Opioid and sedative use are common ‘active’ practices in the provision of mainstream palliative care services, and are typically distinguished from euthanasia on the basis that they do not shorten survival time. Even supposing that they did, it is often argued that they are justified and distinguished from euthanasia via appeal to Aquinas’ Doctrine of Double Effect. In this essay, I will appraise the empirical evidence regarding opioid/sedative use and survival time, and argue for a position of agnosticism. I will (...) then argue that the Doctrine of Double Effect is a useful ethical tool but is ultimately not a sound ethical principle, and even if it were, it is unclear whether palliative opioid/sedative use satisfy its four criteria. Although this essay does not establish any definitive proofs, it aims to provide reasons to doubt—and therefore weaken—the often-claimed ethical distinction between euthanasia and palliative opioid/sedative use. (shrink)

Gilbertson et al should be commended for their insightful exploration of expanded terminal sedation (ETS)1; however, there are a number of concerns that I will address in this response. I will first better characterise the currently accepted and commonplace ‘standard’ TS (STS), and then argue that the advocated forms of ETS draw very close to—and at times clearly constitute a subtype of—euthanasia, as opposed to representing a similar but separate practice. I will then conclude with concerns regarding the inappropriate application (...) of ETS, particularly in the non-voluntary context. Gilbertson et al distinguish ‘gradual’ TS, which they state is the currently accepted form of TS, from ‘rapid’ TS, which is then argued to be a justifiable form of ETS. However, in my experience working in multiple large public teaching hospitals in New South Wales, Australia and consistent with local clinical practice guidelines,2 3 STS falls somewhere in the middle between ‘gradual’ and ‘rapid’ TS. STS explicitly aims to achieve permanent unconsciousness so as to eliminate the potential for (and therefore relieve) suffering; conversely, lighter or more intermittent forms of sedation, or administering sedatives with aims other than to achieve unconsciousness (eg, anxiolysis), do not constitute TS proper. STS uses doses proportionate to the extent of symptoms so as to avoid ‘overshooting’ and inadvertently administering excessive doses which actually hasten/cause death, in order to distinguish STS from euthanasia in this respect. This is achieved by gradually uptitrating doses when the patient appears distressed, and is therefore by definition …. (shrink)

This 1979 text addresses the ways in which the dominant theories in large areas of Western social science have been subject to strong criticisms, particularly ...

Edward Said’s concept of Orientalism portrays the high tide of nineteenth-century imperialism as the defining moment in the establishment of a global discursive hegemony, in which European attitudes and concepts gained a universal validity. The idea of “religion” was central to the civilizing mission of imperialism, and was shaped by the interests of a number of colonial actors in a way that remains visibly relevant today. In East and Southeast Asia, however, many of the concerns that statecraft, law, scholarship, and (...) conversion had for religion transcended the European impact. Both before and after the period of European imperialism, states used religion to engineer social ethics and legitimate rule, scholars elaborated and enforced state theologies, and the missionary faithful voiced the need for and nature of religious conversion. The real impact of this period was to integrate pre-existing concerns into larger discourses, transforming them in the process. The ideals of national citizenship and of legal and scholarly impartiality recast the state and its institutions with a modernist sacrality, which had the effect of banishing the religious from the public space. At the same time, the missionary discourse of transformative conversion located it in the very personal realm of sincerity and belief. The evolution of colonial-era discourses of religion and society in Asia since the departure of European imperial power demonstrates both their lasting power and the degree of agency that remains implicit in the idea of hegemony. (shrink)

Despite the remarkable achievements of novel targeted anti‐cancer drugs, most therapies only produce remission for a limited time, resistance to treatment, and relapse, often being the ultimate outcome. Drug resistance is due to highly efficient adaptive strategies utilized by cancer cells. Exogenous and endogenous stress stimuli are known to induce first‐line responses, capable of re‐establishing cellular homeostasis and determining cell fate decisions. Cancer cells may also mount second‐line adaptive strategies, such as the mutator response. Hypermutable subpopulations of cells may expand (...) under severe selective stress, thereby accelerating the emergence of adapted clones. As with first‐line protective responses, these strategies appear highly conserved, and are found in yeasts and bacteria. We hypothesize that evolutionarily conserved programs rheostatically regulate mutability in fluctuating environments, and contribute to drug resistance in cancer cells. Elucidating the conserved genetic and molecular mechanisms may present novel opportunities to increase the effectiveness of cancer therapies. (shrink)

David Thomas takes a close look at the United Kingdom during the 1970s to examine the emergence of “electroculture.” Mapping class struggle, dispossession, and state violence onto a history of oil, Thomas makes the case that labor politics and energy politics are deeply intertwined.

Much has been written about prisoner research and the controversies surrounding prisoners as human subjects. The Institute of Medicine recently released a report addressing some of these issues. This report, which generated further controversy, needs to be fully discussed in the literature and certain aspects are examined in this work. Further, in the body of literature there has been little acknowledgement of the concept of the right of prisoners to be involved in research. This needs to be pursued from an (...) ethical perspective and eventually a legal one. This paper explores that concept and documents some facilities in which a prisoner's right to research has occurred. (shrink)

In this immensely readable and wide ranging book,Bernard Lewis charts the successive transformations of the Middle East,beginning with the two great empires,the Roman and the Persian,and covering the growth of Christianity,the rise and spread of Islam,the waves of invaders from the east,the Mongol hordes of Jengiz Khan,the rise of the Ottoman Turks,and the changing balance of power between the Muslim and Christian worlds.THE MIDDLE EAST is a brilliant survey of the history and civilisations of the region.

This is a biography of the works of Richard Price, 1723-1791, one of the leading radical intellectuals of the late-18th century. By profession a dissenting minister, he was also a mathematician, a political pamphleteer, particularly on the American and French Revolutions, and a moral philosopher.

This series of three articles describes the history of land law shared by the British and American legal systems, and how and why these legal traditions have diverged from each other in modern times. This Article - part 1 in this series - describes the emerging customs and laws regarding land rights among early inhabitants of Britain, and how succeeding invasions and occupation by Celtic, Roman, Germanic, and Norman peoples altered these customs and laws. The Article details the profound changes (...) in land law worked by massive economic changes in early British society, including sociological occurrences such as the Black Death, and the adoption of laws, such as the Statute of Uses in 1536. (shrink)

Christian-Muslim Relations, a Bibliographical History 1 is a history of all the known works on Christian-Muslim relations from 600 to 1500. It comprises introductory essays and over 200 detailed entries containing descriptions, assessments and compehensive bibliographical details of individual works.

It has been claimed that decisions reached democratically have the consent of those subject to them. It will be shown that arguments for this view rest on either a Kantian or a utilitarian conception of consent. When the distinct nature of these arguments is kept clearly in mind, it becomes apparent that little remains of any of them. Nothing remains of the argument based on the Kantian conception, at least in so far as it is used to support the view (...) that democratic government rests on the consent of the governed. Though something remains of the arguments based on the utilitarian conception, what remains is not what they often are thought to establish. The spurious plausibility of consent arguments for democracy is due to switches between the Kantian conception of consent and the utilitarian. (shrink)

John Locke is one of the most important figures in the history of political thought. His Second Treatise on Government was one of the most significant political statements of its time and provides the foundations of liberal political thought. His views on the social contract, political obligation, rebellion, revolution and property remain strikingly relevant today. Locke on Government introduces and assesses: * Locke's life and the background to the Second Treatise on Government *The text and ideas of the Second Treatise (...) *The continuing importance of Locke's work to philosophy For student's coming to Locke for the first time, Locke on Government will be an invaluable guide to his political thought. (shrink)

John Locke is one of the most important figures in the history of political thought. His _Second Treatise on Government_ was one of the most significant political statements of its time and provides the foundations of liberal political thought. His views on the social contract, political obligation, rebellion, revolution and property remain strikingly relevant today. _Locke on Government_ introduces and assesses: * Locke's life and the background to the _Second Treatise on Government_ *The text and ideas of the _Second Treatise_ (...) *The continuing importance of Locke's work to philosophy For student's coming to Locke for the first time, _Locke on Government_ will be an invaluable guide to his political thought. (shrink)

This Article examines the genesis and evolution of the Restatements of Property. The author argues that, while the Restatement (First) of Property took as its original purpose to restate the law, in the course of its creation it was turned to reform. Subsequent Restatements of Property are dedicated almost wholly to reform. The author concludes that this shift in objectives has sparked criticism and rendered these works of less value and interest to the legislatures, bench and the bar, which have (...) largely ignored the property Restatements. (shrink)

After a definition of ?common sense? it is argued that sociology and common sense both do and ought to interact with one another. Four positions on the sociology?common sense relation in the light of the interaction thesis are then critically discussed: sociology must break with common sense; sociology must be based on common sense; sociology and common sense are incomparable; and sociology and common sense are identical. The first two of these positions are further sub?divided in terms of whether the (...) arguments in their favour are or are not independent of one's conceptions of sociology and common sense. Each of these positions is illustrated by means of a case study of one author. The final section involves a consideration of ethnomethodology on the basis of the above typology: it is argued that ethnomethodology cannot find a site on the sociology?common sense question which is compatible with its basic commitments. (shrink)