BackgroundDuring the arrival of the COVID-19 pandemic, various professional ethical guidance was issued to (and for) health and social care professionals in England and Wales. Guidance can help to inform and support such professionals and their patients, clients and service users, but a plethora of guidance risked information overload, confusion, and inconsistency. MethodsDuring the early months of the pandemic, we undertook a rapid review, asking: what are the principles adopted by professional ethical guidance in England and Wales for dealing with (...) COVID-19? We undertook thematic content analysis of the 29 documents that met our inclusion criteria.ResultsThe 29 documents captured 13 overlapping principles: respect, fairness, minimising harm, reciprocity, proportionality, flexibility, working together, inclusiveness, communication, transparency, reasonableness, responsibility, and accountability.ConclusionsWe intend this attempt to collate and outline the prominent principles to be helpful, particularly, for healthcare practice during the COVID-19 pandemic and, hopefully, for future pandemic planning. We also offer some reflections on the guidance and the principles therein. After describing the principles, we reflect on some of the similarities and differences in the guidance, and the challenges associated not only with the specific guidance reviewed, but also with the nature and import of “professional ethical guidance”. (shrink)

ObjectiveTo compare techniques for computing clustering and switching scores in terms of agreement, correlation, and empirical value as predictors of incident cognitive impairment.MethodsWe transcribed animal and letter F fluency recordings on 640 cases of ICI and matched controls from a national epidemiological study, amending each transcription with word timings. We then calculated clustering and switching scores, as well as scores indexing speed of responses, using techniques described in the literature. We evaluated agreement among the techniques with Cohen’s κ and calculated (...) correlations among the scores. After fitting a base model with raw scores, repetitions, and intrusions, we fit a series of Bayesian logistic regression models adding either clustering and switching scores or speed scores, comparing the models in terms of several metrics. We partitioned the ICI cases into acute and progressive cases and repeated the regression analysis for each group.ResultsFor animal fluency, we found that models with speed scores derived using the slope difference algorithm achieved the best values of the Watanabe–Akaike Information Criterion, but with good net reclassification improvement only for the progressive group. For letter fluency, different models excelled for prediction of acute and progressive cases. For acute cases, NRI was best for speed scores derived from a network model, while for progressive cases, the best model used clustering and switching scores derived from the same network model. Combining variables from the best animal and letter F models led to marginal improvements in model fit and NRI only for the all-cases and acute-cases analyses.ConclusionSpeed scores improve a base model for predicting progressive cognitive impairment from animal fluency. Letter fluency scores may provide complementary information. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Who or What is the Preembryo?S.J. Richard A. McCormick (bio)IntroductionAlthough widely used by scientists, the term "preembryo" has raised some suspicions. Histopathologist Michael Jarmulowicz (1990), for example, asserts that the term was adopted by the American Fertility Society (AFS) and the Voluntary Licensing Authority (VLA) in Britain "as an exercise of linguistic engineering to make human embryo research more palatable to the general public."I cannot speak for the (...) VLA, but I can clarify that this was not the motive of the AFS. As a member of the AFS ethics committee that discussed and adopted this terminology, I know that our discussion was not tied to embryo research or moral issues. The term "preembryo" was adopted because the earliest stages of mammalian development primarily involve establishment of the nonembryonic trophoblast, rather than the formation of the embryo. As Clifford Grobstein (1988, p. 61), a distinguished basic scientist who also sat on the AFS committee notes:The scientific rationale for the term preembryo... is its greater accuracy in characterizing the initial phase of mammalian and human development.... The status implications of such a change in terminology were not at issue in the discussion.This is not to say that the moral status of the preembryo is not a concern worthy of independent consideration. It is an important question with significant practical implications, especially in the context of in vitro fertilization. At stake are issues such as: (1) what may be done to preembryos before transfer; (2) whether all preembryos must be transferred; and (3) what may be done to preembryos that are not transferred (Ethics Committee of the American Fertility Society (AFS) 1986, p. 29S). Furthermore, emergency treatment of rape cases may also depend on such a determination. [End Page 1]Cryopreservation, which entails freezing unused preembryos for possible later use, is one example of a procedure that raises issues associated with the moral status of the preembryo. Cryopreservation decreases the number of stimulated egg recovery cycles a woman must undergo and increases flexibility in transfer protocols. But thawing of the preembryos is not a completely benign process; significant numbers of the preembryos die in the process and injury cannot be excluded.In addition, down the road a year or so lies preimplantation genetic diagnosis, now being tested in several centers of reproductive research. This would involve the removal of one or more cells from a preembryo developing in vitro. The DNA from these cells would be studied and then only genetically normal preembryos would be transferred. With the growth in knowledge about single gene defects and the rapid advance of amplification technology, which allows gene visualization, it is not difficult to imagine scientists embarking on a variety of micromanipulations of the preembryo for the sake of gaining knowledge.Not all research with gametes involves preembryos, but clearly some experiments and procedures await resolution of the moral status of the preembryo. I contend in this paper that the moral status—and specifically the controversial issue of personhood—is related to attainment of developmental individuality (being the source of one individual). This contrasts with the view that holds that personhood occurs earlier, at the point of genetic uniqueness. I believe that an embryo that has developed to the point where it can be one individual and one individual only, differs in moral status from a preembryo that has not, even if in many cases we may choose to treat them similarly.The Scientific UnderpinningsTwo things must be kept in mind—and in a sense, in tension—in turning to science for help in assessing the status of the preembryo. First, science is not competent to decide the question of personhood or ensoulment. As the Catholic document, Declaration on Procured Abortion, which I will return to later, notes: "It is a philosophical problem" (Congregation for the Doctrine of the Faith (CDF) 1974, p. 10, endnote 19). On the other hand, another Catholic document, Donum vitae(CDF 1987), notes that the conclusions of science provide a "valuable indication" for reason's deliberations about personhood. We might say that if science cannot decide the question of personhood, neither can it be decided without science.For my review of embryological science... (shrink)

: Stem cell research that requires the destruction of human embryos is incompatible with Catholic moral principles, and with any ethic that gives serious weight to the moral status of the human embryo. Moreover, because there are promising and morally acceptable alternative approaches to the repair and regeneration of human tissues, and because treatments that rely on destruction of human embryos would be morally offensive to many patients, embryonic stem cell research may play a far less significant role in medical (...) progress than proponents believe. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Books ReceivedThe Ambitions of Curiosity: Understanding the World in Ancient Greece and China. By G.E.R. Lloyd. Cambridge: Cambridge University Press, 2002. Pp. xvi + 175. Price not given.The Art of the Han Essay: Wang Fu's Ch'ien-Fu Lun. By Anne Behnke Kinney. Tempe: Center for Asian Studies, Arizona State University, 1990. Pp. xi + 154. Paper $10.00.The Autobiography of Jamgön Kongtrul: A Gem of Many Colors. By Jamgön Kongtrul Lodrön (...) Thayé and translated by Richard Barron (Chökyi Nyima). Ithaca, New York: Snow Lion Publications, 2003. Pp. xxii + 549. Price not given.Awesome Nightfall: The Life, Times, and Poetry of Saigyō. By William R. LaFleur. Boston: Wisdom Publications, 2003. Pp. xiii + 173. Paper $14.95.Becoming the Compassion Buddha: Tantric Mahamudra for Everyday Life. By Lama Thubten Yeshe, edited by Robina Courtin, and foreword by Geshe Lhundub Sopa. Boston: Wisdom Publications, 2003. Pp. xi + 194. Paper $14.95.Between Two Worlds East and West: An Autobiography. By J. N. Mohanty. New Delhi: Oxford University Press, 2002. Pp. ix + 134. Hardcover RS 525.00.The Chinese Face of Jesus Christ. Edited by Roman Malek, S.V.D. Sankt Augustin, Germany: Institut Monumenta Serica and China-Zentrum; and Nettetal, Germany: Steyler Verlag, 2002. Pp. 391. EUR 40.00.Chinese Medicine in Contemporary China: Plurality and Synthesis. By Volker Scheid. Durham and London: Duke University Press, 2002. Pp. xiv + 407. Hardcover $69.95. Paper $23.95.Confucian Feminist: Memoirs of Zeng Baosun (1893-1978). Translated and adapted by Thomas L. Kennedy. Philadelphia: American Philosophical Society, 2002. Pp. xxi + 170. Price not given.Consciousness Studies: Cross-Cultural Perspectives. By K. Ramakrishna Rao. Jefferson (North Carolina) and London: McFarland and Company, 2002. Pp. 367. Hardcover $65.00.Constituting Communities: Theravāda Buddhism and the Religious Cultures of South and Southeast Asia. Edited by John Clifford Holt, Jacob N. Kinnard, and Jonathan S. Walters. Albany: State University of New York Press, 2003. Pp. viii + 224. Hardcover $65.50. Paper $21.95.Developments in Indian Philosophy from Eighteenth Century Onwards: Classical and Western. By Daya Krishna. Volume X Part 1 of History of Science, Philosophy and Culture in Indian Civilization, edited by D. P. Chattopadhyaya. New [End Page 110] Delhi: Centre for Studies in Civilizations, 2001. Pp. xxiii + 417. Hardcover RS 1200.East and West: Identità e dialogo interculturale. By Giangiorgio Pasqualotto. Venezia: Marsilo Editori, 2003. Pp. 210. EUR 16.00.Effortless Action: Wu-wei as Conceptual Metaphor and Spiritual Ideal in Early China. By Edward Slingerland. New York: Oxford University Press, 2003. Pp. xii + 352. Price not given.Encountering Kā lī: In the Margins, at the Center, in the West. Edited by Rachel Fell McDermott and Jeffrey J. Kripal. Berkeley and Los Angeles: University of California Press, 2003. Pp. xviii + 321. Hardcover $55.00, £37.95. Paper $21.95, £15.95.Encyclopedia of Chinese Philosophy. Edited by Antonio S. Cua. New York and London: Routledge, 2003. Pp. xx + 1020. Hardcover $150.00.Essays on Indian Philosophy. By J. N. Mohanty and edited by Purushottama Bilimoria. New Delhi: Oxford University Press, 2002. Pp. xxxvii + 347. Paper RS 525.00.Faith, Humor, and Paradox. By Ignacio L. Götz. Westport, Connecticut: Praeger Publishers, 2002. Pp. 136. Hardcover $61.95.Four Illusions: Candrakīrti's Advice for Travelers on the Bodhisattva Path. Translated by Karen C. Lang. New York: Oxford University Press, 2003. Pp. xv + 240. Price not given.The Great Awakening: A Buddhist Social Theory. By David R. Loy. Boston: Wisdom Publications, 2003. Pp. 223. Paper $16.95.The Hidden History of The Tibetan Book of the Dead. By Bryan J. Cuevas. New York: Oxford University Press, 2003. Pp. xi + 328. Price not given.Huang Di nei jing su wen: Nature, Knowledge, Imagery in an Ancient Chinese Medical Text. By Paul U. Unschuld. Berkeley and Los Angeles: University of California Press, 2003. Pp. xii + 520. Hardcover $75.00, £52.00.In Dewey's Wake: Unfinished Work of Pragmatic Reconstruction. Edited by William J. Gavin. Albany: State University of New York Press, 2003. Pp. vi + 249. Hardcover $71.50. Paper $23.95.Knowledge and Freedom in Indian Philosophy. By Tara Chatterjea. Lanham, Maryland: Lexington Books, 2002. Pp. xvi + 159. Hardcover... (shrink)

: The idea of enhancing our mental functions through medical means makes many people uncomfortable. People have a vague feeling that altering our brains tinkers with the core of our personalities and the core of ourselves. It changes who we are, and doing so seems wrong, even if the exact reasons for the unease are difficult to define. Many of the standard arguments against neuroenhancements—that they are unsafe, that they violate the distinction between therapy and enhancements, that they undermine equality, (...) and that they will be used coercively—fail to show why the use of any such technologies is wrong in principle. Two other objections—the arguments that such changes undermine our integrity and that they prevent us from living authentic lives—will condemn only a few of the uses that are proposed. The result is that very few uses of these drugs are morally suspect and that most uses are morally permissible. (shrink)

This paper seeks to reconstruct the role of schooling in a moment of accelerated social, political, economic, geo-political, climatic, indeed planetary crisis. It identifies the school as a potentially prefigurative institution, an evolutionary social frontier, capable of nurturing the democratic social character, a form of sensibility apart from which authentic political democracy is not possible. As theorized by Herbert Marcuse and Richard Hart and Antonio Negri, the “new sensibility” or “multitude” is characterized by greater psychological freedom, individuality, social creativity (...) and self-rule, comprising a “whole of singularities” that “acts in common”. It suggests a human subject with a vital, biological drive for liberation, with a consciousness capable of breaking through the material as well as ideological veil of a society based on hierarchy and domination, and is associated politically with democracy and social-anarchism, or what Murray Bookchin called “communalism”. This paper identifies three main characteristics of an institution informed by this form of modal subjectivity, all of them based on student-teacher dialogue: an emergent, project-based curriculum, whole-school direct democratic governance on all levels of the community, and the regular practice of communal philosophical inquiry, through which we problematize the concepts we live by, in the interest of their ongoing reconstruction. (shrink)

For many adolescent Kenyan males genital reshaping is a self-defining experience of enormous positive significance. The same can be said for many Kenyan females. These adolescents, male and female, do not think their bodies have been “mutilated.” Quite the contrary, by their lights the surgical procedure removes a defect of nature and is the means by which a desired state of physical integrity and social maturity is achieved. By their lights the procedure gets rid of unseemly fleshy encumbrances and protrusions (...) and helps them erase unwanted physical traces of childhood bisexuality, thereby making their genitals look smooth and clean and more gender appropriate. By their lights their appearance and... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Human Reproduction: Dominion and LimitsRichard A. McCormick S.J. (bio)The general struggle throughout Christian history has been to seek the proper balance between dominion and limits, intervention and nonintervention, givenness, and creativity. This struggle has worked itself out in six areas that touch human life. In this essay, I will revisit the Catholic tradition’s treatment of these in terms of dominion and limits to see whether we can discern developmental (...) patterns that might suggest an approach to issues pertaining to the sources of life (reproductive ethics) as we move into the next century.1. Abortion. The history of the treatment of abortion in the Catholic tradition is the history of an evaluation. This evaluation was somewhat muddied by [End Page 387] unclarity and inconsistency in the use of terms. Thus, some theologians distinguished three types of abortion: prevention of conception, abortion of an inanimate fetus, and abortion of an animated fetus. Others regarded all interventions into the life-giving process as homicides. Still others argued that termination of a nonanimated fetus was justified to save the life of the mother. And still others said such termination was anticipated homicide or the misuse of semen conceptum.Such unclarities and qualifications eventually vanished and produced an evaluation of fetal life that yielded to very few competing interests, what John Noonan (1970) referred to as “an almost absolute value.” There was some dominion or control, but the limits became increasingly clear and powerful.2. Individual and corporate self-defense. Augustine disallowed lethal individual or personal self-defense, but established the first elementary rules for war. Aquinas allowed both. Vitoria, Suarez, and others refined the criteria justifying war (jus ad bellum) and listed them as three: recovery of property, resistance to aggression, and vindication of injuries (injustices). Pius XII narrowed these to a single reason: national self-defense. The Challenge of Peace (NCCB 1983) moves away from the licitness of nuclear war and nuclear deterrence even for self-defense. Once again, the limits to the dominion over life in war grow stronger and more powerful even as the weapons of such dominion grow more powerful.3. Capital punishment. Over the centuries, Christian thinkers, such as Thomas Aquinas, permitted the use of capital punishment. Three justifications were proposed to found this right of the state: retribution, deterrence, and reform. In the past decades, however, these justifications have been seriously questioned. Both the American and Philippine bishops’ conferences have rejected all use of capital punishment. Most recently John Paul II (1995, n. 56, p. 709) adduces defense of society as the only possible justification for it and sees such cases as “very rare if not practically non-existent.”4. The preservation of life. The theme of a balance between dominion and limits is perhaps nowhere clearer than in the Catholic approach to life preservation. Catholic tradition does not accept our culture’s rejection of death. Rather it asserts that the facts that we are pilgrims, that Christ has overcome death and lives, and that we also will live with him yield a general value judgment on the meaning and value of life as we now live it: Life is a basic good but not an absolute one. It is basic because, as the Congregation for the Doctrine of the Faith (1980, p. 511) worded it, it is the “necessary source and condition of every human activity and of all society.” It is not absolute because there are higher goods for which life can be sacrificed—e.g., the glory of God, salvation of souls, service of one’s brethren, and the like. Thus in John (15:13): “There is no greater love than this: to lay down one’s life for one’s friends. John Paul II (1995, n. 47, p. 706) briefly summarizes this in Evangelium Vitae: “The life of the body in its earthly state is not an absolute good for the believer.” This value [End Page 388] judgment has immediate relevance for care of the ill and dying: Not all means must be used to preserve life.Thus the Catholic tradition has moved between two extremes: medico-moral optimism or vitalism (which preserves life with all means, at any cost... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Environmental Genome Project and BioethicsRichard R. Sharp (bio) and J. Carl Barrett (bio)Eight years ago, the Kennedy Institute of Ethics Journal published a brief selection by Eric Juengst (1991) entitled “The Human Genome Project and Bioethics.” That essay introduced and described the Ethical, Legal, and Social Implications (ELSI) Program at the National Center for Human Genome Research. 1 Since that time, the ELSI program has grown to (...) become one of the largest and most well regarded bioethics programs in the country, sponsoring the work of hundreds of researchers and coordinating bioethics activities both nationally and internationally (Marshall 1996; Meslin, Thomson, and Boyer 1997). In 1991, however, Juengst, the first director of the ELSI program, had no way of anticipating these developments. Juengst’s goal in his essay was simply to highlight some of the moral and social issues that were emerging as focal points for the ELSI program. Looking back, the issues he outlined may seem vague and overly broad. At the time, however, the essay served an important purpose, to identify areas requiring additional study and thereby to serve as a guide to others interested in joining in these discussions.In many ways, Juengst’s article serves as an inspiration to those of us working on a new bioethics project. The National Institute of Environmental Health Sciences (NIEHS) recently launched a multi-year project aimed at better understanding genetic influences on environmentally associated diseases (Albers 1997; Brown and Hartwell 1998; Cannon 1997; Kaiser 1997). This project, known as the Environmental Genome Project (EGP), plans to identify and study a number of common genetic variants that may play an important role in determining how individuals respond to environmental exposures. NIEHS hopes that the information learned through the EGP will be instrumental in developing more effective disease-prevention strategies and intervention programs. Following the precedent developed in connection with the Human Genome Project, NIEHS also plans to address the moral and social implications of the EGP. Efforts in this regard include sponsoring workshops and conferences to address such issues, as well as supporting research on the ethical, legal, and social implications of the EGP. Through this work, NIEHS hopes to anticipate potential problems before [End Page 175] they arise and to develop policies that maximize the benefits of the research while avoiding potential misuses of the information learned.In exploring the social implications of the EGP, we at NIEHS are very fortunate to be able to draw upon the work being done by the ELSI program at the National Human Genome Research Institute (NHGRI), as well as the ever-expanding bioethics literature that has been sparked by the ELSI program. Still, there is much to be done and this is an exciting time for those of us involved with the EGP. Many of the ethical, legal, and social implications of the project are only beginning to become clearer, and several of these issues appear quite different from the sorts of concerns that have previously been discussed in connection with other types of genetic research.This essay highlights some of the ethical, legal, and social implications that are emerging as important focal points for the Environmental Genome Project. Like Juengst’s 1991 paper, the goal of this article is to provide an overview of current areas of interest and to encourage others to join us in thinking about these difficult issues.The Environmental Genome ProjectIndividuals differ greatly in their responses to chemicals, drugs, radiation, smoking, alcohol, and other environmental exposures. These differential responses are the result of complex interactions between many factors, including an individual’s genetic make-up, age, sex, nutritional status, and overall health. The EGP aims to better understand the genetic basis of differential responses to environmental exposures. The vast majority of diseases, many forms of cancer, for example, are the consequence of both environmental and genetic contributions (Perera 1997). Hence, understanding the relationships between genetic variation and response to environmental exposure is important for understanding the causes of human disease and is crucial for the development of effective disease-prevention strategies.The EGP and projects like it represent a new stage of genomic research. It is expected that the Human Genome Project will complete... (shrink)

Machine generated contents note: 1. Introduction Juliette Kennedy and Roman Kossak; 2. Historical remarks on Suslin's problem Akihiro Kanamori; 3. The continuum hypothesis, the generic-multiverse of sets, and the [OMEGA] conjecture W. Hugh Woodin; 4. [omega]-Models of finite set theory Ali Enayat, James H. Schmerl and Albert Visser; 5. Tennenbaum's theorem for models of arithmetic Richard Kaye; 6. Hierarchies of subsystems of weak arithmetic Shahram Mohsenipour; 7. Diophantine correct open induction Sidney Raffer; 8. Tennenbaum's theorem and recursive reducts (...) James H. Schmerl; 9. History of constructivism in the 20th century A. S. Troelstra; 10. A very short history of ultrafinitism Rose M. Cherubin and Mirco A. Mannucci; 11. Sue Toledo's notes of her conversations with Gödel in 1972-1975 Sue Toledo; 12. Stanley Tennenbaum's Socrates Curtis Franks; 13. Tennenbaum's proof of the irrationality of [the square root of] 2́. (shrink)

In the United States, property rights are afforded protection, but moral rights are not. Up until 1989, the United States adamantly refused to join the Berne Copyright Convention, the first multilateral copyright treaty, now ratified by seventy-eight countries. The American government refused to comply because the Berne Convention grants moral rights to authors. This international policy was—and is—incompatible with United States copyright law, which recognizes only economic rights. Although ten states have enacted some form of moral rights legislation, federal copyright (...) laws tend to prevail, and those are still wholly economic in their motivation. Indeed, the recent pressure for the United States to agree, at least in part, to the terms of the Berne Convention came only as a result of a dramatic increase in the international piracy of American records and films.In September 1986, Senator Edward M. Kennedy of Massachusetts first introduced a bill called the Visual Artists Rights Act. This bill attempts to amend federal copyright laws to incorporate some aspects of international moral rights protection. The Kennedy bill would prohibit the intentional distortion, mutilation, or destruction of works of art after they have been sold. Moreover, the act would empower artists to claim authorship, to receive royalties on subsequent sales, and to disclaim their authorship if the work were distorted.4 This legislation would have prevented Clement Greenburg and the other executors of David Smith’s estate from authorizing the stripping of paint from Several of Smith’s later sculptures so that they would resemble his earlier—and more marketable—unpainted sculptures. Such moral rights legislations would have prevented a Japanese bank in New York from removing and destroying a sculpture by Isamu Noguchi simply because the bank president did not like it. And such legislation would have prevented the United States government from destroying Tilted Arc. 4. Although this section appeared in the original version of Kennedy’s bill, the current version provides for a study of resale royalties. Richard Serra is known for his large-scale site-specific works in landscapes, urban environments, and museums. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 16.4 (2006) 379-396MuseSearchJournalsThis JournalContents[Access article in PDF]Pharmacists and Conscientious Objection *In March 2005, a Wisconsin pharmacist's act of conscience garnered headlines across the United States. After a married woman with four children submitted a prescription for the morning-after pill, the pharmacist, Neil Noesen, not only refused to fill it, but also refused to transfer the prescription to another pharmacist or to return the (...) prescription to the customer. As more such incidents occurred, many states "... decided to consider and enact laws setting the bounds of pharmacists' and other health care workers' professional obligations" (III, Grady 2006, p. 327). Discussions of objector legislation, also referred to as "conscience clauses," "refusal clauses," and "abandonment laws" (III, Appel 2005, p. 279), are not limited to professional ethics, but also draw from philosophical, theological, and legal perspectives. The purpose of this Scope Note is to present a wide variety of viewpoints on the health provider's right to conscience.More than 40 years ago the development of "The Pill" as the first reliable method of birth control not only ushered in a feminist revolution, but also provided a new focus for concerns of conscience for those who were part of the anti-abortion movement based on religious belief in the sanctity of life. Similarly, in the past ten years, worldwide, and seven years (1999) since the emergency contraception "morning after" pill first became available as a prescription item, there has been an upsurge in the number of medical personnel who refuse to prescribe or dispense it on grounds of personal conscience, whether for religious reasons or not. Their actions bring into play issues of power and control for health care personnel and for patients—in this case women, which also raises women's rights issues. Ironically, studies in France, Sweden, and the United Kingdom have shown that emergency contraception does not reduce the abortion rate—it is too infrequently used (II, Glasier 2006).It is important to underline the difference between the "morning-after" pill or "Plan B," which is made up of two progestin pills containing levonorgestrel (a synthetic derivative of the female hormone progesterone), and RU-486 (Mifiprex [End Page 379] or mifipristone with misoprostol). Plan B, if taken within 72 hours post-coitus prevents implantation, and therefore pregnancy, by suppressing the output of luteinizing hormone, the hormone that triggers the ovulation process. Scientists have been unable to determine whether this action could destroy already fertilized eggs, but even if it does, it uses the same mechanism as occurs with the birth-control pill, that was developed some 45 years ago. By contrast, RU-486 acts up to 49 days after implantation by blocking the action of progesterone in order to terminate the pregnancy and as such is an abortifacient (II, US FDA 1).On 24 August 2006, the U.S. Food and Drug Administration announced approval of the Plan B pill for over-the-counter (OTC ) sales (II, US FDA 2). Although this action makes the drug more widely available, it remains to be seen whether pharmacists who are conscientious objectors and who refuse to dispense it also will refuse to provide it OTC.A survey article by Rebecca Dresser (II, 2005, p. 9) succinctly sums up the problem for conscientious objectors: "Because emergency contraception can act to block implantation of a fertilized egg, people who believe in protection of human life after conception find it morally objectionable."When conscientious objections are raised over abortion or birth control services performed, prescribed, or dispensed, they affect not only the health professionals—physicians, pharmacists, nurses, and health technicians—who may object, as well as their colleagues and/or managers, but also the consumers: the female patients who are then forced to reconsider or to seek an alternative supplier, as well as their spouses or partners. Alta Charo (II, 2005, p. 2473) makes the point that the patient needs to have access to a system of counseling and referral "so... (shrink)

If we distance ourselves from the content of the debate for and against the destruction of human embryos for scientific research purposes, we may be struck by its rhetorical form. Each side thinks not only that it has the superior argument, but that its conclusion is wholly obvious, while the other side’s position is obviously mistaken. Those who defend splitting embryos to obtain stem cells say that it is ridiculous to claim that a tiny zygote or blastocyst without a brain (...) is the same sort of being as we, while those who oppose this research claim it to be clear as day that each of us is the same being we were when newly conceived, though now .. (shrink)

In this book, Cioran writes of politics, of history, and of the utopian dream. "A small masterwork... a stringent examination of some persistent and murky notions in human history.... It is best to read Cioran while sitting. The impact upon the intellect can be temporarily stunning, and motor systems may give way under the assault."—Joseph Patrick Kennedy, _Houston Chronicle_ "Cioran has a claim to be regarded as among the handful of original minds... writing today."—_New York Times_ "A sort of (...) final philosopher of the Western world. [Cioran's] statements have the compression of poetry and the audacity of cosmic clowning."—_Washington Post_ E. M. Cioran was born and educated in Romania and lived in Paris from 1937 until his death. He is the author of numerous works, including _On the Heights of Despair_, also available from the University of Chicago Press. (shrink)

kind of joke to ask what is the case if the antecedent is false—“And where are the biscuits if I don’t want any?”, “And what’s on PBS if I’m not interested?”, “And who shot Kennedy if that’s not what I’m asking?”. With normal indicative conditionals like.

In Truthfulness and Tragedy Stanley Hauerwas provides an account of moral existence and ethical rationality that shows how Christian convictions operate, or should operate, to form and direct lives. In attempting to conceptualize the basis of Christian ethics in a manner that will render Christian convictions morally intelligible, the author casts fresh light on traditional theoretical issues and articulates the distinctive Christian response to contemporary concerns such as suicide, medical ethics, and child care. The first section of the book deals (...) with methodological issues: the meaning and nature of practical reason, obligation claims, natural law, and self deception, and the affinity of story and ethics. It focuses on the relation of truthfulness and tragedy and the need for a story--a set of religious convictions or "grammar of theology"--that does justice to the tragic character of human existence. The second section addresses substantive issues: suicide, euthanasia, and the value of survival; the moral limits of population growth; the definition of "person" for medical reasons; and social involvement and Christian ethics. The overall theme is the need for a community in which truthfulness is a way of life. In the final section, devoted to the problem of how to care for retarded children, the implications of the author's ethical position are given concrete expression. He discusses the assumptions underlying the willingness to have children, criteria for humanness, medical ethics, and how truthful communities deal with suffering. In Truthfulness and Tragedy Stanley Hauerwas extends and clarifies the ethical position set forth in his earlier books Character and the Christian Life and Vision and Virtue. He is associate professor of theology at the University of Notre Dame. He was a senior fellow in Christian medical ethics at the Joseph and Rose Kennedy Institute for the Study of Reproduction and Bioethics, and taught medical ethics at the University of Texas medical branch in Galveston. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Richard H. Popkin 1923-2005Harry M. Bracken and Richard A. WatsonRichard H. Popkin, founding editor of the journal of the History of Philosophy, died on April 14, 2005. He was 81 years old and had continued his research and writing to the last moment before he entered the hospital on march 21st with extreme respiratory difficulties.Popkin's The History of Scepticism from Erasmus to Descartes (1960) revolutionized the study (...) and understanding of early modern philosophy. Popkin entered the minds and world of thinkers from Erasmus to Descartes in a way few other scholars had done, and he showed how the development of philosophy and science was far from an easy series of steps from success to success. Instead, philosophers and scientists pursued a dozen lines from the scepticism of Sextus Empiricus through religious belief, atheism, numerology, astrology, alchemy, eschatology, magic, and millenarianism—a maelstrom of ideas out of which emerged the major figures and ideas of Modern philosophy and science. Dick once explained that actually he lived in the 17th century, and certainly he knew as many of those thinkers and their thoughts as did many people who actually lived at that time. Of course Popkin did not originate the notion of exploring the history of philosophy in the context of its times, but he made that approach central today. It led him not only through the Early Modern period, but also from medieval jewish philosophy to a critical analysis of the Kennedy assassination.Popkin received his PhD at Columbia University, and in his career he taught at the universities of Connecticut, Iowa, California (San Diego and Los Angeles), Washington University in St. Louis, and Harvey Mudd College. He served as the first editor of the Journal of the History of Philosophy, and as president of JHP, Inc. For many years, and was active in its operation for over four decades, having attended the annual meeting of the Board of Directors a little over a month before he died. After retirement, he lived in close association with the Clark Library in Los Angeles. He was well known to scholars and librarians throughout the world. Whatever library he visited, he was likely to find some obscure or hidden document that would either clear up some mystery, or give rise to a new problem. His memory was extraordinary. During his final years when he was virtually blind, he would sift through his mind, send assistants off to look for something that had to be in this or that library and write papers in his head for later dictation. Besides his memory, indispensable throughout his lifetime he had Julie, his co-worker and wife of 60 years, without whom, the Popkin we knew could not have existed.These few paragraphs are meant to be neither an obituary nor an adequate memorial. We were Dick's first two PhDs, and we were barely five years his junior. He treated us from the beginning as colleagues and he became a lifelong friend. He changed our lives, as he did the lives of many other aspiring scholars. We miss him.Copyright © 2005 Journal of the History of Philosophy, Inc.... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Who or What is the Preembryo?S.J. Richard A. McCormick (bio)IntroductionAlthough widely used by scientists, the term "preembryo" has raised some suspicions. Histopathologist Michael Jarmulowicz (1990), for example, asserts that the term was adopted by the American Fertility Society (AFS) and the Voluntary Licensing Authority (VLA) in Britain "as an exercise of linguistic engineering to make human embryo research more palatable to the general public."I cannot speak for the (...) VLA, but I can clarify that this was not the motive of the AFS. As a member of the AFS ethics committee that discussed and adopted this terminology, I know that our discussion was not tied to embryo research or moral issues. The term "preembryo" was adopted because the earliest stages of mammalian development primarily involve establishment of the nonembryonic trophoblast, rather than the formation of the embryo. As Clifford Grobstein (1988, p. 61), a distinguished basic scientist who also sat on the AFS committee notes:The scientific rationale for the term preembryo... is its greater accuracy in characterizing the initial phase of mammalian and human development.... The status implications of such a change in terminology were not at issue in the discussion.This is not to say that the moral status of the preembryo is not a concern worthy of independent consideration. It is an important question with significant practical implications, especially in the context of in vitro fertilization. At stake are issues such as: (1) what may be done to preembryos before transfer; (2) whether all preembryos must be transferred; and (3) what may be done to preembryos that are not transferred (Ethics Committee of the American Fertility Society (AFS) 1986, p. 29S). Furthermore, emergency treatment of rape cases may also depend on such a determination. [End Page 1]Cryopreservation, which entails freezing unused preembryos for possible later use, is one example of a procedure that raises issues associated with the moral status of the preembryo. Cryopreservation decreases the number of stimulated egg recovery cycles a woman must undergo and increases flexibility in transfer protocols. But thawing of the preembryos is not a completely benign process; significant numbers of the preembryos die in the process and injury cannot be excluded.In addition, down the road a year or so lies preimplantation genetic diagnosis, now being tested in several centers of reproductive research. This would involve the removal of one or more cells from a preembryo developing in vitro. The DNA from these cells would be studied and then only genetically normal preembryos would be transferred. With the growth in knowledge about single gene defects and the rapid advance of amplification technology, which allows gene visualization, it is not difficult to imagine scientists embarking on a variety of micromanipulations of the preembryo for the sake of gaining knowledge.Not all research with gametes involves preembryos, but clearly some experiments and procedures await resolution of the moral status of the preembryo. I contend in this paper that the moral status—and specifically the controversial issue of personhood—is related to attainment of developmental individuality (being the source of one individual). This contrasts with the view that holds that personhood occurs earlier, at the point of genetic uniqueness. I believe that an embryo that has developed to the point where it can be one individual and one individual only, differs in moral status from a preembryo that has not, even if in many cases we may choose to treat them similarly.The Scientific UnderpinningsTwo things must be kept in mind—and in a sense, in tension—in turning to science for help in assessing the status of the preembryo. First, science is not competent to decide the question of personhood or ensoulment. As the Catholic document, Declaration on Procured Abortion, which I will return to later, notes: "It is a philosophical problem" (Congregation for the Doctrine of the Faith (CDF) 1974, p. 10, endnote 19). On the other hand, another Catholic document, Donum vitae(CDF 1987), notes that the conclusions of science provide a "valuable indication" for reason's deliberations about personhood. We might say that if science cannot decide the question of personhood, neither can it be decided without science.For my review of embryological science... (shrink)

We have benefited from conversations with Archon Fung, Brian Jacob, Todd Pittinsky, Peter Schuck, Ani Satz, Andrew Williams, and students in a joint class on statistics and ethics at the John F. Kennedy School of Government in October 2002. We are also grateful to our audience at the conference “The Priority of Practice,” organized by Jonathan Wolff at University College London in September 2003, and to Arthur Applbaum, Miriam Avins, Frances Kamm, Simon Keller, Frederick Schauer, Alan Wertheimer, and the (...) Editors of Phi- losophy & Public Affairs for insightful comments. We have benefited from prepublication reading of Schauer’s work on profiling, Profiles, Probabilities, and Stereotypes (Cambridge, Mass: Harvard University Press, 2003). We thank Avedis Koutoujian for research assistance. (shrink)

Both Richard Dawkins’s book The God Delusion and Philip Kennedy’s book A Modern Introduction to Theology: New Questions for Old Beliefs were published in 2006. This article aims to compare the two books and to argue that Kennedy does not oppose Dawkins’s views but, in fact, debates along similar lines. Kennedy is adamant that the Augustinian paradigm of Christianity no longer makes sense, because it is based on an outdated cosmology and anthropology. He firmly maintains that (...) Christianity requires a new paradigm, which is informed by our current knowledge and worldview. Thomas Kuhn’s ideas of paradigm and paradigm changes in the history of natural sciences are utilised in comparing the books, seeing that Dawkins accepts and works within the Darwinian paradigm of evolutionary biology, and Kennedy argues that Christians and Christian theologians adhere to the Augustinian paradigm of Fall-Redemption-Judgement. It is argued that Dawkins should have referred to the paradigm change in the study of the Bible, which occurred towards the end of the 19th and the beginning of the 20th centuries, and the plea of theologians, like Kennedy, for a paradigm change in theology. The article concludes that only a paradigm change in Christianity, which is in line with the modern worldview, will enable Christians to keep the tradition alive. (shrink)

A revision of George Kennedy's translation of, introdution to, and commentary on Aristotle's On Rhetoric. His translation is most accurate, his general introduction is the most thorough and insightful, and his brief introductions to sections of the work, along with his explanatory footnotes, are the most useful available.

Michael Martin aims to affirm a certain pattern of first-person thinking by advocating disjunctivism, a theory of perceptual experience which combines naive realism with the epistemic conception of hallucination. In this paper I argue that we can affirm the pattern of thinking in question without the epistemic conception of hallucination. The first part of my paper explains the link that Martin draws between the first-person thinking and the epistemic conception of hallucination. The second part of my paper explains how we (...) can achieve Martin’s ambition without Martin’s theory. One resource that I enlist for this purpose is a naive-realist friendly conception of first-person access to experience. The metaphysical theory that I enlist is a form of naive realism that endorses an intentionalist or representationalist “common-factor” approach to veridical and hallucinatory experience. The third part of my paper briefly develops this theory. (shrink)

In this paper I argue that there is an urgent need for more empirical research into everyday experiences of living with datafication, something that has not been prioritised in the emerging field of data studies to date. As a result of this absence, the knowledge produced within data studies is not as aligned to the aims of data activism as it might be. Data activism seeks to challenge existing, unequal data power relations and to mobilise data in order to enhance (...) social justice, yet data studies has focused primarily on identifying the former and not on imagining the latter. To build a picture of what more just conditions of datafication might look like, I argue that it is important to take account of everyday experiences of datafication, of what people themselves say would enable them to live better with data and would constitute more just data arrangements, based on their experiences. I explore two possible approaches to this endeavour, both of which suggest the need for a vocabulary of emotions in researching everyday living with data. (shrink)

Drawing on Sir Ian Kennedy's extensive experience in healthcare law, ethics and public policy-making, this book explores vital issues in the law surrounding healthcare and regulation. The book contains a range of published and unpublished essays and speeches with the addition of notes and commentaries by the author that bring the pieces up to the present day. Those who want to understand developments, from transplants to confidentiality, from COVID-19 to public inquiries to regulation will find a rich seam of (...) rigorous, informed analysis. The author's unique range of experience allows him to share insights on a variety of issues; from the conduct of the disgraced breast surgeon, Ian Paterson, to research at Porton Down, to the economics of innovation in drug development at NICE. His abiding interest in the welfare of children informs his trenchant forensic examination of how children fare in the NHS. Those involved in or with an interest in law, moral philosophy, and public policy will find much food for thought. (shrink)

Diagnostic testing can be used for many purposes, including testing to facilitate the clinical care of individual patients, testing as an inclusion criterion for clinical trial participation, and both passive and active surveillance testing of the general population in order to facilitate public health outcomes, such as the containment or mitigation of an infectious disease. As such, diagnostic testing presents us with ethical questions that are, in part, already addressed in the literature on clinical care as well as clinical research (...) (such as the rights of patients to refuse testing or treatment in the clinical setting or the rights of participants in randomized controlled trials to withdraw from the trial at any time). However, diagnostic testing, for the purpose of disease surveillance also raises ethical issues that we do not encounter in these settings, and thus have not been much discussed. In this paper we will be concerned with the similarities and differences between the ethical considerations in these three domains: clinical care, clinical research, and public health, as they relate to diagnostic testing specifically. Via an examination of the COVID-19 case we will show how an appeal to the concept of diagnostic justice helps us to make sense of the (at times competing) ethical considerations in these three domains. (shrink)

Democracy faces threats from an emerging right-wing movement in democratic governments around the world. This may be even more prevalent in the United States because there is an evil that uses rhetorical tropes to undermine the anchor institutions of democracy: press, courts, universities, and Congress. This evil has a personification--former President Donald Trump. All the rhetorical critiques of Trump, that he is a demagogue, an authoritarian, a serial liar, a populist on steroids, fail to take into account the evil that (...) is fomented by his angry and vengeful rhetoric. Pictures of evil in Scripture, philosophy, and rhetoric bear a striking resemblance to Trump. It is not enough to say that he is dangerous to democracy. Kennedy claims that he is the evil seed in democracy that is even now sprouting new versions of the Trump rhetoric as each acolyte attempts to outrage the next. Good and Evil in the Garden of Democracy screams at the evil, fights against the evil, and then attempts to sing the songs of goodness and democracy from poets, prophets, and rhapsodes. For the health of democracy these words have been written. (shrink)

Net Work provides a detailed study of the work of web designers. It draws on empirical research carried out from the birth of web design as an area of work in the 1990s to its professionalization in the twenty-first century and addresses the politics of building an inclusive WWW for people of diverse abilities.

A considerable amount of academic attention has been paid to John Kennedy and to his group of advisors during the Cuban missile crisis. Next to no attention has been accorded other bodies of the Kennedy White House that had daily access to a President's most private moments and possibly to his important deliberations. Drawing on Richard Reeves' account of President Kennedy: Profile of Power, I revisit the early 1960s looking for bodies of power that are culturally (...) sexed female by others and compelled into being as workaday secretaries and confidants, and para-Everythings for Kennedy. In doing so, I draw on the feminist body theorizing of Judith Butler, Rosi Braidotti and Elizabeth Grosz, as well as the evocations of bodies in important but abjected places featured in Margaret Atwood's Handmaid's Tale. After constructing the historically broad category of the handmaid to Washington power, I reread constructions of decision-making in the Cuban missile crisis offered by Graham Allison and conclude that the feint of mancentred Washington masks bodies given the locations, skills and resources to ooze into spaces of decision and power canonically forbidden to them. (shrink)

This book presents a straightforward account of disease, the problems of practice, and the moral, legal and financial questions in the field.