Michael A. Petersa and Fazal Rizvib aBeijing Normal University, Beijing, PR China; bMelbourne University, Melbourne, Australia Our minds are still racing back and forth, longing for a return to ‘no...

The Dutch law states that a physician may perform euthanasia according to a written advance euthanasia directive when a patient is incompetent as long as all legal criteria of due care are met. This may also hold for patients with advanced dementia. We investigated the differing opinions of physicians and members of the general public on the acceptability of euthanasia in patients with advanced dementia.

On 11 September 2019, the verdict was read in the first prosecution of a doctor for euthanasia since the Termination of Life on Request and Assisted Suicide Act of 2002 was installed in the Netherlands. The case concerned euthanasia on the basis of an advance euthanasia directive for a patient with severe dementia. In this paper we describe the review process for euthanasia cases in the Netherlands. Then we describe the case in detail, the judgement of the Regional Review Committees (...) for Termination of Life on Request and Euthanasia and the judgement of the medical disciplinary court. Both the review committees and the disciplinary court came to the conclusion there were concerns with this case, which mainly hinged on the wording of the AED. They also addressed the lack of communication with the patient, the absence of oral confirmation of the wish to die and the fact that the euthanasia was performed without the patient being aware of this. However, the doctor was acquitted by the criminal court as the court found she had in fact met all due care criteria laid down in the act. We then describe what this judgement means for euthanasia in the Netherlands. It clarifies the power and reach of AEDs, it allows taking conversations with physicians and the testimony of the family into account when interpreting the AED. However, as a practical consequence the prosecution of this physician has led to fear among doctors about prosecution after euthanasia. (shrink)

In pluralist societies, stakeholders in healthcare may have different experiences of and moral perspectives on health, well-being, and good care. Increasing cultural, religious, sexual, and gender diversity among both patients and healthcare professionals requires healthcare organizations to address these differences. Addressing diversity, however, comes with inherent moral challenges; for example, regarding how to deal with healthcare disparities between minoritized and majoritized patients or how to accommodate different healthcare needs and values. Diversity statements are an important strategy for healthcare organizations to (...) define their normative ideas with respect to diversity and to establish a point of departure for concrete diversity approaches. We argue that healthcare organizations ought to develop diversity statements in a participatory and inclusive way in order to promote social justice. Furthermore, we maintain that clinical ethicists can support healthcare organizations in developing diversity statements in a more participatory way by fostering reflective dialogues through clinical ethics support. We will use a case example from our own practice to explore what such a developmental process may look like. We will critically reflect on the procedural strengths and challenges as well as on the role of the clinical ethicist in this example. (shrink)

We often explain by citing an absence or an omission. Apart from the problem of assigning a causal role to such apparently negative factors as absences and omissions, there is a puzzle as to why only some absences and omissions, out of indefinitely many, should figure in explanations. In this paper we solve this ’many absences problem’ by using the contrastive model of explanation. The contrastive model of explanation is developed by adapting Peter Lipton’s account. What initially appears to be (...) only a trivial amendment to Lipton’s Difference Condition enables us both to offer a much more satisfactory solution to the ’many absences problem’ than David Lewis did, and also to explain why explanation in terms of absences and omissions should be so common. (shrink)

Volume 20, Issue 6, June 2020, Page 70-72.

The worldwide COVID-19 pandemic has shed more light on the difficulty of making health care decisions integrating scientific knowledge and values associated to life and death issues, human suffering, quality of life, economic losses, liberty of movement, etc. But the difficulties related to health care decisions and the use of innovative drugs or technologies are not new, and many countries have created agencies that have the mandate to evaluate new technologies in health care. Health Technological Assessment (HTA) reports’ aim is (...) to guide the decision makers in these difficult matters. There are two ethical components in HTA. The first is the report’s presentation of an ethical evaluation of the technology. The second is the value-ladenness of the HTA decision-making process itself. When implicit value judgments are not elicited, the justification of the final decision cannot be transparent. The present paper aims to identify and elicit the implicit value-judgments related to each step of the HTA process. This research is grounded on an applied ethics decision-making paradigm based on the role of value judgments in the decision-making process. The first part discusses two different approaches to values and value judgments in HTA. In the second part, citations mentioning value judgments extracted from a systematic review on the integration of ethics into HTA were categorized to elicit the value judgments and their criteria for each different HTA decision-making steps. The results show that there are 18 decision-making steps in the HTA process where 23 implicit value-judgments can be recognized. The range of these value judgments encompasses the whole HTA process: from the initial request, the presenting of the principal issues, to the final report’s dissemination. Since stakeholders need to understand which value judgments the conclusion of a report relies on, eliciting the implicit value judgments in the HTA decision-making process should yield more transparency. (shrink)

This co-edited volume compares Chinese and Western experiences of engineering, technology, and development. In doing so, it builds a bridge between the East and West and advances a dialogue in the philosophy of engineering. Divided into three parts, the book starts with studies on epistemological and ontological issues, with a special focus on engineering design, creativity, management, feasibility, and sustainability. Part II considers relationships between the history and philosophy of engineering, and includes a general argument for the necessity of dialogue (...) between history and philosophy. It continues with a general introduction to traditional Chinese attitudes toward engineering and technology, and philosophical case studies of the Chinese steel industry, railroads, and cybernetics in the Soviet Union. Part III focuses on engineering, ethics, and society, with chapters on engineering education and practice in China and the West. The book’s analyses of the interactions of science, engineering, ethics, politics, and policy in different societal contexts are of special interest. The volume as a whole marks a new stage in the emergence of the philosophy of engineering as a new regionalization of philosophy. This carefully edited interdisciplinary volume grew out of an international conference on the philosophy of engineering hosted by the University of the Chinese Academy of Sciences in Beijing. It includes 30 contributions by leading philosophers, social scientists, and engineers from Australia, China, Europe, and the United States. (shrink)

Mental health chatbots (MHCBs) designed to support individuals in coping with mental health issues are rapidly advancing. Currently, these MHCBs are predominantly used in commercial rather than clinical contexts, but this might change soon. The question is whether this use is ethically desirable. This paper addresses a critical yet understudied concern: assuming that MHCBs cannot have genuine emotions, how this assumption may affect psychotherapy, and consequently the quality of treatment outcomes. We argue that if MHCBs lack emotions, they cannot have (...) genuine (affective) empathy or utilise countertransference. Consequently, this gives reason to worry that MHCBs are (a) more liable to harm and (b) less likely to benefit patients than human therapists. We discuss some responses to this worry and conclude that further empirical research is necessary to determine whether these worries are valid. We conclude that, even if these worries are valid, it does not mean that we should never use MHCBs. By discussing the broader ethical debate on the clinical use of chatbots, we point towards how further research can help us establish ethical boundaries for how we should use mental health chatbots. (shrink)

Reading Feminist Theory: From Modernity to Postmodernity interweaves classical and contemporary writings from the social sciences and the humanities to represent feminist thought from the late eighteenth century to the present. Editors Susan Archer Mann and Ashly Suzanne Patterson pay close attention to the multiplicity and diversity of feminist voices, visions, and vantage points by race, class, gender, sexuality, and global location. Along with more conventional forms of theorizing, this anthology points to multiple sites of theory production--both inside and (...) outside of the academy--and includes personal narratives, poems, short stories, zines, and even music lyrics. Offering a truly global perspective, the book devotes three chapters and more than thirty readings to the topics of colonialism, imperialism and globalization. It also provides extensive coverage of third-wave feminism, poststructuralism, queer theory, postcolonial theory, and transnational feminisms. (shrink)

This study develops a detailed reading of the interrelations between aesthetics, ideology, language, gender and political economy in two highly influential works by Edmund Burke: his Philosophical Enquiry into the Origin of our Ideas of the Sublime and the Beautiful (1757), and the Reflections on the Revolution in France (1790). Tom Furniss's close attention to the rhetorical labyrinths of these texts is combined with an attempt to locate them within the larger discursive networks of the period, including texts by Locke, (...) Hume and Smith. This process reveals that Burke's contradictions and inconsistencies are symptomatic of a strenuous engagement with the ideological problems endemic to the period. Burke's dilemma in this respect makes the Reflections an audacious compromise which simultaneously defends the ancien régime, contributes towards the articulation of radical thought, and makes possible the revolution which we call English Romanticism. (shrink)

Cet article propose un regard historique sur la notion d’exercice en art, à travers le cas du métier de comédien dans la seconde moitié du XVIIIe siècle. Alors qu’une véritable théâtromanie s’empare de la société française, les acteurs et les actrices doivent répondre aux exigences d’un public friand de nouveautés à l’affiche. L’article met en lumière des pratiques peu visibles du travail artistique, comme l’effort de mémorisation des rôles, ou les modalités d’organisation des exercices au sein de la première école (...) dramatique française (1786-1789). Nous montrons également que la reconnaissance croissante de la centralité de l’exercice, à la fois corporel et intellectuel, dans le métier de comédien contribue à définir la spécificité de l’art dramatique dans le second XVIIIe siècle. (shrink)

Individuals are faced with the many opportunities to pirate. The decision to pirate or not may be related to an individual''s attitudes toward other ethical issues. A person''s ethical and moral predispositions and the judgments that they use to make decisions may be consistent across various ethical dilemmas and may indicate their likelihood to pirate software. This paper investigates the relationship between religion and a theoretical ethical decision making process that an individual uses when evaluating ethical or unethical situations. An (...) ethical decision making model was studied for general unethical scenarios and for the unethical behavior of software piracy. The research model was tested via path analysis using structural equation modeling and was found to be appropriate for the sample data. The results suggest that there is a relationship between religion and the stages of an ethical decision making process regarding general ethical situations and software piracy. (shrink)

The Eurocentric canon remains the predominant focus of music education often excluding the role of music and experiences of Black individuals and people of color. This singular perspective creates an incomplete and inaccurate understanding of the comprehensive nature of music and the humans who create, perform, and engage with it. In this article, the author shares her experience as a Black music educator and her aspirations for a music profession that incorporates the full range of human music engagement and expression. (...) The paper begins with a reflection on W.E.B. DuBois’s double consciousness followed by an exploration of the nuances, complexities, contradictions, and beauty of being a Black educator in a primarily white field. Subsequently, the essay presents four conceptual principles for a reimagined, inclusive music education approach, drawing inspiration from Sylvia Wynter’s “new science of the Word.” These principles advocate retelling the music education narrative to incorporate historically marginalized voices, reorienting music education to be human-centered, embracing interdisciplinary approaches to view music teaching and learning, and acknowledging the power of music in uplifting the human condition. Finally, this paper proposes a pathway for reconciling diverse identities prevalent in American culture with music education and academia. (shrink)

Historically, patients have deferred to physicians′ judgments about appropriate medical care, thereby limiting patient participation in treatment decisions. In this model of medical decision making, physicians typically decided upon the treatment plan. Communication with patients focused on securing their cooperation in accepting a treatment decision that essentially had already been made.

"In recent years, we have grown accustomed to philosophical language that is intensely self-conscious and rhetorically thick, often tragic in tone. It is enlivening to read Bergson, who exerts so little rhetorical pressure while exacting such a substantial effort of thought.... Bergson's texts teach the reader to let go of entrenched intellectual habits and to begin to think differently—to think in time.... Too much and too little have been said about Bergson. Too much, because of the various appropriations of his (...) thought. Too little, because the work itself has not been carefully studied in recent decades."—from Thinking in Time Henri Bergson, whose philosophical works emphasized motion, time, and change, won the Nobel Prize for Literature in 1927. His work remains influential, particularly in the realms of philosophy, cultural studies, and new media studies. In Thinking in Time, Suzanne Guerlac provides readers with the conceptual and contextual tools necessary for informed appreciation of Bergson's work. Guerlac's straightforward philosophical expositions of two Bergson texts, Time and Free Will and Matter and Memory, focus on the notions of duration and memory—concepts that are central to the philosopher's work. Thinking in Time makes plain that it is well worth learning how to read Bergson effectively: his era and our own share important concerns. Bergson's insistence on the opposition between the automatic and the voluntary and his engagement with the notions of "the living," affect, and embodiment are especially germane to discussions of electronic culture. (shrink)

The value of applied philosophy is often taken to consist in its contribution to our understanding of practical issues with which applied philosophy engages and in its contribution to their satisfactory resolution. This chapter examines the relationship between the nature of applied philosophy and its value. It regards the value of applied philosophy as dependent both on its philosophical quality and on its contribution to the understanding and (potential) resolution of practical issues with which it engages. These dual points of (...) reference are difficult simultaneously to fulfill and arguably sometimes in tension with one another. The chapter takes issue with the idea that the value of applied philosophy consists, or ought to consist, in its direct impact on actual policy or practice. (shrink)

This article proposes a situated reading of maternal love, loss and lovelessness in Donna Hemans’ novel River Woman, locating her text in relation to other contemporary Caribbean women writers and to the early fiction of Toni Morrison. I argue that the complex affects that her representation of ‘child-shifting’ produces, can be articulated both in relation to literary texts that re-imagine historical and contemporary practices leaving a child in order to save her, and in the context of the plantation, where ruptured (...) ties at the level of community and culture continue to be reproduced in the personal, emotional and family spheres. I use the concept of marronage, developed in the work of Glissant and Depestre, to define strategies of survival that necessitated actual and imaginative flight or escape, to contextualise the complex affects of the plantation that are repeated and reproduced in the novel's present—the late twentieth-century Caribbean. (shrink)

In this essay Suzanne Rice examines Aristotle's ideas about virtue, character, and education as elements in an Aristotelian conception of good listening. Rice begins by surveying of several different contexts in which listening typically occurs, using this information to introduce the argument that what should count as “good listening” must be determined in relation to the situation in which listening actually occurs. On this view, Rice concludes, there are no “essential” listening virtues, but rather ways of listening that may (...) be regarded as virtuous in the context of particular concrete circumstances. (shrink)

While artificial intelligence (AI) is increasingly applied for decision- making processes, ethical decisions pose challenges for AI applica- tions. Given that humans cannot always agree on the right thing to do, how would ethical decision-making by AI systems be perceived and how would responsibility be ascribed in human-AI collabora- tion? In this study, we investigate how the expert type (human vs. AI) and level of expert autonomy (adviser vs. decider) influence trust, perceived responsibility, and reliance. We find that partici- pants (...) consider humans to be more morally trustworthy but less capable than their AI equivalent. This shows in participants’ re- liance on AI: AI recommendations and decisions are accepted more often than the human expert’s. However, AI team experts are per- ceived to be less responsible than humans, while programmers and sellers of AI systems are deemed partially responsible instead. (shrink)

Proportionality is widely accepted as a necessary condition of justified self-defense. What gives rise to this particular condition and what role it plays in the justification of self-defense seldom receive focused critical attention. In this paper I address the standard of proportionality applicable to personal self-defense and the role that proportionality plays in justifying the use of harmful force in self-defense. I argue against an equivalent harm view of proportionality in self-defense, and in favor of a standard of proportionality in (...) self-defense that requires comparable seriousness and takes into account the wrong, as opposed simply to the harm that the victim is fending off. I distinguish the standard of proportionality in self-defense from proportionality in circumstances of necessity, and I discuss whether proportionality is an internal or an external constraint on the right of self-defense. (shrink)

I argue that in the Phaedo, Plato maintains that the soul is located in space and is capable of locomotion and of interacting with the body through contact. Numerous interpreters have dismissed these claims as merely metaphorical, since they assume that as an incorporeal substance, the soul cannot possess spatial attributes. But careful examination of how Plato conceives of the body throughout his corpus reveals that he does not distinguish it from the soul in terms of spatiality. Furthermore, assigning spatial (...) attributes to the soul plays an important role in Plato’s account of the relation of body and soul. (shrink)

In this book, Suzanne Kirschner traces the origins of contemporary psychoanalysis back to the foundations of Judaeo-Christian culture, and challenges the prevailing view that modern theories of the self mark a radical break with religious and cultural tradition. Instead, she argues, they offer an account of human development which has its beginnings in biblical theology and neoplatonic mysticism. Drawing on a wide range of religious, literary, philosophical and anthropological sources, Dr Kirschner demonstrates that current Anglo-American psychoanalytic theories are but (...) the latest version of a narrative that has been progressively secularized over the course of nearly two millennia. She displays a deep understanding of psychoanalytic theories, while at the same time raising provocative questions about their status as knowledge and as science. (shrink)

Do individuals have a positive right of self-defence? And if so, what are the limits of this right? Under what conditions does this use of force extend to the defence of others? These are some of the issues explored by Dr Uniacke in this comprehensive 1994 philosophical discussion of the principles relevant to self-defence as a moral and legal justification of homicide. She establishes a unitary right of self-defence and the defence of others, one which grounds the permissibility of the (...) use of necessary and proportionate defensive force against culpable and non-culpable, active and passive, unjust threats. Particular topics discussed include: the nature of moral and legal justification and excuse; natural law justifications of homicide in self-defence; the Principle of Double Effect and the claim that homicide in self-defence is justified as unintended killing; and the question of self-preferential killing. This is a lucid and sophisticated account of the complex notion of justification, revolving around a critical discussion of trends in the law of self-defence. (shrink)

Moral distress forms a major threat to the well-being of healthcare professionals, and is argued to negatively impact patient care. It is associated with emotions such as anger, frustration, guilt, and anxiety. In order to effectively deal with moral distress, the concept of moral resilience is introduced as the positive capacity of an individual to sustain or restore their integrity in response to moral adversity. Interventions are needed that foster moral resilience among healthcare professionals. Ethics consultation has been proposed as (...) such an intervention. In this paper, we add to this proposition by discussing Moral Case Deliberation (MCD) as a specific form of clinical ethics support that promotes moral resilience. We argue that MCD in general may contribute to the moral resilience of healthcare professionals as it promotes moral agency. In addition, we focus on three specific MCD reflection methods: the Dilemma Method, the Aristotelian moral inquiry into emotions, and CURA, a method consisting of four main steps: Concentrate, Unrush, Reflect, and Act. In practice, all three methods are used by nurse ethicists or by nurses who received training to facilitate reflection sessions with these methods. We maintain that these methods also have specific elements that promote moral resilience. However, the Dilemma Method fosters dealing well with tragedy, the latter two promote moral resilience by including attention to emotions as part of the reflection process. We will end with discussing the importance of future empirical research on the impact of MCD on moral resilience, and of comparing MCD with other interventions that seek to mitigate moral distress and promote moral resilience. (shrink)

Two articles have appeared in Law and Philosophy that provide detailed criticisms of aspects of my account of the justification of individual self-defense. One of these articles misconstrues central aspects of my account. The other raises a less central, but nonetheless an important issue that invites clarification. The criticisms raised in these two articles to which I respond here have important bearing on the nature of the justification of self-defense.

BackgroundExisting clinical ethics support (CES) instruments are considered useful. However, users report obstacles in using them in daily practice. Including end users and other stakeholders in developing CES instruments might help to overcome these limitations. This study describes the development process of a new ethics support instrument called CURA, a low-threshold four-step instrument focused on nurses and nurse assistants working in palliative care. MethodWe used a participatory development design. We worked together with stakeholders in a Community of Practice throughout the (...) study. Potential end users (nurses and nurse assistants in palliative care) used CURA in several pilots and provided us with feedback which we used to improve CURA.ResultsWe distinguished three phases in the development process. Phase one, Identifying Needs, focused on identifying stakeholder and end user needs and preferences, learning from existing CES instruments, their development and evaluation, and identify gaps. Phase two, Development, focused on designing, developing, refining and tailoring the instrument on the basis of iterative co-creation. Phase three, Dissemination, focused on implementation and dissemination. The instrument, CURA, is a four-step low-threshold instrument that fosters ethical reflection.ConclusionsParticipatory development is a valuable approach for developing clinical ethics support instruments. Collaborating with end users and other stakeholders in our development study has helped to meet the needs and preferences of end users, to come up with strategies to refine the instrument in order to enhance its feasibility, and to overcome reported limitations of existing clinical ethics instruments. (shrink)

This article presents an ethics support instrument for healthcare professionals called CURA. It is designed with a focus on and together with nurses and nurse assistants in palliative care. First, we shortly go into the background and the development study of the instrument. Next, we describe the four steps CURA prescribes for ethical reflection: (1) Concentrate, (2) Unrush, (3) Reflect, and (4) Act. In order to demonstrate how CURA can structure a moral reflection among caregivers, we discuss how a case (...) was discussed with CURA at a psychogeriatric ward of an elderly care home. Furthermore, we go into some considerations regarding the use of the instrument in clinical practice. Finally, we focus on the need for further research on the effectiveness and implementation of CURA. (shrink)

Translator's Preface LA LOGIQUE DE HUSSERL, etude sur "Logique for- melle et logique transcendentale" the original of the present translation, was published ...

This paper defends an intellectualist interpretation of Diotima’s speech in Plato’s Symposium. I argue that Diotima’s purpose, in discussing the lower lovers, is to critique their erōs as aimed at a goal it can never secure, immortality, and as focused on an inferior object, themselves. By contrast, in loving the form of beauty, the philosopher gains a mortal sort of completion; in turning outside of himself, he also ceases to be preoccupied by his own incompleteness.

Preference utilitarianism is widely considered a significant advance on classical utilitarianism when it comes to explaining why it is wrong to kill people. This paper focuses attention on the nature of the preference utilitarian 'direct' objection to killing a person and on the related claim that a person's preferences are non-replaceable. I argue that the preference utilitarian case against killing people is overstated and overrated. My concluding remarks indicate the relevance of this discussion to deeper issues in normative moral theory.

summary, crtiques, strengths and limitation of the article.

Contesting Extinctions: Decolonial and Regenerative Futures critically interrogates the discursive framing of extinctions and how they relate to the systems that bring about biocultural loss. The chapters in this multidisciplinary volume examine approaches to ecological and social extinction and resurgence from a variety of fields, including environmental studies, literary studies, political science, and philosophy. Grounding their scholarship in decolonial, Indigenous, and counter-hegemonic frameworks, the contributors advocate for shifting the discursive focus from ruin to regeneration. -/- .