aspect is a property’s way of being. The importance of aspects is twofold. Firstly, by introducing aspects to identity theory, the theory becomes more precise. Secondly, aspects allow for a novel theory of powerful qualities, the dual aspect account, which maintains that dispositionality and qualitativity are aspects, but rejects the identity claim. Giannotti’s aim is to show that even if identity theory is false, the dual aspect account remains an available theory for advocates of powerful qualities. This paper will be a critical examination of Giannotti’s ideas. Firstly, I will clarify Giannotti’s notion of aspects, explaining how it involves a misunderstanding of supervenience, and why it does not offer the advantages that he claims it does. Secondly, in light of my discussion of aspects, I will argue that the dual aspect account lacks relative advantages over the compound view of powerful qualities. (shrink)

Que signifie " mourir dans la dignité "? La dignité est-elle affaire de convenance personnelle? Doit-il y avoir une " exception d'euthanasie "? À quoi servent les soins palliatifs? La philosophie nous apprend-elle quelque chose sur la mort? Telles sont les principales questions, d'une actualité brûlante pour la plupart, auxquelles ce recueil apporte quelques éléments de réponse. L'auteur chemine en compagnie d'Epicure, de Kierkegaard, Levinas et bien d'autres. Qu'il analyse un avis du Comité national d'éthique ou expose la pensée de (...) Jankélévitch, son propos reste accessible à " l'honnête homme ". Et prodigue une réflexion éclairée sur " l'impensable " de la mort. (shrink)

Introduction to ABA, ethics, and core ethical principles -- Contextual factors that influence ethical decision-making -- Creating behavioral systems to support ethical behavior in autism treatment -- Identifying your scope of competence in autism treatment -- The decision-making process of evidence-based practice -- Interdisciplinary collaboration -- Common errors and mistakes made during ethical analyses and application.

Effective palliative care that rests on a sound ethical foundation requires ongoing discussions about patient and family values and preferences. This is especially important when addressing care at end-of-life including artificial nutrition and hydration, withdrawal of life-sustaining therapies and palliative sedation as well as requests for assistance in hastening death. The eighth volume in the HPNA Palliative Nursing Manuals series, Legal and Ethical Aspects of Palliative Care, provides an overview of critical communication skills (...) and formal organizational mechanisms, such as ethics committees and interdisciplinary rounds, required for decisions in ethical dilemmas which respect diversity in the views of colleagues, as well as patients. The content of the concise, clinically focused volumes in the HPNA Palliative Nursing Manuals series is one resource for nurses preparing for specialty certification exams and provides a quick-reference in daily practice. (shrink)

This book offers an in-depth analysis of the wide range of issues surrounding "passive euthanasia" and "allow-to-die" decisions. The author develops a comprehensive conceptual model that is highly useful for assessing and dealing with real-life situations. He presents an informative historical overview, an evaluation of the clinical settings in which treatment abatement takes place, and an insightful discussion of relevant legal aspects. The result is a clearly articulated ethical analysis that is medically realistic, philosophically sound, and legally (...) viable. (shrink)

Objectives To determine the frequencies and types of limitation of medical treatment performed by physician members of the German Society for Palliative Medicine and to analyse the findings with respect to clinical and ethical aspects of end-of-life practices. Design Cross-sectional postal survey. Setting Data collection via the secretary of the German Society for Palliative Medicine using the German language version of the EURELD survey instrument. Subjects All 1645 physician members of the German Society for (...) class='Hi'>Palliative Medicine. Main outcome measures Types and frequencies of limitation of treatment and possible determinants. Results 901 physicians participated in the study (response rate 55.8%). Participants reported limitation of treatment in 69.1% of cases. These decisions most often affected artificial nutrition (19%), chemotherapy (14%), antibiotics (11%) and medication other than antibiotics (11%). In the majority of eligible cases, physicians estimated the life-shortening effect of limitation of treatment to be <7 days. However, estimations differ depending on the medical measures in question. Bivariate statistical analysis indicated that withholding of treatment was performed significantly more frequently for patients aged ≥65 years (p=0.019). In addition, there were significant associations between the incidence of limitation of treatment and the different diseases reported by respondents as the underlying cause of death. Conclusion The findings of this study provide information on the current state of an ethically and clinically challenging aspect of clinical practice and can serve as a starting point for further interdisciplinary research on normative and empirical aspects of treatment decision-making at the end of life. (shrink)

Patients with advanced dementia are less likely than those with other terminal illnesses to receive palliative care. Due to the nature and course of dementia, there may be a failure to recognize the terminal stage of the disease. A possible and under-investigated explanation for this healthcare disparity is the healthcare practitioner who plays a primary role in end-of-life decision-making. Two potential areas that might impact provider decision-making are cognitive biases and moral considerations. In this analysis, we demonstrate how (...) the cognitive biases and moral considerations of practitioners related to clinical decision-making are inherent in clinical practice and may impact on providers’ accuracy related to diagnostic and treatment related decision-making associated with patients with advanced dementia. Anchoring, default, availability, representativeness and framing biases are cognitive biases based on the "Two System Model" that relate to decision-making in end-of-life care. In patients with advanced dementia, those biases may result in a tendency to adhere to traditional mandatory care, involving an aggressive approach to care, which values saving lives at all costs, without taking into account the possible suffering and long-term consequences. Aspects such as moral sensitivity and moral courage play an important role in ethical decision-making related to advanced dementia. Investigations of clinical decision-making that include the cognitive biases and ethical considerations of practitioners might advance the comprehensive understanding of the clinical decision-making process related to care of patients with advanced dementia and promote the quality of care given to this population. (shrink)

Los cuidados paliativos deben manejar los diferentes problemas que los pacientes y las familias pueden tener al final de la vida. La sedación es una maniobra terapéutica utilizada con cierta frecuencia en cuidados paliativos y constituye una buena práctica médica cuando está bien indicada; sin embargo, presenta el riesgo de conculcar algunos principios éticos. Los principios de beneficencia y autonomía son posiblemente los principios éticos mayormente afectados cuando se considera la sedación. Se deben cumplir los siguientes requisitos: síntoma refractario, enfermedad (...) terminal y consentimiento, y en lo posible estar avalada por una segunda opinión médica. La sedación paliativa no es eutanasia y las diferencias están en el objetivo, el proceso y el resultado. En el presente trabajo se discuten algunos de los aspectos para prevenir la conculcación de los principios éticos, asimismo se proporcionan algunas sugerencias para ayudar en la toma de decisiones. Palliative care to the different problems encountered by patients and their families at the end of life. Sedation is a therapeutic manoeuvre frequently used in palliative medicine, that could eventually infringe some ethical principles. From our standpoint, beneficence and autonomy are probably the most affected principles when sedation is considered. The following conditions are required in order for it to be applied: refractory symptom, terminal illness and consent, and as long as possible, the decision must be supported by a second medical opinion Palliative sedation is different from euthanasia, and the differences lie in the objective, the pro- cess and the result. Some measures to prevent such violations to occur are discussed, and suggestions intended to guide in decision making are proposed. (shrink)

A central theme of Kant’s approach to moral philosophy is that moral obligations are categorical, by which he means that they provide supremely authoritative reasons for acting independently of an agent’s ends or interests. Kant argues that this is a reflection of our distinctive freedom or autonomy, as he calls it, as moral agents. A less, well- appreciated aspect of the Kantian picture of morality and respect for the dignity of each individual person is the idea of (...) reciprocal accountability, that moral agents are mutually responsible for their treatment of one another. Viewing Kant’s ethics from this second-person standpoint opens up a line of thought that promises to vindicate the Kantian idea that moral obligations are categorical imperatives. (shrink)

A lot of interest has been generated by the possibility of deriving gametes from embryonic stem cells and bone marrow stem cells. These stem cell derived gametes may become useful for research and for the treatment of infertility. In this article we consider prospectively the ethical issues that will arise if stem cell derived gametes are used in the clinic, making a distinction between concerns that only apply to embryonic stem cell derived gametes and concerns that are also (...) relevant for gametes derived from adult stem cells. At present, it appears preferable to use non-embryonic stem cells for the derivation of gametes. Adult stem cell derived gametes do not present any problems with regard to the moral status of the human embryo, bypass the safety risks linked to SCNT and do not present any ambiguity or novel problems with regard to informed consent, psychological consequences for the child or genetic parenthood. A remaining ethical concern, however, regards the safety of the procedure in terms of the welfare of the resulting children. This should spark a thorough reflection on how far one must go to accommodate a person’s wish to have a genetically related child. (shrink)

This informative and entertaining study addresses ethical considerations for deceptive works and proposes cataloging solutions that are provocative and designed to spark debate. An extensive annotated bibliography describes books that are not what they seem.

This book explores an undeveloped area in postmodern thought: organizational ethics. Ethical debates and analyses usually focus on a particular act or action, an actor, and/or how a secular society should address any of those particular persons or events. In the Post Modern age, ethical decisions and policies are characterized by moral and cultural pluralism. However, there is a second factor that complicates ethical and policy decisions even further. This book argues that in the postmodern age (...) ethical decisions often need to be understood as part of the decision making of organizations and bureaucracies. Organizational decisions often have direct bearing on the choices made by individuals. Two areas that exemplify postmodern issue are the areas of health care and education. For example the decision making of Admissions Officers in American higher education, are influenced by decisions that have been made by the university about the size of the class and the diversity of the class. Health Care organizations make policy decisions that affect every aspect of a patient’s care from admission to treatment and the types of care that are or are not offered. Both education and health care are the object of the significant investment of resources, both areas are value laden in postmodern, pluralistic societies, and yet we do not have a comprehensive method to understand them or evaluate them. This book is of interest to bioethicists, physicians, nurses, health care policy students, educational policy experts, students and government regulators. (shrink)

Why do so many doctors have profound misgivings about the push to legalise euthanasia and assisted suicide? Ole Hartling uses his background as a physician, university professor and former president of the Danish Council of Ethics to introduce new elements into what can often be understood as an all too simple debate. Alive to the case that assisted dying can be driven by an unattainable yearning for control, Hartling concentrates on two fundamental questions: whether the answer to suffering is to (...) remove the sufferer, and whether self-determination in dying and death is an illusion. He draws on his own experience as a medical doctor to personalize the ethical arguments, share patients' narratives and make references to medical literature. Here is a sceptical stance towards euthanasia, one that is respectful to those who hold different opinions and well-informed about the details and nuances of different euthanasia practices. Written from a Scandinavian perspective, where respect for autonomy and high quality palliative care go hand in hand, Hartling's is a nuanced, valuable contribution to the arguments that surround a question doctors have faced since the birth of medicine. He shows us how the intentions of doing something good can sometimes lead to even greater dilemmas, opening us up to those situations where an inclination to end suffering by ending life is deeply conflicting both for the clinician and for any fellow human being. (shrink)

In this paper, we explore the desires that play a role at the palliative stage and relate them to various approaches to patient autonomy. What attitude can physicians and other caregivers take to the desires of patients at the palliative stage? We examine this question by introducing five physicians who are consulted by Jackie, an imaginary patient with metastatic lung carcinoma. By combining the models of the physician-patient relationship developed by Emanuel and Emanuel (1992) and the Hellenistic approaches (...) to desires analyzed by Nussbaum (1994), five different ways of dealing with desires in the context of palliative care are sketched. The story of Jackie shows that desires are to a certain extent responsive to reasoning. In the palliative process, that can be a reason to devote attention to the desires of patients and caregivers and to determine which desires need to be fulfilled, which are less important, and how they are linked to emotions the patient has. (shrink)

Machine generated contents note: Table of Cases xi -- Table of legislation xv -- Introduction: Medicine Men, Outlaws and Voluntary Euthanasia 1 -- 1. To Kill or not to Kill; is that the Euthanasia Question? 9 -- Introduction-Why Euthanasia? 9 -- Dead or alive? 16 -- Euthanasia as Homicide 25 -- Euthanasia as Death with Dignity 29 -- 2. Euthanasia and Clinically assisted Death: from Caring to Killing? 35 -- Introduction 35 -- The Indefinite Continuation of Palliative Treatment (...) 38 -- Withholding or Withdrawing Treatment 44 -- The Principle of Double Effect 54 -- Physician Assisted Suicide 60 -- Mercy Killing 64 -- Conclusions 66 -- 3. Consent to Treatment but Not to Death 69 -- Introduction-Why Consent? 69 -- Without Consent 70 -- Killing and Consent 73 -- Valid Consent, Freely Given? 74 -- Old Enough to Consent 80 -- Deciding for Others 82 -- Conclusions-A Consent Too Far? 93 -- 4. Autonomy, Self-determination and Self-destruction 95 -- Introduction-Autonomous Choices 95 -- Choosing to Die-Suicide and Autonomy 100 -- Suicidal Intentions 107 -- Autonomous Clinical Discretion 110 -- Deciding to Live or Die-Whose Decision? 112 -- 5. Living Wills and the Will to Die 115 -- Introduction 115 -- I Know My Will 118 -- This is My Will 121 -- I Will Decide 128 -- Will My Will be Done? 134 -- Where There's a Will 137 -- Conclusions 143 -- 6. Is Euthanasia a Dignified Death? 145 -- Introduction-Why Dignity? 145 -- Needing Dignity 146 -- Finding Dignity 149 -- Achieving Dignity in Dying 151 -- Dignifying Death 157 -- 7. Conclusions: Dignified Life, Dignified Death and Dignified Law 165 -- Select Bibliography 175 -- Index 183. (shrink)

Coercive Care: The Ethics of Choice in Health and Medicine asks probing and challenging questions regarding the use of coercion in health care and social services. This book combines philosophical analysis with comparative studies of social policy and law in a large number of industrialized countries and proposes an ideal of judicial security on a global scale.

One of the most important aspects of our lives is the conception which we have of ourselves. For the way in which we view ourselves fundamentally affects how we interact among others and, most importantly perhaps, how we think others should treat us. For instance, one will not expect others to regard one as having a high mathematical acumen if one. realizes that one's mathematical skills are very minimal. Of course, persons may be mistaken in their assessment of themselves. (...) And it is not clear, at least to me, that we are for the most part morally justified in trying to get persons to have an accurate assessment of themselves, especially in the case of those whose mistaken assessment of themselves is in their favor. To deal someone a severe blow to their self-esteem comes very close to being cruel. Yet, it is very difficult to tell someone that he is not as good as he thinks he is without dealing such a blow to his self-esteem. Again, one will not expect others to regard one as a talented artist if one realizes that one is not. And so on. What is more, not every person can rightly take him-or herself to be talented in this or that area. And given that this is so, what inevitably follows is that the self-esteem of some will be lower than the self-esteem of others, and rightly so.See note 7 above.But if I have argued soundly in this essay, we have seen that there is a respect in which no person rightly thinks less of him-or herself vis à vis any other person. For each person, it has been shown, is deserving of fair treatment in virtue of the fact that he or she is a person. I have called the sense of worth which corresponds with having this conviction self-respect. Whatever a person's abilities are, whatever a person's moral character is like, he should not lose sight of the fact that he is deserving of fair treatment in any case. The social institutions of a society are fairly arranged, I have argued, when they are conducive to persons having this conviction.Little has been said on the connection between morality and our self-concept. And if anything, I have only touched the surface of what needs to be said. I should like to acknowledge the recent appearance of Stephen L. Darwall's important essay “Two Kinds of Respect,” Ethics, Vol. 88 (1977), although I have not been able to take into account the differences between his views and mine. (shrink)

Coercive medico-legal interventions are often employed to prevent people deemed to be unable to make competent decisions about their health, such as minors, people with mental illness, disability or problematic alcohol or other drug use, from harming themselves or others. These interventions can entail major curtailments of individuals' liberty and bodily integrity, and may cause significant harm and distress. The use of coercive medico-legal interventions can also serve competing social interests that raise profound ethical, legal and clinical questions. Examining (...) the ethical, social and legal issues involved in coerced care, this book brings together the views and insights of leading researchers from a range of disciplines, including criminology, law, ethics, psychology and public health, as well as legal and medical practitioners, social-service 'consumers' and government officials. Topics addressed in this volume include: compulsory treatment and involuntary detention orders in civil mental health and disability law; mandatory alcohol and drug treatment programs and drug courts; community treatment orders; the use of welfare cards with Indigenous populations; mandated treatment of seriously ill minors; as well as adult guardianship and substituted decision-making regimes. These contributions attempt to shed light on why we use coercive interventions, whether we should, whether they are effective in achieving the benefits that are offered to justify their use, and the impact that they have on some of society's most vulnerable citizens in the names of 'justice' and 'treatment'. This book is essential reading for clinicians, researchers and legal practitioners involved in the study and application of coerced care, as well as students and scholars in the fields of law, medicine, ethics and criminology. The collection asks important questions about the increasing use of coercive care that demand to be answered, and offers critical insights, guidance and recommendations for those working in the field. (shrink)

Providing a thorough, well-researched investigation of the socio-legal issues surrounding medically assisted death for the past century, this book traces the origins of the controversy and discusses the future of policymaking in this arena domestically and abroad.

In this paper, the results of a pilot interview study with 19 subjects participating in an EEG-based non-invasive brain–computer interface (BCI) research study on stroke rehabilitation and assistive technology and of a survey among 17 BCI professionals are presented and discussed in the light of ethical, legal, and social issues in research with human subjects. Most of the users were content with study participation and felt well informed. Negative aspects reported include the long and cumbersome preparation procedure, discomfort (...) with the cap and the wet electrodes, problems concerning BCI control, and strains during the training sessions. In addition, some users reflected on issues concerning system security. When asked for morally problematic issues in this field of non-invasive BCI research, the BCI professionals stressed the need for correct information transfer, the obligation to avoid unrealistic expectations in study participants, the selection of study participants, benefits and strains of participation, BCI illiteracy, the possibility of detrimental brain modifications induced by BCI use, and problems that may arise at the end of the trials. Furthermore, privacy issues were raised. Based on the results obtained, psychosocial and ethical aspects of EEG-based non-invasive BCI research are discussed and possible implications for future research addressed. (shrink)

Interest in Aristotelianism and in virtue ethics has been growing for half a century but as yet the strengths of the study of Aristotelian ethics in politics have not been matched in economics. This ground-breaking text fills that gap. Challenging the premises of neoclassical economic theory, the contributors take issue with neoclassicism’s foundational separation of values from facts, with its treatment of preferences as given, and with its consequent refusal to reason about final ends. Contributions critically engage with (...) class='Hi'>aspects of corporate capitalism, managerial power and neoliberal economic policy, and reflect on the recent financial crisis from the point of view of Aristotelian virtue ethics. Containing a new chapter by Alasdair MacIntyre, and deploying his arguments and conceptual scheme throughout, the book critically analyses the theoretical presuppositions and institutional reality of modern capitalism. (shrink)

This book introduces major philosophical theories and issues in the context of the contemporary debate about the so-called culture wars in American society. It is designed to make these theories come alive as they are related to these vital contemporary concerns and to provide a framework within which to assess the ongoing debate about the future direction of Western culture. As a book in ethical theory, it is designed to provide the framework for clear and comprehensive thinking about our (...) cultural development. Classical ethical positions like cultural relativism, emotivism, egoism, hedonism, utilitarianism and theorists like Kant are introduced and assessed. The contemporary theorists John Rawls and Alasdair MacIntyre are given extensive treatment and made accessible to the introductory student in philosophy. Culture War and Ethical Theory exhibits a non-ptolemical tone as it relates these theories, for heuristic purposes, to the contrasting perspective of fundamentalism and secular humanism. These two viewpoints are treated fairly without pretense of thorough exposition. They were chosen because they set the contemporary debate in stark relief. Thus, they assist the reader in understanding the relationship of philosophical reflection to commonly held perspectives. (shrink)

Raimo Tuomela’s we-mode groups are partly characterized by norms. Some norms may be characteristic of all we-mode groups like the norm restricting a member’s right to leave the group. Some think that this aspect of Tuomela’s theory has implausible ethical implications concerning the rights and autonomy of members in we-mode groups. That worry vanishes, I argue, on a plausible interpretation of Tuomela’s notion of social normativity and a reasonable precisification of the notion of autonomy in this context. On the (...) other hand, Tuomela’s general silence on the nature of moral normativity makes it unclear how his distinction between social and moral normativity should be drawn more precisely. Is this a difference in kind, or merely a difference in the scope or social basis of the norms in question? I find this worth exploring with the aid of resources available within a broadly Tuomelian framework. Like Jeremy Koons (2019), I believe that Tuomela’s framework could be used to refine Wilfrid Sellars theory of ethical judgments as expressions of we-intentions. My preferred interpretation of Tuomela differs from Koons’ though, and so does the resulting reconstruction of Sellars, which is more Humean than Kantian. (shrink)

In the first work of investigative journalism in decades to give a comprehensive view into contemporary psychiatric incarceration and forced interventions, Your Consent Is Not Required exposes how rising numbers of people from many walks of life are being subjected against their will to surveillance, indefinite detention, and powerful tranquilizing drugs, restraints, seclusion, and electroshock.

The importance of the collective management of immaterial resources is a key variable in the valorisation of products in a post-industrial economy. The purpose of this paper is to analyse how, in post-industrial economies, it is possible to devise alternative forms of mediation between producers and consumers, such as organic farmers' markets, to curb the appropriation of rent by transnational and/or local business elites from the value created by immaterial resources. More specifically, we analyse those aspects of the collective (...) management of ethical values that, in the case of organic farmers' markets, can be a strategic source of competitive advantage for local producers. In this paper, the Ecomercado de Granada is studied as an example of mediation between production and consumption in a post-industrial economy. (shrink)

The issues surrounding ethical controversies in sport have filled the media recently. This book of invited original essays by mainstream philosophers as well as philosophers of sport will provide the reader with a discussion in ethics and sport based on a sound philosophical footing. It will be accessible to a wide range of teachers and students in the field of sport and leisure studies. Contributions from international, highly regarded experts in the fIeld provide the reader with systematic treatment (...) of the ethics of sport from a diverse perspective. (shrink)

Ethical Considerations at the Intersection of Psychiatry and Religion aims to give mental health professionals a conceptual framework for understanding the role of R/S in ethical decision-making and serve as practical guidance for approaching challenging cases. Part I addresses general considerations, including the basis of therapeutic values in a pluralistic context, the nature of theological and psychiatric ethics, spiritual issues arising in diagnosis and treatment, unhealthy and harmful uses of religion, and practical implications of personal spirituality. Part (...) II examines how these considerations apply in specific contexts: inpatient and outpatient, consultation-liaison, child and adolescent, geriatric, disability, forensic, community, international, addiction and disaster and emergency psychiatry, as well as in the work of religious professionals, ethics committees, psychiatric education, and research. Thick descriptions of case examples analyzed using the framework of Jonson and Winslow show the clinical relevance of understanding the contributions of religion and spirituality to patient preferences, quality of life, decision making, and effective treatment. (shrink)

Moral Victories is the first book-length treatment of the ethical dimensions of victory in war.

With narrow exception, physicians’ treatment of incapacitated patients requires the consent of health surrogates. Although the decision-making authority of surrogates is appropriately broad, their moral authority is not without limits. Discerning these bounds is particularly germane to ethically complex treatments and has important implications for the welfare of patients, for the professional integrity of clinicians, and, in fact, for the welfare of surrogates. Palliative sedation is one such complex treatment; as such, it provides a valuable model (...) for analyzing the scope of surrogates’ moral authority. Guidelines for palliative sedation that present it as a “last-resort” treatment for severe and intractable suffering yet require surrogate consent in order to offer it are ethically untenable, precisely because the moral limits of surrogate authority have not been considered. (shrink)

Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliative care offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but (...) it does not include a comprehensive system of care as is provided by hospice. The practice of palliative care and hospice is filled with sometimes overt (requests for hastened death in an environment where such acts are legally prohibited) and other times covert (the delay in palliative care referral because the health care team believes it will undermine disease directed treatment) ethical issues. The contributors to this volume use a series of case presentations within each chapter to illustrate some of the palliative care and hospice challenges with significant ethical dimensions across the three overarching domains: 1) care delivery systems; 2) addressing the many dimensions of suffering; and 3) difficult decisions near the end of life. The contributors are among the most experienced palliative care, hospice and ethics scholars in North America and Western Europe. Each has been given relatively free reign to address what they feel are the most pressing ethical challenges within their domain, so a wide range of positions and vantage points are represented. As a result, the volume provides a very diverse ethical exploration of this relatively young field that can deepen, stretch, and at times confront any simple notion of the challenges facing patients, their families, professional caregivers, and policy makers. (shrink)