The concept of autonomy plays atleast two roles in moral theory. First, itprovides a source of constraints upon action:because I am autonomous you may not interferewith me, even for my own good. Second, itprovides a foundation for moral theory: humanautonomy has been thought by some to producemoral principles of a more general kind.This paper seeks to understand what autonomyis, and whether the autonomy of which we arecapable is able to serve these roles. We wouldnaturally hope for a concept of autonomy (...) thatis value-neutral rather than value-laden. Thatis to say, we would want the judgement that Iam autonomous to depend wholly on, say,structural features of my psychology, and in noway to require us to make ethical judgements, orother value judgements. Being value-neutral isperhaps desirable in a concept of autonomyserving the first role, and plausiblyindispensible in one playing the second. Ishall argue, however, that value-neutral conceptionsof autonomy are impoverished and out of linewith our intuitions; set out and defendan explicitly value-laden conception ofautonomy; and explore the implications of such a view for theability of autonomy to play the rolesmentioned above. (shrink)

Sexual and reproductive health is a challenge worldwide, and much progress is needed to reach the relevant UN Sustainable Development Goals. This paper presents cross-sectional data collected in Sierra Leone on sexual and gender-based violence, family planning, child, early and forced marriage, and female genital mutilation using an innovative method of measurement: situational judgment tests, as a subset of questions within a larger survey tool. For the SJTs, respondents saw hypothetical scenarios on these themes and had to indicate how they (...) would react. The objective is to give an impression of beliefs and norms on specific behaviors, which provide insights for social and behavior change interventions. Data was collected by enumerators traveling to villages randomly selected in six districts of the country. The sample is composed of 566 respondents. Results show that FGM in particular seem to be a priority topic, in comparison to the other topics for which the norms seem to be stronger against those practices. Age differences emerged and suggest priority groups to be targeted. In terms of validity of the measurement methods, situational judgment test answers correlated positively with other items in the survey, but the magnitude of the association is often small, and sometimes not significant. Thus, more studies are needed to further explore the validity of this measure by comparing against a reference value. Using SJTs could complement other data collection tools to perform community assessment, and orient the direction of the program in its planning phase. (shrink)

Parents’ freedom to choose infant male circumcision is the correct policyIndividuals and groups lobbying to have infant male circumcision prohibited or restricted often argue that the practice of routinely circumcising infants is unjustified. For instance, in this issue of the journal, John Hutson argues that it is virtually impossible to justify a policy in which the medical establishment should be able to embark on a “mass circumcision” campaign of 100% of the infant male population [see page 238].1Indeed, I would be (...) hard pressed to find anyone who could rationally disagree with this contention. However, this is because no one is currently arguing for the enactment of a policy that stipulates that all healthy male infants should be routinely circumcised . Arguments seeking to support a prohibition of “routine infant circumcision”, such as the one by Hutson, are arguing against a straw man—and a pitiful one at that.2 Such arguments only serve to misconstrue the debate and avoid engaging in the real and pressing issues concerning the legitimacy of the provision of this procedure.The questions that should be considered, and the ones which I shall be interested in discussing here, are what reasons are justifiable for allowing parents to choose to have their son circumcised? After well informed and careful deliberation should parents have the freedom to choose to have their son circumcised? These are the most relevant questions to be considered because there is a growing collection of citizens, medical practitioners, and lawyers who are currently lobbying for the practice of infant male circumcision to be outlawed—for example, there is a bioethicist who argues that the criminal law should be used …. (shrink)

Emotions, Values, and the Law brings together ten of John Deigh's essays written over the past fifteen years. In the first five essays, Deigh ask questions about the nature of emotions and the relation of evaluative judgment to the intentionality of emotions, and critically examines the cognitivist theories of emotion that have dominated philosophy and psychology over the past thirty years. A central criticism of these theories is that they do not satisfactorily account for the emotions of babies or animals (...) other than human beings. Drawing on this criticism, Deigh develops an alternative theory of the intentionality of emotions on which the education of emotions explains how human emotions, which innately contain no evaluative thought, come to have evaluative judgments as their principal cognitive component. The second group of five essays challenge the idea of the voluntary as essential to understanding moral responsibility, moral commitment, political obligation, and other moral and political phenomena that have traditionally been thought to depend on people's will. Each of these studies focuses on a different aspect of our common moral and political life and shows, contrary to conventional opinion, that it does not depend on voluntary action or the exercise of a will constituted solely by rational thought. Together, the essays in this collection represent an effort to shift our understanding of the phenomena traditionally studied in moral and political philosophy from that of their being products of reason and will, operating independently of feeling and sentiment to that of their being manifestations of the work of emotion. (shrink)

This article examines the social development of Hong Kong's cultural and national identity since its return from the UK to the People's Republic of China nearly six years ago, focusing on the extent to which Hong Kong students are now inculcated in traditional Chinese music and express their devotion to the PRC through singing the national anthem. Hong Kong music teachers experience conflicts concerning their roles as music teachers and as purveyors of values education. These observations raise fundamental questions concerning (...) the sociopolitical function of values education in the music classroom. (shrink)

I shall argue, however, that there can be genuine ambivalence between a judgment that A is v and a judgment that A is not v. Such ambivalence may, moreover, be precisely of the kind that appears to be either impossible or destructive for ethics. Objectivist ambivalence, as we shall call it, is neither an accidental nor peripheral feature of our value discourse. At the same time it is not destructive to ethics or to value judgments in general, but (...) only to certain received philosophical conceptions of ethics and value. Once the phenomenon of objectivist ambivalence of value judgment is identified, it can be analyzed, and in conducting that analysis I shall set out three aspects that are involved in it. The analysis of the mental attitude of ambivalence will have consequences for the logic of values. We shall see that this logic allows and invites tensions in a non-mysterious way. (shrink)

An independent attempt to discover the standards of judging goodness and right, based on a description of the ways in which such judgments arise in economics and law. The approach and outcome are generally Kantian, and the author concludes with an effort to reconcile the claims of causality and freedom.--R. H.

This volume celebrates the career of John Martin Fischer, whose work on a wide range of topics over the past forty years has been transformative and inspirational. Fischer's semicompatibilist view of free will and moral responsibility is perhaps the most widely discussed view of its kind, and his emphasis on the significance of reasons-responsiveness as the capacity that underlies moral accountability has been widely influential. Aside from free will and moral responsibility, Fischer is also well-known for his work on freedom (...) and foreknowledge, the problem of evil, the badness of death, the meaning of life, and the allure of immortality. This volume gathers new essays by leading scholars on some of the major themes of Fischer's work, and it also includes a new piece by Fischer in which he offers a systematic reflection on and defense of the motivations that have shaped his theorizing about moral responsibility. Freedom, Responsibility, and Value will be of interest to scholars and students working on a variety of issues in metaphysics, ethics, and philosophy of religion. (shrink)

In a secular society, does Christmas mean anything anymore? As we stuff ourselves with plumped-up turkeys, unwrap the latest useless gadget, and gather round the family tree, what real relevance does the festive season have and why do we perpetuate it? The Philosophy of Christmas is designed to be a fun book but one underpinned by an exploration of serious philosophical issues. The way we celebrate Christmas says a lot about the way we relate to each other, our society and (...) values. For instance, did you know that Santa's outfit is only red and white because those are the colours of the Coca Cola company? Already a bestselling author, Stephen Law takes a look at such things as the virgin birth (David Hume's theories on miracles), Bertrand Russell's turkey, the existential angst of Santa, and peace on earth to produce a humourous, varied and thought-provoking collection. (shrink)

Mr Jarvis, a Christian, was asleep in bed, dreaming of the Last Judgement. In his dream, Jarvis found himself seated next to God in a great cloud-swept hall. God had just finished handing down judgement on the drunkards, who were slowly shuffling out of the exit to the left. Angels were now ushering a group of nervous-looking men through the entrance to the right. As the men were assembled before Him, God began to speak.

Evidence suggests that the incidence of research misconduct is not in decline despite efforts to improve awareness, education and governance mechanisms. Two responses to this problem are favoured: first, the promotion of an agent-centred ethics approach to enhance researchers’ personal responsibility and accountability, and second, a change in research culture to relieve perceived pressures to engage in misconduct. This article discusses the challenges for both responses and explains how normative coherence through values alignment might assist. We argue that research integrity (...) and research ethics convey mixed messages, which are likely to contribute to a form of normative confusion. For the successful adoption of an agent-centred approach, normative coherence is needed between the two. To facilitate normative coherence, we propose that research ethics and research integrity be underpinned by a shared set of moral values that can be enacted via codes and guidelines and imbue research environments. Furthermore, to facilitate culture change, the same normative coherence is necessary at all levels of an institution. Only via values alignment between institutional aims, management, institutional practices and researchers can an ethical culture become truly embedded in research institutions. (shrink)

Many people are uncomfortable with the idea that pleasure from certain sources is genuinely beneficial. These sources can be sorted into two classes: ones that involve others’ pain; and ones that involve what seems to be damage rather than benefit to the person involved. Here’s an example of the latter: a woman who claims that she enjoys her work performing in hard-core pornographic films. Some find it hard to take such a claim at face value – they instinctively assume (...) that the woman is insincere or self-deceived.1 The reason seems a strongly paternalistic one: because the activity is assumed to be bad, it’s thought that only someone who was in some way damaged could genuinely like it. A statement from Brian Hill, the director of a documentary about such women, illustrates this: ‘I felt certain that she couldn’t enjoy what she does, that there must be some reason why she’s undergoing this kind of experience. But there was nothing: no messed-up childhood, no sense of pain or humiliation.’ Forced to conclude that the woman in question really does enjoy her work, Hill changes his view to imply that the pleasure gained cannot be truly beneficial: ‘When I hear a young woman talking about doing videos of fisting and asphyxiation, I have to wonder what it’s doing to her – even if she says that she’s having fun.’. (shrink)

This paper analyses the Verlagsanzeige of the humanist, mathematician, astronomer and publisher Johannes Regiomontanus. How is humanism expressed in this famous document from German early printing and what is its relationship to philosophy? The article shows that Regiomontanus advocated a special form of humanism that went beyond the standard humanism that he valued, with ‘truth’ as its most important aspect. From the epistemological perspective of the history of philosophy in Regiomontanus’s publishing programme, the ‘truth’ of mathematics is seen, analogous to (...) some predecessors, as a paradigm of programmatic testimony. The integration of philosophy is evident in this, as in another specified way as well. (shrink)

This paper suggests the adoption of a ‘capability approach’ to key concepts in healthcare. Recent developments in theoretical approaches to concepts such as ‘health’ and ‘disease’ are discussed, and a trend identified of thinking of health as a matter of having the capability to cope with life’s demands. This approach is contrasted with the WHO definition of health and Boorse’s biostatistical account. We outline the ‘capability approach’, which has become standard in development ethics and economics, and show how existing work (...) in those areas can profitably be adapted to healthcare. Cases are used to illustrate the value of adopting a capability approach. (shrink)

Street art and graffiti are on the rise and their problematic relationship with the law is becoming an increasingly pressing issue. This paper considers a series of high profile street art controversies involving famous street artists Banksy and Alice Pasquini as cases studies for illuminating such a relationship. First, by discussing the “Banksy’s Law” – a “law” protecting street artworks in the style of Banksy while condemning graffiti – and its perceived arbitrariness, I investigate what I call the structural differences (...) between aesthetic and legal judgments. While not denying some continuity in reasoning about the law and the arts, I argue that legal judgments possess a degree of formality that cannot be found in their aesthetic counterpart. Second, in expanding my discussion, I also maintain that aesthetic considerations should not function as overriding reasons in legal determinations. By being illegal, many street artworks and graffiti acquire subversive power. If deprived of the possibility of challenging the law because of their aesthetic value, these art forms would lose much of their political value. And, more generally, a world where artworks cannot challenge the law is a world where the arts are rather superficial forms of entertainment. (shrink)

PURPOSE: The purpose of this paper is to consider some of the philosophical and bioethical issues raised by the creation of the draft social values framework developed to facilitate data collection and country-specific presentations at the inaugural workshop on "Social values and health priority setting" held in February 2011. -/- DESIGN/METHODOLOGY/APPROACH: Conceptual analysis is used to analyse the term "social values", as employed in the framework, and its relationship to related ideas such as moral values. The structure of the framework (...) (process and content values) is considered in light of current debate in philosophy and bioethics about the political and moral aims served by these kinds of values, and the extent to which they are either suited to, or sufficient for, the policy context. -/- FINDINGS: There is much to be gained by engaging with the arguments presented in the philosophical literature in order to further refine the framework. The framework should remain neutral in respect of the importance of procedural values in different contexts and should be as inclusive as possible in respect of the principles it includes. Further development would be best served by taking a multidisciplinary approach. The framework could provide a valuable space in which future debates about procedural/substantive values can be considered. -/- ORIGINALITY/VALUE: The paper brings philosophical and bioethics perspectives to bear on a new framework proposed for the analysis of social values in health priority setting. It identifies how such a practical, policy-focused framework might be informed by engagement with deeper, and often unresolved, questions or principle around resource allocation in health. (shrink)

The question of whether old age should or should not play a role in medical decision-making for the elderly patient is regularly debated in ethics and medicine. In this paper we investigate exactly how age influences the decision-making process. To explore the normative argumentation in the decisions regarding an elderly patient we make use of the argumentation model advanced by Toulmin. By expanding the model in order to identify normative components in the argumentation process it is possible to analyse the (...) way that age-related value judgements influence the medical decision-making process. We apply the model to practice descriptions made by medical students after they had attended consultations and meetings in medical practice during their clinical training. Our results show the pervasive character of age-related value judgements. They influence the physician’s decision in several ways and at several points in the decision-making process. Such explicit value judgements were not exclusively used for arguments against further diagnosis or treatment of older patients. We found no systematic “ageist” pattern in the clinical decisions by physicians. Since age plays such an important, yet hidden role in the medical decision-making process, we make a plea for revealing such normative argumentation in order to gain transparency and accountability in this process. An explicit deliberative approach will make the medical decision-making process more transparent and improve the physician–patient relationship, creating confidence and trust, which are at the heart of medical practice. (shrink)

Law's Judgement elucidates and defends a feature of contemporary law that is currently either overlooked or too glibly dismissed as morally troublesome or historically anachronistic. That feature is the abstract nature of law's judgement and its three components show that, when law judges us, it often does so in ignorance of our particular characters and abilities, on the one hand, and in ignorance of our context and circumstances, on the other. Law's judgement is thus insensitive to all or much that (...) makes us the particular people we are. The book explores various connections between this mode of judgement and some of our most important legal and political values. It shows that law's abstract judgement is closely related to important juristic conceptions of personhood, responsibility and impartiality, and that these notions are not without moral significance. The book also examines the connections between modern law's judgement and three of our most important political values, namely, dignity, equality and community. It argues that, if we value particular conceptions of dignity, equality and community, then we must also value law's judgement. Illuminating these connections therefore serves a double purpose: first, it makes a case against those who counsel liberation from law's abstract judgement and, second, it redirects attention to the task of morally evaluating law's abstract judgement in its own terms. (shrink)

This paper explores a colonial controversy: the imposition of state rules to limit salmon fishing in a Scandinavian subarctic river. These rules reflect biological fish population models intended to preserve salmon populations, but this river has also been fished for centuries by indigenous Sámi people who have their own different practices and knowledges of the river and salmon. In theory, the Norwegian state recognizes traditional ecological knowledge and includes this in its biological assessments, but in practice this does not happen, (...) so Sámi fishing practices and the realities that they enact are disappearing. This paper explores how to conceptualize colonial differences in knowing. Drawing on recent anthropology, it asks how “settler” and “nomadic” enact worlds and their realities, suggesting that, unlike the latter, the former create a single reality intolerant of alternatives. The focus is thus on a “politics of how” and the ways in which colonial realities and knowledges might intersect less destructively. (shrink)

This article asks how contexts are made in science as well as in social science, and how the making of contexts relates to political agency and intervention. To explore these issues, it traces contexting for foot-and-mouth disease and the strategies used to control the epidemic in the United Kingdom in 2001. It argues that to depict the world is to assemble contexts and to hold them together in a mode that may be descriptive, explanatory, or predictive. In developing this argument, (...) it explores how contexts are assembled in a series of different descriptive and explanatory narratives in epidemiology, policy, critical social science, and social studies of science. (shrink)

As Hong Kong is the only common law jurisdiction operating in Chinese, alongside English, writing a common law judgment in Chinese is like exploring an uncharted domain in legal discourse. Apart from those judgments originally written in Chinese, Chinese judgments have also been prepared by way of translation from English. Besides, there are also English translations of Chinese judgments of jurisprudential value. Judgments in Hong Kong therefore present an interesting case for study both from a legal point of view (...) and from the perspective of discourse analysis. As Chinese judgments in Hong Kong to a large extent mirror images of their English counterparts, they provide us with insights into how judicial thinking embodied in one language is carried over to another. As the translation of court judgments can serve as a clue to the understanding of how judicial thinking is transferred and reflected in another language, this study looks into some of the fundamental problems of legal translation in general and translation of court judgments in particular, showing how the sociosemiotic approach can shed light on those problems. (shrink)

From the Supreme Court to the bedroom, privacy is an intensely contested interest in our everyday lives and privacy law. Some people appeal to privacy to protect such critical areas as abortion, sexuality, and personal information. Yet, privacy skeptics argue that there is no such thing as a right to privacy. I argue that we cannot abandon the concept of privacy. If we wish to avoid extending this elusive concept to cover too much of our lives or shrinking it to (...) cover too little, we must come to understand it. After exploring the privacy arguments of philosophers and constitutional and tort privacy law, I argue for a new definition of privacy and an explanation of its value that clarifies and resolves many of our conflicts. Privacy is critical because it allows us to protect a realm in which we can have intimate relations with others. (shrink)

EspañolEl libro de Lucy conecta magistralmente las tesis jurídicas y filosóficas en discusión con un sólido conocimiento de las áreas doctrinales, mostrando cómo las reivindicaciones presentadas inciden en los problemas reales y urgentes que enfrenta la práctica jurídica. El libro también proporciona una discusión refrescantemente amplia de algunos valores jurídicos fundamentales.InglésLucy’s book stands out as an exception to this state of affairs in that it masterfully connects the legal and philosophical theses under discussion with a solid knowledge of doctrinal areas, (...) showing how the claims advanced bear on the real, pressing, problems facing legal practice. The book also departs from the ‘you’d better know a lot about a little’ kind of approach that is characteristic of analytic philosophy of law and provides a refreshingly broad discussion of some fundamental legal values.FrancésLe livre de Lucy relie magistralement les thèses juridiques et philosophiques en discussion à une solide connaissance des domaines doctrinaux, en montrant comment les revendications présentées affectent les problèmes réels et urgents auxquels la pratique juridique est confrontée. Le livre propose également une discussion complète et rafraîchissante de certaines valeurs juridiques fondamentales.PortuguésO livro do Lucy conecta com maestria as teses jurídicas e filosóficas em discussão com um sólido conhecimento das áreas doutrinárias, mostrando como as reivindicações apresentadas afetam os problemas reais e urgentes da prática jurídica. O livro também oferece uma discussão refrescantemente abrangente de alguns valores jurídicos essenciais.ChinoLucy的书巧妙地将典型领域正在讨论的法律和哲学论断与该领域的共识联系起来，显示出索赔申请如何影响法律实践中所面临的现实和紧急问题。 该书还提供了一些核心法律价值的令人耳目一新的全面讨论。. (shrink)

Randomization procedures are used in legal and statistical applications, aiming to shield important decisions from spurious influences. This article gives an intuitive introduction to randomization and examines some intended consequences of its use related to truthful statistical inference and fair legal judgment. This article also presents an open-code Java implementation for a cryptographically secure, statistically reliable, transparent, traceable, and fully auditable randomization tool.

The issue of interpersonal comparisons of utility is about the possibility (or not) of comparing the utility or welfare or the mental states in general, of different individuals. Embedded in the conceptual framework of utilitarianism, interpersonal comparisons were admissible in economics as part of the theoretical justification of welfare policies until the first decades of the twentieth century. Under the strong influence of the scientific philosophy of positivism as reflected in the works of early neoclassical economists and as epitomized by (...) Lionel Robbins, utility comparisons were subsequently rejected as a value judgement. Robbins’ methodological stance is still prevalent among mainstream economists. Despite the explicit rejection of comparability by the majority of economists, interpersonal comparisons are necessary for many key policy issues, such as progressive taxation, social welfare policies, GDP-based welfare comparisons, cost–benefit analysis, and public goods provision. In this paper, the case of interpersonal utility comparisons is discussed as an illustrative example of the usefulness of the study of the role of value judgements, and generally of the interrelationship between ethics and economics. It is argued that the current tension between theory and policy practice might be resolved through the efforts of prominent economists and philosophers to challenge positivism, and especially its problematic treatment of value judgements and of ethical assumptions in general. The discussion also provides more strength to the view that policy makers and their economic advisers cannot avoid ethical questions in their analysis of the workings of the economic system. (shrink)

The paper analyses economic evaluations by distinguishing evaluative statements from actual value judgments. From this basis, it compares four solutions to the value neutrality problem in economics. After rebutting the strong theses about neutrality (normative economics is illegitimate) and non-neutrality (the social sciences are value-impregnated), the paper settles the case between the weak neutrality thesis (common in welfare economics) and a novel, weak non-neutrality thesis that extends the realm of normative economics more widely than the other weak (...) thesis does. (shrink)

A key objective of the law in the assessment of decision-making capacity in clinical settings is to allow clinicians and judges to avoid making value judgements about the reasons that patients use to refuse treatment. This paper advances two lines of argument in respect of this objective. The first is that authorities cannot rationally avoid significant evaluative judgements in the assessment of a patient’s own assessment of the facts of their case. Assessing reasoning is unavoidably value-laden. (...) Yet the underlying motivation behind clinicians’ and the law’s value-neutral aims, ie, the avoidance of undue paternalism, is worth preserving. That being so, the second line of argument will try to show that that underlying motivation is better served in a limited range of cases by embedding a ‘reversibility standard’ in the assessment process so that the patient can, if they wish, and in due course, bring about the consequences that they were prevented from realising as a result of a determination of incapacity. (shrink)

Karl Marx entitled his first major work on the theory of capitalism an Introduction to the Critique of Political Economy, not, it should be stressed, An Introduction to … Political Economy. The inclusion of the crucial ‘the critique of provides the key to Marx's break with classical political economy. As much as he respected the contribution of bourgeois writers, especially Ricardo, he did not consider himself a radical member of the political economy school. That the political economy school's most outstanding (...) members focused upon class relations did not save them from an analysis that, in Marx's judgement, was ‘vulgar', in that it focused upon the appearance of phenomena rather than their underlying causes. Political economy focused on relations of exchange, rather than on class relations among human beings. As he wrote famously in an oftquoted letter, for at least a generation before him bourgeois writers had recognised both class divisions in capitalism and that the basis of profit was exploitation; were these the central elements of his work, his contribution would have been trivial. (shrink)

The modern idea of the right to freedom of each human being can be briefly described as follows: it is the right to personal judgment in matters of what is true and good and to selfdetermination of one’s life and actions in view of this judgment. Today this right is considered as the most basic, or one of the most basic, unquestionable rights of the individual. At the same time, our present situation is characterized by an undeniable pluralism. We have (...) practically given up the hope that individuals, through their own judgment, will come to an agreement as to what are the central values in life, as to what is the good life. On the contrary, too much unity and agreement immediately raises the suspicion of more or less hidden constraint or indoctrination.In a pluralistic, free society, every defense of what is the good can only be seen as the defense of a particular conception of the good, which is potentially threatening for the self-determination of other individuals. The combination of the stress on freedom and the fact of pluralism, leads to an extreme importance being given to tolerance. Tolerance, together with the multiplicity of life-styles, seems to be something positive in itself. Within this perspective, the real question does not seem to be whether tolerance is something positive in itself, but whether it has any limitations. (shrink)

The widespread application of technology in health care has imposed a broad range of challenges. The field of health technology assessment (HTA) is developed in order to face some of these challenges. However, this strategy has not been as successful as one could hope. One of the reasons for this is that social and ethical considerations have not been integrated in the HTA process. Nowadays however, such considerations have been included in many HTAs. Still, the conclusions and recommendations of the (...) HTAs are not followed. The reason for this may be that the methods for integrating ethics for HTA are not sufficiently developed, or that they are not adequate. This article presents a supplementary approach to the ethical inquiry in HTA. It is argued that a value analysis is crucial in order to address the ethical issues of health care technology in a fruitful way and to make viable decisions about such technology. (shrink)

We reflect, using a vignette, on conceptual tensions and the value judgements that lie behind difficult decisions about whether or not the older person with dementia should return home or move into long-term care following hospital admission. The paper seeks, first, to expose some of the difficulties arising from the assessment of residence capacity, particularly around the nature of evaluative judgements and conceptual tensions inherent in the legal approach to capacity. Secondly, we consider the assessment of best (...) interests around place of residence, which demonstrates significant conceptual tensions. In addition, ‘best interests’ raise issues around the perception of risk and the perceptions of the family and crucially involve the notions of autonomy and trust. Finally, we not only gesture at some practical considerations based on insights from values-based medicine, but also make the suggestion that we require tighter functional assessments of residence capacity coupled with broader judgements about best interests. (shrink)

In this paper, I present an interpretation about the meaning of value judgements (moral and aesthetic) in the philosophy of David Hume. I state that although they are essentially descriptive of a fact (a sentiment that any spectator placed in the disinterested point of view can feel), these judgements also express a particular sentiment, at least in some cases. To achieve this aim, after introducing the questions and interpretative possibilities approached (section 1), I explain the interpretations called (...) expressivist (mainly, its projectivist subtype, commonly called ‘error theory’) and descriptivist (and its subtypes, called subjectivist and causalist), as well as the problems of accepting each one of them univocally (respectively, sections 2 and 3). Then, I argue in favor of an hybrid or conciliating interpretation according to which Hume’s philosophy is better understood as a form of descriptivism, while preserving an expressivist feature, based on the possibility of solving those problems (section 4). (shrink)

The aim of this paper is to determine how a Pyrrhonian considers the Law and can respond to Aristocles’ objection that a Pyrrhonian is unable to obey laws. First, we analyze the function of the Law in the 10th Mode of Aenesidemus, in order to show laws as a dogmatic source of value. But Sextus shows also that the Sceptic can live in a human society by following laws and customs, according to so-called ‘sceptical conformism’. In the light of (...) Pyrrhonian Hypotyposes 1.23–24 and Against the Mathematicians 11.162–164, I discuss the validity of the label ‘conformism’ in order to understand the nature of the political effect of the suspension of judgement. The real nature of the political position of Pyrrhonian Scepticism – that lack of commitment does not mean indifference to politics but rather a criticism of fanaticism and praise for political cautiousness – appears by comparison with the Scepticism of the New Academy. (shrink)

Raz's method is as unusual, and as admirable, as the substance of his sometimes rather unfortunately labeled "perfectionist liberalism"—unfortunate because "it is not perfectionist in the more ordinary sense of the term" in that it recognizes that "imperfect ways of life may be the best which is possible for people" and "is strongly pluralistic", while understanding its fundamental value of well-being as the active and autonomous making of a life of one's own. Raz's approach is simultaneously alert to the (...) complexity of argument, to a degree that practitioners of practical ethics sometimes are not, and aware of the limits of theorizing, as devotees of theoretical ethics rarely are. Thus, while scorning "supermarket liberalism" and rejecting, in company with Rawls, "hand-to-mouth piecemeal intuitionism", Raz also doubts whether ideal theory in the Rawlsian mode is "a meaningful enterprise", emphasizing wisely, in my judgment, that "not everything we know can be exhaustively stated in the abstract". The "dense webs of complex actions and interactions" that give meaning to our lives "defy explicit learning or comprehensive articulation. They are available only to those who have or can acquire practical knowledge of them, that is, knowledge embodied in social practices and transmitted by habituation". (shrink)

Aim: Explore nurses’ values and perceptions regarding the practice of medical aid in dying. Background: Medical aid in dying is becoming increasing legal in the United States. The laws and American Nurses Association documents limit nursing involvement in this practice. Nurses’ values regarding this controversial topic are poorly understood. Methodology: Cross-sectional electronic survey design sent to nurse members of the American Nurses Association. Inductive thematic content analysis was applied to open-ended comments. Ethical Considerations: Approved by the institutional review board (#191046). (...) Participants: 1213 nurses provided 3639 open-ended comments. More than 80% of participants self-identified as white 58% held a graduate degree; and half were of Christian faith. Results: Values ranged on a continuum expressed through four themes: “Honoring Patient Autonomy without Judgment,” “Honoring with Limitations,” “Not until...,” and “Adamantly against.” Some felt it was a duty to honor the patients’ wishes, set aside own beliefs, and respect patients’ choices often with a spiritual connotation. Nurses held concerns about the process, policy, potential psychological harm, legal risk, and the need to learn more about MAID. Nurse who were adamantly against MAID associated the practice with murder/suicide and against religious beliefs. Disparate values were expressed about changing the MAID legislation to allow patient support with taking MAID medications and allowing MAID via advance directive. Conclusions: Nurses desire more education on MAID. There is not one universally held position on the nurse’s role during MAID. Healthcare policy/standards need to accommodate the wide variation in nurses’ values. Implications: Nurses desire education regarding their role in MAID. Nurses are encouraged to participate in policy discussions as the practice becomes increasingly legal. Managers need to expect that nurses, patients, and families will need psychological support to participate in MAID. Careful construction of policy/standards is needed to minimize conflict, moral distress, and psychological harm amongst nurses. Further research is needed. (shrink)

Biobanking in Europe has made major steps towards harmonization and shared standards for the collection and processing of data and samples stored in biobanks. Still, biobanks and researchers face substantial legal difficulties in the field of data protection and sample management. Data protection law was harmonized almost 15 years ago while rights in samples fall under the competence of the Member States of the EU. Despite the Data Protection Directive the field of data protection shows a substantial degree of deviation (...) as public health was excluded from the harmonization. Biobanks seem to have substantially fewer difficulties to cope with in terms of the legal requirements in the field of sample management. This paper discusses the legal framework, experiences of different biobanks in Europe and potential ways forward. It also highlights the need for a health economic analysis of the costs and benefits of privacy protection in Europe. At the moment, policymakers seem to build their decisions on an insufficient evidence base which underestimates the potential value of biobanks for European public health. Within the past few years little progress has been achieved with regards to the development of a unified legal framework in Europe, The diversity in the legal system is also reflected in the different approaches of ethics committees towards biobanking. To secure the responsible and effective use of data and samples, more efforts are needed to come up with pathways for a solution. (shrink)