OBJECTIVES: Life-sustaining treatment at the end of life gives rise to many ethical problems in Japan. Recent surveys of Japanese physicians suggested that they tend to treat terminally ill patients aggressively. We studied why Japanese physicians were reluctant to withhold or withdraw life-support from terminally ill patients and what affected their decisions. DESIGN AND PARTICIPANTS: A qualitative study design was employed, using a focus group interview with seven physicians, to gain an in-depth understanding of attitudes and rationales in Japan regarding (...) medical care at the end of life. RESULTS: Analysis revealed that physicians and patients' family members usually make decisions about life-sustaining treatment, while the patients' wishes are unavailable or not taken into account. Both physicians and family members tend to consider withholding or withdrawing life-sustaining treatment as abandonment or even killing. The strongest reason to start cardiopulmonary resuscitation- and to continue it until patients' family members arrive-seems to be the family members' desire to be at the bedside at the time of death. All physicians participating in our study regarded advance directives that provide information as to patients' wishes about life-sustaining treatment desirable. All expressed concern, however, that it would be difficult to forego or discontinue life-support based on a patient's advance directive, particularly when the patient's family opposed the directive. CONCLUSION: Our group interview suggested several possible barriers to death with dignity and the appropriate use of advance directives in Japan. Further qualitative and quantitative research in this regard is needed. (shrink)

This paper explores the value of respect for personal autonomy in relation to clearly immoral and irrational acts committed freely and intentionally by competent people. Following Berlin's distinction between two kinds of liberty and Darwall's two kinds of respect, it is argued that coercive suppression of nonautonomous, irrational, and self-harming acts of competent persons is offensive to their human dignity, but not disrespectful of personal autonomy. Irrational and immoral choices made by competent people may claim only the negative liberty to (...) be left alone. Lives disposed to autonomy are worthy of solidarity and active support in addition to the right of free choice and action. Autonomous premeditated desires (distinguished from mere consent) may embody transcendental choices, which transcend consideration of physical and psychological well-being. Choices made by incompetent persons (e.g., children and the mentally disabled) are not related to autonomy, but to self-directedness. The value of human dignity confers protection to self-directedness, but not at the expense of other vital interests. (shrink)

Following a discussion of some historical roots of conscience, we offer a systematized version of reflective equilibrium. Aiming at a comprehensive methodology for bioethical deliberation, we develop an expanded variant of reflective equilibrium, which we call ‘triangular reflective equilibrium’ and which incorporates insights from hermeneutics, critical theory and narrative ethics.We focus on a few distinctions, mainly between methods of justification in ethics and the social practice of bioethical deliberation, between coherence in ethical reasoning, personal integrity and consensus formation, and between (...) political and moral deliberation.The ideal of deliberation is explicated as a sharing of conscience within a special commitment to sincerity and openness to persuasion. Personal growth in wisdom is an indirect by-product of the continuous practice of moral deliberation. This is explicated in the light of Sternberg's balance theory of wisdom and in the context of medicine as a profession embodying altruistic responsibilities of care in democratic and pluralistic societies. (shrink)

Special issue: Pre ́cis and Commentaries on Veit’s ‘Animal Consciousness’ Abstract: Facing stress and producing stress responses are crucial aspects of an organism’s life and the evolution of both its species and of the other species in its environment, which are co-evolving with it. Philosophers and biologists emphasize the importance of environmental complexity and how organisms deal with it in evolution of cognitive processes. This article adds to these discussions by highlighting the importance of stress physiology in processes connected to (...) plant cognition. While this article supports the thesis that life means cognizing (i.e., sensing the environment, arranging internal processes according to that perception, and affecting the environment with its actions), it also emphasizes that there are various kinds of organisms. In this regard, plant cognition is not animal cognition. However, given both the variety and continuity in evolutionary processes and the similarities even between the distantly related organisms in the tree of life, I argue that it is usually useful to consider and compare physiological and molecular mechanisms in plants and animals as well as the concepts and research processes in animal and plant science. Although the “pathological complexity” thesis that Veit (2023) presents is fruitful in considering the evolution of consciousness and cognition, I argue that, when thinking of biological processes in relation to cognition, stress can be a helpful concept (maybe even as suitable as pathological complexity) in thinking of organisms’ responses to environmental complexity and their adaptation and acclimation processes. (shrink)

La presente versión del tratado De Bono Habitu Liber o El libro sobre la buena condición, de Galeno de Pérgamo, se presenta al lector de habla hispana como un acercamiento a la prolífca obra flosófca de quien fuera reconocido en su época como un notable médico anatomista y físico. Los argumentos expuestos por el autor acerca de la ‘buena condición’ dan cuenta de la infuencia retórica de Platón y Aristóteles, al mismo tiempo, de las enseñanzas médicas de Hipócrates. Junto al (...) texto original y la traducción al español, se ofrece una versión en latín empleada en el proceso de traducción como un apoyo para resolver las difcultades textuales y léxicas que presentaba el texto griego, al permitir confrontar una recepción medieval del tratado. (shrink)

El presente artículo busca proponer un acercamiento a la influencia del pensamiento de Thomas Hobbes y su obra en el pensamiento económico. En especial en las escuelas marxista, neoclásica y keynesiana. El influjo de su pensamiento puede evidenciarse en el abordaje metodológico, antropológico e institucional. Se ofrece una Mirada sobre la sociedad civil (comercial), el Mercado y el Estado al mismo tiempo. Hobbes ha sido la inspiración de un concepto de Estado monolítico en lo político, en este sentido, la mirada (...) de la economía bajo el concepto de un gran planificador centralizado, tiene importantes antecedentes en este autor. El ejercicio del control social del individuo como propuesta institucional, en varias escuelas de la economía comparten con Hobbes, varios antecedentes que merecen ser analizados. (shrink)

This chapter examines the structure and role of ambiguity in the Japanese Organ Transplant Law by looking at the Chinese Huayen Buddhist doctrine of dharmadhatu-pratityasamutpada or universal dependent “coarising”, a major interpretation of the Buddha's pratityasamutpada, dependent-coarising or interdependence. Specifically, it will examine the nature of ambiguity through the zhuban yuanming jude men or “the attribute of the complete accommodation of principal and secondary dharmas” that Fazang formulated. The interdependent and evolving Buddhist vision of reality causes ambiguity in decision making (...) and action. (shrink)

Against the common assumption that modern medicine is altogether secular and scientific, this article argues that the practice of medicine manifests characteristic features of religion. This exposition is predicated upon a delineation of the phenomenological characteristics of religion and upon a critical analysis of the ways scientific medicine does or does not manifest these characteristics. Insofar as medical practice is unknowingly religious, that practice can cause harm and delusion. An acknowledgment that scientific medicine embodies features of religion is a beginning (...) point for scholarly reflection, criticism, and research from a variety of academic perspectives. (shrink)

The obesity epidemic is not only impairing the health of millions of Americans but also giving rise to billions of added dollars in health care spending. Climbing rates of obesity over the past decades are one of the predominant determinants behind the surging progression of health care expenses in the United States. Moreover, the less fit and less productive U.S. workforce has gradually eroded the nation’s industrial competitiveness. Since the early 1970s, adult obesity rates have doubled and childhood obesity rates (...) have more than tripled, while health expenditures have risen two percentage points faster than the Gross Domestic Product, burgeoning from 8.8 percent in 1980 to a projected 17.9 percent in 2011. Studies analyze that greater than a quarter of America’s health care expenses are attributed to obesity. The stunning growth in obesity has been imputed for 20 to 30 percent of the increase in health care costs since the late 1970s. If the proportion of obese population had stayed unchanged, then health care expenditures in America would be approximately 10 percent less on a per capita average than they are today. (shrink)

In the Anthropology, the person has a self-organizing communicative structure, so person cannot be unique, lonely. This has been called by Polo: «Coexistence». It shows that the «Díada» (Duality) is richness, plenitude (fullness). This makes possible to mark the difference between two complementary person’s types: the male person and the female person. They could be called: «coexistence-from» and «coexistence-in».

_Purpose._ The authors aim to reveal the influence of philosophical and esoteric principles on the formation and further development of Roberto Assagioli’s concept of psychosynthesis. _The theoretical basis_ of the study is determined by the latest methodological approaches in the study of the relationship between philosophical, psychological, and esoteric approaches in the study of the unconscious and the formation of a harmonious personality. _Originality._ For the first time, a systematic analysis of the anthropological foundations of Roberto Assagioli’s work has been (...) carried out in Ukrainian philosophical literature, the specificity of the connection between esoteric teachings and psychosynthesis has been revealed on the basis of a thorough study of primary sources and biographical evidence of the life and work of the famous Italian thinker. _Conclusions._ Psychosynthesis, which is one of the leading directions of modern psychology, has a rather multicultural philosophical and methodological basis. Its founder Roberto Assagioli, while developing his concept, was influenced by theosophical-esoteric, pragmatic kabbalistic, and Eastern religious concepts and practices. Unlike psychoanalysis, which saw the unconscious as physiological-naturalistic determinants of the human psyche and behavior, psychosynthesis considers the unconscious as a hidden potential for self-development of the individual. Roberto Assagioli went through a long and difficult way to finally form his own concept, which became the basis of the psycho-techniques of disidentification and work with subpersonalities, which help to discover the true transpersonal self, which is the source of human self-improvement. Modern discussions about the relationship between psychosynthesis and various forms of parapsychology once again testify to the synthetic nature of Assagioli’s teaching, which combines various psychotherapeutic practices. This is what gives psychosynthesis a new push for development in the conditions of wars, disasters, loneliness, and related psychological disorders. (shrink)

The American Journal of Bioethics, Volume 12, Issue 3, Page 37-39, March 2012.

Translation of: La deshumanización del arte (1924).

In this study, complex dynamics of Briggs–Rauscher reaction system is investigated analytically and numerically. First, the Briggs–Rauscher reaction system is reduced into a new nonlinear parametric oscillator. The Melnikov method is used to derive the condition of the appearance of horseshoe chaos in the cases ω = Ω and ω ≠ Ω. The performed numerical simulations confirm the obtained analytical predictions. Second, the prediction of coexisting attractors is investigated by solving numerically the new nonlinear parametric ordinary differential equation via the (...) fourth-order Runge–Kutta algorithm. As results, it is found that the new nonlinear chemical system displays various coexisting behaviors of symmetric and asymmetric attractors. In addition, the system presents a rich variety of bifurcations phenomena such as symmetry breaking, symmetry restoring, period doubling, reverse period doubling, period-m bubbles, reverse period-m bubbles, intermittency, and antimonotonicity. On the contrary, emerging chaotic band attractors and period-1, period-3, period-9, and period-m bubbles routes to chaos occur in this system. (shrink)

The determination of the place of life in nature has been a major philosophic issue. Some, in their attempt to show the continuity of nature, have resorted to the reductive method and have argued that the living differ in no significant sense from the non-living, unless it be in their complexity; others, in their desire to emphasize the qualitatively varied aspects of nature, have drifted to disjunctive method and have claimed that there is an unbridgeable gap between the living and (...) the non-living. Yet life in its natural setting presents both continuity with the physical world and a distinctive difference from it. One need neither sunder the continuity in nature nor deny the empirically observable qualitative differences. It is this principle that will guide the present discussion of life. (shrink)

Suffering repeated experiences of moral distress in intensive care units due to applications of futility reflects on nurses’ patient care negatively, increases their burnout, and reduces their job satisfaction. This study was carried out to investigate the levels of job satisfaction and exhaustion suffered by intensive care nurses and the relationship between them through the futility dimension of the issue. The study included 138 intensive care nurses. The data were obtained with the futility questionnaire developed by the researchers, Maslach Burnout (...) Inventory and Minnesota Satisfaction Questionnaire. It was determined that nurses who agreed to the proposition that the application of futility demoralizes health-care professionals had low levels of job satisfaction but high levels of depersonalization. It was determined that nurses had moderate levels of job satisfaction, emotional exhaustion, and personal achievements but high levels of sensitivity. Nurses’ job satisfaction and sensitivities are positively affected when they consider that futility does not contradict the purposes of medicine. (shrink)