In Matters of Life and Death Elliot Dorff thoroughly addresses this unavoidable confluence of medical technology and Jewish law and ethics.

This book moves away from the frameworks that have traditionally guided ethical decision-making in the Western clinical setting, towards an inclusive, non-coercive and, reflective dialogic approach to moral decision-making. Inspired in part by Jürgen Habermas's discourse theory of morality and principles of communicative action, the book offers a proportionist approach as a way of balancing out the wisdom in traditional frameworks, set in the actual reality of the clinical situation at hand. Putting this approach into practice requires (...) having a conversation, a dialogue or a discourse, with collaboration amongst all the stakeholders. The aim of the dialogue is to reach consensus in the decision, via mutual understanding of the values held by the patient and others whom they see as significant. This book aims to underscore the moral philosophical foundations for having a meaningful conversation. Life and Death Decision in the Clinical Setting is especially relevant in our contemporary era, characterised medically by an ever-increasing armamentarium of life-sustaining technology, but also by increasing multiculturalism, a multiplicity of faiths, and increasing value pluralism. (shrink)

Change according to Heraclitus is the only abiding substance observable in the universe. The implication of this view is that apart from change which remains the only constant thing, there is nothing that is held to be permanent. That is why life though relatively blissful, sooner or later is overtaken by death. Of course, death is always a dread to human conciousness. It is a phenomenon which man has always whished that it not be a reality. It (...) is this facticity and the finitude of life that the writer intends to critically examine in this paper. With the methodological approach of critical reflection, he aimed at achieving the goal of the study which concludes that death is an inescapable phenomenon awaiting every single existent being, though not the end of existence. (shrink)

***Translated a Korean-language book to English with Dr. Chang-Seong Hong*** Venerable Hyun-Eung's Enlightenment and History is the first book of Buddhist philosophy of history published in South Korea; possibly the first of its kind in the world. In this book of telling points and clear visions, Hyun-Eung discusses East Asian Buddhist traditions in light of Western-philosophical perspectives and presents his views on the theory and praxis in contemporary Buddhism in a way that Western readers can easily understand. East Asian Buddhist (...) philosophy has had little introduction to English-speaking societies compared with the philosophies of other traditions in Buddhism. This book provides penetrating insight into such major issues of East Asian Mahayana Buddhism as enlightenment, compassion, emptiness, and sudden enlightenment in the Zen traditions. Hyun-Eung s approach is creative, clear, logical, and methodologically modernized. Hyun-Eung s Buddhist philosophy of history is not a mere product of armchair philosophy. He wrote most essays in this book during the 1980 s while South Korea was undergoing serious political turmoil as it tried to overthrow a government backed by military generals. This book presents a philosophy that evolved from his contemplations on the real issues of South Korean society. Defining the ideal form of life as the life of bodhisattva in Mahayana Buddhism, Hyun-Eung summarizes the theme of this book as follows: My book Enlightenment and History is a collection of essays that interpret Buddhist doctrines under a new light. In particular, this book interprets bodhisattva as the combination of bodhi (enlightenment) and sattva (life, history), and defines the life of bodhisattva as enlightenment s becoming history and history s becoming enlightenment. This is the representative of all the new interpretations in this book. Also, I classify the issue of fact judgments on how to understand facts and phenomena as the area of bodhi (enlightenment) and the issue of value judgments on how to live life as the area of sattva (history), and thereby I make their logical differences clear. However, at the same time, I claim that harmonizing these two areas into one area of life is the model of a nice and practical life, which is the bodhisattva that Mahayana Buddhism praises. From Introduction. (shrink)

This paper addresses the killing of Freya the Walrus by the Norwegian fishing authorities in August 2022. Freya became famous for sunbathing on boats in the marina in the Oslo fjord, but she was soon euthanized in the name of public safety. Her death caused international outrage, and the aim of our paper is to demonstrate using philosophical argument why her death was unjust. We examine her plight through frameworks developed by animal ethicists involving co-sovereignty, capability, and individuality, (...) concluding that any one of these frameworks, let alone several, would have led to a more just outcome for Freya. We argue that policy makers could put these insights into practice in a number of concrete ways going forward, as such incidents are likely to reoccur given the changes in migration patterns for animals in the Anthropocene era. (shrink)

This is a compact, nicely written book that provides a rejuvenating alternative to the utilitarian orthodoxy that dominates contemporary bioethics. There is currently a dearth of bioethical literature presenting what might be called a more traditional approach to medicine and health care. This contribution is a short and useful introduction to such an approach. The book announces itself as being written with “both the general reader and students and professionals in medicine, nursing, law, philosophy and related areas in (...) mind”. Accordingly, it assumes no prior knowledge of ethics. It gives a neat introductory overview of some ethical concerns raised by reproduction, death, and dying. The issues considered include euthanasia and withdrawal of treatment, the persistent vegetative state, abortion, cloning, and in vitro fertilisation. By beginning the early chapters with a real-life case, Watt captures the interest of the reader. The case is introduced and discussed dispassionately. It is then employed as a springboard for a general discussion of principles often thought dry and difficult. Newcomers to the study of ethics will …. (shrink)

BackgroundCompetent end-of-life care is an essential component of total health care provision, but evidence suggests that it is often deficient. This study aimed to evaluate the knowledge and attitudes about key end-of-life issues and principles of good death among doctors in clinical settings.MethodsA cross-sectional study was conducted among allopathic medical doctors working in in-ward clinical settings of tertiary care hospitals in Sri Lanka using a self-administered questionnaire with open- and close-ended questions as well as hypothetical clinical scenarios. (...) Univariate and logistic regression analysis were used to identify the independent factors associated with knowledge and attitudes.ResultsOf the responders who had not been a caregiver for a terminally ill relative (n = 390), 57.9% were men with a mean age of 36.5 years (SD = 8.2). Compared to undergraduate (65.6%; n = 256), only 27.4% (n = 107) had received end-of-life care training at postgraduate level. Only 65.9% of doctors favoured disclosing terminal prognosis to patients; 27.7% of doctors were aware of advance directives; 14.6% were aware of the correct time of death when certifying brain death; 70.3% felt more comfortable in withholding than withdrawing life-sustaining treatment; 61.3% were aware of do-not-attempt cardiopulmonary resuscitation (DNACPR) decisions while 26.7% felt reluctant to administer it; 15.1% thought that all life-sustaining therapy should be withdrawn with a DNACPR decision; and only17.9% were able to name the four principles of medical ethics while 57.9% could not name a single. Participants scored a mean of 9.2 (SD = 3.9) of a maximum 14 points when tested on principles of a ‘good death’. Doctors who had pursued postgraduate studies were more likely to be aware of breaking bad news (adjusted-Odds-Ratio:1.99; 95%CI = 1.19–3.32), advance directives (adjusted-OR: 4.15; 95%CI = 2.49–6.94), aware of certifying the correct time of death (adjusted-OR:2.37; 95%CI = 1.33–4.2) and less reluctant to make DNACPR decisions (adjusted-OR:1.74; 95%CI = 1.13–2.68). Doctors who had worked in ICU were more comfortable withholding than withdrawing treatment (adjusted-OR:1.99; 95%CI = 1.2–3.31).ConclusionsKnowledge and attitudes about end-of-life care, good death and principles of medical ethics among doctors in Sri Lanka were suboptimal. Structured training of end-of-life care needs to be integrated within curricula and in-service training. (shrink)

This is a breakthrough work expanding the debate of the dilemmas of life and death in contemporary American society by carrying it beyond the insights of Western religious and philosophic thought to include ethical perspectives of the Hindu tradition. The topics covered are the timely ethical issues that concern both Americans and all people of the world — abortion, suicide, euthanasia, and the environment. A lively East-West dialogue probes the roots of each issue in its native setting, and (...) the fruit of this historical approach is a clear-cut analysis of up-to-date cases, giving their current status in terms of ethics, religion, philosophy, medicine, and law. Unlike traditional textbooks that concentrate on a theoretical analysis to the exclusion of practical issues, this book does justice to both theoretical and practical ethics. (shrink)

Life education, also known as life and death education, is an important subject in Taiwan with institutions offering degree programs and courses that focus on quality learning and implementation of life education. What is interesting from the perspective of Taiwanese Education is that the teaching of life education also incorporates a number of Eastern-derived and conceptualized tenets, for example, Buddhist teaching and the importance of spiritual wisdom. This premise contends then that life education in (...) Taiwan, in general, is concerned with the promotion, fulfillment, and cherishing of quality life experiences (e.g., personal contentment, happiness). One example of life education, which resonates with other spiritual beliefs and religious faiths (e.g., Hinduism), is related to spiritual cultivation and the enlightenment of life wisdom. Our own teaching of the subject, likewise, places emphasis on the goal of teaching students to seek meaningful understanding of and appreciation for three major, interrelated components of life education: life wisdom, life practice, and life care. Life education is a beneficial subject as its theoretical understanding may help individuals cope with pathologies and negative life experiences. One negative life experience, in this case, is the ultimate fate of humankind: death. Approaching death and/or the onset of grief is something that we all have to experience. How does one approach death? It is not easy feat and, of course, grief for a loved one is personal and some of us struggle with this. We contend that spiritual cultivation and enlightenment, arising from life education, may assist us with the coping of death (e.g., the possibility of transcendence beyond the realm of life). Forming the premise of the present article, we propose that a person’s ‘spiritual and enlightened self’, reflecting the convergence of three major aspects of life education (i.e., Philosophical reflection, Enrichment of personal well-being, and Spiritual cultivation), would result in the initiation and creation of a number of virtues and positive characteristics – for example: having a positive outlook in life, showing compassion, forgiveness, etc. These virtues and quality characteristics, from our philosophical reasoning, are equivalent to those qualities that positive psychology advocates for. (shrink)

From Antiquity to the Postmodern world, the approaches of philosophical and literary thought to death have changed but also remained similar from philosopher to philosopher and from writer to writer. Many of these approaches emphasize the dualities of life/death and soul/body, relying on the argument that everything arises from its opposite through the continuous process of reproduction, just as everything dies. This paper will deal with the concept of death in the work of three authors, Ndre (...) Mjedja, Lasgush Poradeci, and Mitrush Kuteli, who are the main writers and cultural personalities in Albanian literature of the 20th century. The selected authors conceive, create, and promote a plurality of discourses and themes, highlighting the theme of death, through which they reveal the philosophical power of the literary text and the possibilities implicit to literature itself. Their views provide a poetic and cultural background for a theoretical discussion of literary and cultural facets of death. A prelude exploring the concept of death generally will be followed by a discussion of the authors’ works, and finally, a theoretical analysis of these works will round off the investigation of death as a literary and philosophical theme in Albanian letters. (shrink)

There is currently a dearth of bioethical literature presenting what might be called a more traditional approach to medicine and health care. Life and Death in Healthcare Ethics promises a reasoned and clear alternative. It considers ethical concerns raised by reproduction and death and dying. The issues considered include euthanasia and withdrawal of treatment, the persistent vegetative state, abortion, cloning and in vitro fertilization. Given its clarity and simplicity the book is likely to be read eagerly (...) by students from a range of different disciplines. For those who want a basic text to introduce them to life and death issues in bioethics, this is a most welcome contribution. (shrink)

Jack Miles, a former member of the Society of Jesus (Jesuits), and Mark Taylor, a philosophical atheist, have both in different ways brought religious and philosophical concerns into the wider world. Approaching the end of their careers as well as the end of their lives, they were prompted by the advent of a deadly pandemic amid worldwide political crises to think through matters of "ultimate concern": what is the human self, embedded as it is in a cosmos of nonhuman and (...) artificial intelligences? Within this larger ecology, what is the meaning of individual death? And can philosophy help us intellectually, emotionally, and spiritually understand and accept our fundamental impermanence? The authors' sense of urgency about their impending mortality, the worth of a life, the grief of loss and what was left undone, the fragility of existence, the uncertainty of the ending permeate their conversations. Readers will be drawn into the inner lives, the hidden fears and emotions, the existential dread experienced by these two exceptional philosophers facing life's close in extraordinary times when both annihilation and revolutionary new beginnings seem equally possible. The authors glean insight from Kierkegaard and Weil, Dickinson and Baldwin, Nagarjuna and Mahavira, Bateson and El Greco, leavened with a little Gluck, Auden, Borges, Ella Fitzgerald, and Hamilton. Reminiscent of the intimate conversations in "My Dinner with Andre," they confront an unknown future. Combining the diary's closeness to the self with the reflection of the personal letter much as Karl Ove Knausgaard combines diary with novelistic realism, these two distinctive voices are uncompromising, immediate, and raw. At the book's end they decide that their dialogue "will continue to change us even after one of us, perhaps both of us, dies." Ghosts may not be holy spirits, but even an atheist can believe that they are real. (shrink)

One of the unique insights provided by the growing number of fully sequenced genomes is the pervasiveness of gene duplication and gene loss. Indeed, several metrics now suggest that rates of gene birth and death per gene are only 10–40% lower than nucleotide substitutions per site, and that per nucleotide, the consequent lineage‐specific expansion and contraction of gene families may play at least as large a role in adaptation as changes in orthologous sequences. While gene family evolution is (...) pervasive, it may be especially important in our own evolution since it appears that the “revolving door” of gene duplication and loss has undergone multiple accelerations in the lineage leading to humans. In this paper, we review current understanding of gene family evolution including: methods for inferring copy number change, evidence for adaptive expansion and adaptive contraction of gene families, the origins of new families and deaths of previously established ones, and finally we conclude with a perspective on challenges and promising directions for future research. (shrink)

This is a compact, nicely written book that provides a rejuvenating alternative to the utilitarian orthodoxy that dominates contemporary bioethics. There is currently a dearth of bioethical literature presenting what might be called a more traditional approach to medicine and health care. This contribution is a short and useful introduction to such an approach. The book announces itself as being written with “both the general reader and students and professionals in medicine, nursing, law, philosophy and related areas in (...) mind”. Accordingly, it assumes no prior knowledge of ethics. It gives a neat introductory overview of some ethical concerns raised by reproduction, death, and dying. The issues considered include euthanasia and withdrawal of treatment, the persistent vegetative state, abortion, cloning, and in vitro fertilisation. By beginning the early chapters with a real-life case, Watt captures the interest of the reader. The case is introduced and discussed dispassionately. It is then employed as a springboard for a general discussion of principles often thought dry and difficult. Newcomers to the study of ethics will …. (shrink)

The purposes of research were to describe the neonatal clinicians' personal views and attitudes on neonatal ethical decision-making, to identify factors that might affect these attitudes and to compare the attitudes between neonatal physicians and neonatal nurses in Taiwan. Research was a cross-sectional design and a questionnaire was used to reach different research purposes. A convenient sample was used to recruit 24 physicians and 80 neonatal nurses from four neonatal intensive care units in Taiwan. Most participants agreed with suggesting a (...) do not resuscitate (DNR) order to parents for dying neonates (86.5%). However, the majority agreed with talking to patients about DNR orders is difficult (76.9%). Most participants agree that review by the clinical ethics committee is needed before the recommendation of ‘DNR’ to parents (94.23%) and nurses were significantly more likely than physicians to agree to this (p=0.043). During the end-of-life care, most clinicians accepted to continue current treatment without adding others (70%) and withholding of emergency treatments (75%); however, active euthanasia, the administration of drug to end-of-life, was not considered acceptable by both physicians and nurses in this research (96%). Based on our research results, providing continuing educational training and a formal consulting service in moral courage for neonatal clinicians are needed. In Taiwan, neonatal physicians and nurses hold similar values and attitudes towards end-of-life decisions for neonates. In order to improve the clinicians' communication skills with parents about DNR options and to change clinicians' attitudes for providing enough pain-relief medicine to dying neonates, providing continuing educational training and a formal consulting service in moral courage are needed. (shrink)

I argue that bioethics needs to focus less exclusively on our character as rational choice-making sentient beings, and take more into account our character and interests as living beings of the sort we are, of which our consciousness is but one aspect I propose that we adopt what I deem a biocentric ethic, centring on our nature and character as living human beings. As I develop them, the central biocentric conceptions are as follows: A living being is best thought of (...) not as a thing but as a living system, an ongoing life-process of a particular sort.Our interests as living beings spring from our particular character and lie in whatever contributes to our coherent effective functioning as ongoing life processes of that character.Our interests encompass our whole being, and not just our character as sentient, conscious, rational, decision-making beings.I argue that such conceptions can help us deal with matters of bioethical concern, including issues of euthanasia, abortion, autonomy, and perhaps genetic engineering. (shrink)

Dongchundang Songjoongil (1606-1672) was a scholar who represented Gihoyeahak and Sanlim (山林) influencing the society of Chosŏn dynasty since the middle of 17th century. This report focus on its contemporary purport and reconciliation spirit on the Kyoung (敬) of Dongchundang. The Kyoung is the core idea that elucidates Dongchundang's philosophy and its characteristic. Dongchundang tried to continue to live the life of 'according knowledge and action' (知行一致) and dreamed the world of 'harmonization but not same' (和而不同) which indicates the (...) principle of heaven, meaning the harmony never following suit without reflection and a just and great cause, going through with his original idea through the Kyoung. In addition, Dongchundang expanded the Kyoung from personal existential problems to social ethic practical ones in the viewpoint of more reason than vitality, and aimed to build the ethic kingdom that came the harmony andreconciliation of all the communities together, interacting his subjectivity and the universal. The Kyoung and reconciliation spirit of Dongchundang is the orthodoxy of Dohak(道學), and it made him live moral intention and through real life and summarized the manner and spirit pursuing the just and great cause beyond factions. In this sense, Dongchundang's philosophy is the concentration of the Kyoung and philosophical expression of reconciliation spirit. As the peculiarity of Dongchundang's philosophy is based on the Kyoung, it is the everlasting principle of what one should do and practice in human life. (shrink)

The paper presents different approaches to the relationship of life and death among selected authors as a review of their articles within the last volume of the Ethics & Bioethics (in Central Europe) journal. The resource of the review is an article by Peter Singer The challenge of brain death for the sanctity of life ethics. Firstly, I try to analyze the issue when death occurs and when we can talk about death as a (...) phenomenon that each and every living human being must come to terms within the course of their lives. Ethics of social consequences is used to analyze different approaches and states a conclusion defending the principles of humanity and human dignity within the scope of this ethical theory applied to various problem cases. I strive to support the question of the quality of life through the paternalistic approach of physicians influenced by their humane and dignified understanding of their relationship towards the patients. Ethics of social consequences offers many solutions to the discussed issues throughout the reviewed articles. (shrink)

This paper addresses two issues: what it is for a metaphor to be either alive or dead and what a metaphor must be in order to be either alive or dead. Both issues, in turn, bear on the contemporary debate whether metaphor is a pragmatic or semantic phenomenon and on the dispute between Contextualists and Literalists. In the first part of the paper, I survey examples of what I take to be live metaphors and dead metaphors in order to establish (...) that there is a phenomenon here to be explained. I then propose an explanation of metaphorical vitality in terms of the dependence of the interpretation of a metaphor on a family or network of expressions specific to its context of utterance. I then argue that only a Literalist account of metaphor — one that posits metaphorical expressions )—and not Contextualist and Gricean approaches can accommodate this explanation. Finally, I discuss some objections to my Literalist account and sketch an explanation of types to counter Platonistic objections to my metaphorical expression types. (shrink)

Shortages of new therapeutics to treat coronavirus disease (COVID-19) have forced clinicians, public health officials, and health systems to grapple with difficult questions about how to fairly allocate potentially life-saving treatments when there are not enough for all patients in need (1). Shortages have occurred with remdesivir, tocilizumab, monoclonal antibodies, and the oral antiviral Paxlovid (2) -/- Ensuring equitable allocation is especially important in light of the disproportionate burden experienced during the COVID-19 pandemic by disadvantaged groups, including Black, Hispanic/Latino (...) and Indigenous communities, individuals with certain disabilities, and low-income persons. However, many health systems have resorted to first-come, first-served approaches to allocation, which tend to disadvantage individuals with barriers in access to care (3). There is mounting evidence of racial, ethnic, and socioeconomic disparities in access to medications for COVID-19 (4, 5). -/- One potential method to promote equitable allocation is to use a weighted lottery, which is an allocation strategy that gives all eligible patients a chance to receive the scarce treatment while also allowing the assignment of higher or lower chances according to other ethical considerations (6). We sought to assess the feasibility of implementing a weighted lottery to allocate scarce COVID-19 medications in a large U.S. health system and to determine whether the weighted lottery promotes equitable allocation. (shrink)

For those who believe in the promise of higher education to shape a better future, this may be a time of unprecedented despair. Stories of students regularly cheating in their classes, admissions officers bending the rules for VIPs, faculty fudging research data, and presidents plagiarizing seem more rampant than ever before. If those associated with our institutions of higher learning cannot resist ethical corruption, what hope do we have for an ethical society? In this edited volume, higher education experts and (...) scholars tackle the challenge of understanding why ethical misconduct occurs in the academy and how we can address it. The volume editor and contributing authors use a systems framework to analyze ethical challenges in common functional areas (e.g., testing and admissions, teaching and learning, research, fundraising, spectator sports, and governance), highlighting that misconduct is shaped by both individuals and the contexts in which they work, study, and live. The volume argues compellingly for colleges and universities to make ethics a strategic, institutional priority. Higher education researchers, students, and practitioners will find this volume and its application of empirical research, real-life examples, and illustrative case studies to be an inspiring and applicable read. (shrink)

ObjectiveThe impact of the mindfulness-based stress reduction program on psychological outcomes and quality of life in lung cancer patients remains unclear. This meta-analysis aimed to evaluate the effectiveness of the MBSR program on psychological states and QoL in lung cancer patients.MethodsEligible studies published before November 2021 were systematically searched from PubMed, EMBASE, Cochrane Library, PsycINFO, China National Knowledge Infrastructure, and Wanfang databases. The risk of bias in eligible studies was assessed using the Cochrane tool. Psychological variables and QoL were (...) evaluated as outcomes. We used the Grading of Recommendations Assessment, Development and Evaluation system to grade the levels of evidence. Statistical analysis was conducted using RevMan 5.4 and STATA 14.0.ResultsA total of 17 studies involving 1,680 patients were included for meta-analysis eventually. MBSR program significantly relieved cancer-related fatigue and negative psychological states, enhanced positive psychological states, and improved quality of sleep. Evidence on MBSR programs' overall treatment effect for QoL revealed a trend toward statistical significance.ConclusionBased on our findings, the MBSR program shows positive effects on psychological states in lung cancer patients. This approach should be recommended as a part of the rehabilitation program for lung cancer patients.Systematic Review Registrationhttps://archive.org/details/osf-registrations-mwvbq-v1, identifier: 10.17605/OSF.IO/MWVBQ. (shrink)

In this paper, I make a case for an intercultural philosophy of religion from an African perspective. I focus on the philosophical underpinnings of the various meaningful religious practices and beliefs that give rise to the concepts of God, death and the problem of evil. A philosophical study of African traditional religions, based on anthropological findings across African cultural orientations, gives us a good starting point in understanding African worldviews and religious experiences. It also reveals that the various world (...) religions may all be seen as offering different perspectives on the same reality. Specifically, I argue that traditional African conceptions of God, death and the problem of evil could make significant contributions to global discourses in the philosophy of religion. First, I articulate points of convergence and divergence between African traditional religions with Saint Aquinas’ proofs for God’s existence; Second, I question the phenomenon of death and one’s life’s meaning. And third, I approach the problem of evil and attempt an African solution to the Epicurean dilemma. (shrink)

On Being and Becoming offers a new approach to existentialist philosophy and literature, as responding to competing demands for universal truth and the defense of the irreducible singularity of the individual. On Being and Becoming traces the heterogeneity of existentialist thinking beyond the popular wartime philosophers of the Parisian Left Bank, demonstrating their critical dependence on sources from the nineteenth century and their complements in modernist works across the European continent and beyond. While quintessentially modern, existentialism inherits ideas of (...) the past and anticipates challenges of the present. Despite its individualism, existentialist attention to the human self is related to conceptions of world, others, the earth, and the more encompassing concept of being. The predominance of ideas of authenticity, individuality, and self-determination makes any existentialist manifesto self-contradictory, while existentialist thinkers above all wanted to make their philosophy relevant to concrete human existence as it is lived. Prevailing models of existential authenticity life tend to overlook the rich diversity of its prospects, which, as this volume shows, involve not only anxiety, absurdity, awareness of death and of the loss of religious reassurances, but also hope, the striving for happiness, and a sense of the transcendent—all of these grounded our human capacity to create meaning. In spite of the diversity of existentialism, all of its thinkers recognize the self as becoming, and recognize the courage and creativity human individuality demands. On Being and Becoming elaborates pragmatic and philosophical relevance of existentialism for being human in the contemporary world. (shrink)

The celebrated author of _Gender Trouble_ here redefines Antigone's legacy, recovering her revolutionary significance and liberating it for a progressive feminism and sexual politics. Butler's new interpretation does nothing less than reconceptualize the incest taboo in relation to kinship -- and open up the concept of kinship to cultural change. Antigone, the renowned insurgent from Sophocles's _Oedipus,_ has long been a feminist icon of defiance. But what has remained unclear is whether she escapes from the forms of power that she (...) opposes. Antigone proves to be a more ambivalent figure for feminism than has been acknowledged, since the form of defiance she exemplifies also leads to her death. Butler argues that Antigone represents a form of feminist and sexual agency that is fraught with risk. Moreover, Antigone shows how the constraints of normative kinship unfairly decide what will and will not be a livable life. Butler explores the meaning of Antigone, wondering what forms of kinship might have allowed her to live. Along the way, she considers the works of such philosophers as Hegel, Lacan, and Irigaray. How, she asks, would psychoanalysis have been different if it had taken Antigone -- the "postoedipal" subject -- rather than Oedipus as its point of departure? If the incest taboo is reconceived so that it does not mandate heterosexuality as its solution, what forms of sexual alliance and new kinship might be acknowledged as a result? The book relates the courageous deeds of Antigone to the claims made by those whose relations are still not honored as those of proper kinship, showing how a culture of normative heterosexuality obstructs our capacity to see what sexual freedom and political agency could be. (shrink)

Background Studies describing physicians’ experiences with sedation at the end of life are indispensible for informed palliative care practice, but they are scarce. We describe the accounts of physicians from the USA and the Netherlands, two countries with different regulations on end-of-life decisions regarding their use of sedation.Methods Qualitative face-to-face interviews were held in 2007–2008 with 36 physicians , including primary care physicians and specialists. We applied purposive sampling and conducted constant comparative analyses.Results In both countries, the use (...) of sedation was described in diverse terms, especially in the USA, and was often experienced as emotionally challenging. Respondents stated different and sometimes multiple intentions for their use of sedation. Besides alleviating severe suffering, most Dutch respondents justified its use by stating that it does not hasten death, while most American respondents indicated that it might hasten death but that this was justifiable as long as that was not their primary intention. While many Dutch respondents indicated that they initiated open discussions about sedation proactively to inform patients about their options and to allow planning, the accounts of American respondents showed fewer and less-open discussions, mostly late in the dying process and with the patient's relatives.Conclusions The justification for sedation and the openness with which it is discussed were found to differ in the accounts of respondents from the USA and the Netherlands. Further clarification of practices and research into the effect and effectiveness of the use of sedation is recommended to enhance informed reflection and policy making. (shrink)

The sudden arrival of the coronavirus disease 2019 (COVID-19) pandemic in South Africa drastically changed the normal way of life in all sectors. It compelled everyone to look at the meaning of life and death differently and more painfully than before. This article investigates the cultural theories and religious narratives on the meaning of life and death, associated with the pervasiveness of the COVID-19 pandemic. The coronavirus affected individuals, families and communities, some directly or indirectly, (...) no one is or was immune to the virus. The article argues that due to COVID-19 restrictions and lockdowns, culture, religious practices and protocols have been upended. The COVID-19 pandemic challenged inkcubeko nenkolo yabantu [culture, people’s religious belief systems and practices]. This article consists of in-depth qualitative interviews with four religious leaders from the Christian and Muslim faiths. Because of the interviews with persons, oral historians conduct open-ended interviews, as a form of social inquiry. Oral history narratives thus connect the individual and the social, drawing on cultural and religious expressions to tell one’s story. Contribution: The scholarly contribution of this article adds value and significance to oral history research, as a way of collecting and interpreting human memories and experiences on the meaning of life and death during the COVID-19 crisis. It discusses the dreadfulness of the COVID-19 scourge concerning religious and cultural effects, social sciences and people’s narrative reflections. (shrink)

We discuss the meaning of “being alive” and “being dead.” Our primary aim is to pave the way for a sound and accurate ethical debate concerning these two concepts. In particular, we analyze a metabolic approach and a genetic one and discuss the reasons for their failure to constitute a good starting point for successive debates. We argue that any ethical or social discussion of topics involving life and death must introduce cultural constructs such as, on the (...) one hand, the concept of clinical death and, on the other hand, the concept of existence. We argue that these two cultural constructs, although consistent with biomedical knowledge, cannot be ontologically grounded in it. To conclude, we apply our findings to the case of human embryos. (shrink)

A farming systems approach to development has meant many things over the past 15 years, depending on its institutional and ecological setting, its target populations, and the goals motivating its implementation. Despite the diversity of approaches, and the sometimes rancorous discussion over which was best and why, the approach is now recognized in many places as the only one that can identify and respond to the needs of limited resource farm families, especially those in marginal ecosystems. Involving an (...) iterative process of diagnosis, design, testing and extension, the farming system approach to date has done more to change research objectives at national and international institutions than to change actual farmer practices. By legitimizing what limited resource farmers do and why they do it, a farming systems approach lends itself to policy analysis as well. Recent research in farming systems suggests greater attention should be payed to exogenous variables, including policy and infrastructure, as well as to development of technology that really responds to the felt needs of limited resource farmers in improving their level of living. (shrink)

Kamm's approach to patient selection qualifies the notion that fairness makes need for scarce, transplantable organs inversely proportional to age. She defines need as how much adequate conscious life a person will have had before death. Length of adequate conscious life correlates highly with age. If so, then younger persons are usually needier than older ones. Since Kamm allows for past periods of non‐adequate conscious life, I argue that this correlation may be neither as close, (...) nor as easy to apply, as she wants it to be. Fairness should require assessment of experiential content in determining how long one's life has been adequately conscious. I argue that such assessments involve some of the goods of experience and quality of life judgements that Kamm thinks a reliance on adequate conscious life will avoid. (shrink)

Interdisciplinary in approach, this book combines philosophy, hybrid theory, and architectural theory with case studies, explicitly linking the traditions together to investigate the eco-aesthetics of the urban environment.

Autonomy is a vital principle in medical law and ethics. It occupies a prominent place in all medico-legal and ethical debate. But there is a dangerous presumption that it should have the only vote, or at least the casting vote. This book is an assault on that presumption, and an audit of autonomy's extraordinary status. This book surveys the main issues in medical law, noting in relation to each issue the power wielded by autonomy, asking whether that power can be (...) justified, and suggesting how other principles can and should contribute to the law. It concludes that autonomy's status cannot be intellectually or ethically justified, and that positive discrimination in favour of the other balancing principles is urgently needed in order to avoid some sinister results. 'This book is a sustained attack on the hegemony of the idea of autonomy in medical ethics and law. Charles Foster is no respecter of authority, whether of university professors or of law Lords. He grabs his readers by their lapels and shakes sense into them through a combination of no-nonsense rhetoric and subtle argument that is difficult to resist.' Tony Hope, Professor of Medical Ethics, Oxford University 'This book is unlikely to be in pristine state by the time you have finished reading it. Whether that is because you have thrown it in the air in celebration or thrown it across the room in frustration will depend on your perspective. But this book cannot leave you cold. It is a powerful polemic on the dominance of autonomy in medical law, which demands a reaction. Charles Foster sets out a powerful case that academic medical lawyers have elevated autonomy to a status it does not deserve in either ethical or legal terms. In a highly engaging, accessible account, he challenges many of the views which have become orthodox within the academic community. This will be a book which demands and will attract considerable debate.' Jonathan Herring, Exeter College, Oxford University 'This is a learned, lively and thought-provoking discussion of problems central to the courts' approach to ethical issues in medical law. What principles are involved? More significantly, which really underlie and inform the process of seeking justice in difficult cases? Charles Foster persuasively argues, and demonstrates, that respect for autonomy is but one of a number of ethical principles which interact and may conflict. He also addresses the sensitive issue of the extent to which thoughts and factors which go to influence legal decisions may not appear in the judgments.' Adrian Whitfield QC. 'Introducing the Jake La Motta of medical ethics. Foster is an academic street-fighter who has bloodied his hands in the court room. He provides a stinging, relentless, ground attack on the Goliath of medical ethics: the central place of autonomy in liberal medical ethics. This is now the first port of call for those who feel that medical ethics has become autonomized.' Julian Savulescu, Uehiro Chair in Practical Ethics, University of Oxford. "This important book offers a robust challenge to anyone, whether lawyer or 'ethicist', who sees respect for autonomy as the only game in town. It argues eloquently and effectively that, on the one hand, despite the reverence paid to it by judges, in practice the law, even in the context of consent, weaves together a number of moral threads of which autonomy is merely one, in the pursuit of a good decision. It argues on the other hand, that were the day-to-day practice of law to be guided primarily by respect for autonomy, this would be wrong. Foster concludes that whilst, 'any society that does not have laws robustly protecting autonomy is an unsafe and unhappy one', so too would be a society in which too much emphasis was placed on respect for autonomy at the expense of other important moral principles. This is essential reading for anyone interested in the role of autonomy and indeed of medical ethics, in the law." Michael Parker, Professor of Bioethics, University of Oxford. (shrink)

How might we change ourselves without ending our existence? What could we become, if we had access to an advanced form of bioengineering that allowed us dramatically to alter our genome? Could we remain in existence after ceasing to be alive? What is it to be human? Might we still exist after changing ourselves into something that is not human? What is the significance of human extinction? Steven Luper addresses these questions and more in this thought-provoking study. He defends an (...) animalist account, which says that we are organisms, but claims that we are also material objects. His book goes to the heart of the most complex questions about what we are and what we might become. Using case studies from the life sciences as well as thought experiments, Luper develops a new way of thinking about the nature of life and death, and whether and how human extinction matters. (shrink)

The dilemma of whether to allow relatives to see or even touch their loved one while she undergoes cardiopulmonary resuscitation has been discussed for roughly four decades. However, Family Presence During Adult Resuscitation is still not widely implemented. In this paper, I espouse relational autonomy to make a case for a clinical approach of family-centered care and FPDR. In recent years, family-centered care has gained increasing support. I argue that relational autonomy provides a conceptual framework for both FCC and (...) FPDR. In turn, FCC provides a plausible clinical approach to justify FPDR, while the empirical evidence that supports FPDR provides a useful example to justify FCC. (shrink)

Volume 52, Issue 13, December 2020, Page 1347-1357.

The ethics of hastened death are complex. Studies on physicians’ opinions about assisted dying exist, but changes in physicians’ attitudes towards hastened death in clinical decision-making and the background factors explaining this remain unclear. The aim of this study was to explore the changes in these attitudes among Finnish physicians. A questionnaire including hypothetical patient scenarios was sent to 1182 and 1258 Finnish physicians in 1999 and 2015, respectively. Two scenarios of patients with advanced cancer were (...) presented: one requesting an increase in his morphine dose to a potentially lethal level and another suffering a cardiac arrest. Physicians’ attitudes towards assisted death, life values and other background factors were queried as well. The response rate was 56%. The morphine dose was increased by 25% and 34% of the physicians in 1999 and 2015, respectively. Oncologists approved the increase most infrequently without a significant change between the study years. Oncological specialty, faith in God, female gender and younger age were independent factors associated with the reluctance to increase the morphine dose. Euthanasia, but not assisted suicide, was considered less reprehensible in 2015. In both years, most physicians withheld cardiopulmonary resuscitation. Finnish physicians accepted the risk of hastening death more often in 2015 than in 1999. The physicians’ specialty and many other background factors influenced this acceptance. They also regarded euthanasia as less reprehensible now than they did 16 years ago. (shrink)

The celebrated author of _Gender Trouble_ here redefines Antigone's legacy, recovering her revolutionary significance and liberating it for a progressive feminism and sexual politics. Butler's new interpretation does nothing less than reconceptualize the incest taboo in relation to kinship -- and open up the concept of kinship to cultural change. Antigone, the renowned insurgent from Sophocles's _Oedipus,_ has long been a feminist icon of defiance. But what has remained unclear is whether she escapes from the forms of power that she (...) opposes. Antigone proves to be a more ambivalent figure for feminism than has been acknowledged, since the form of defiance she exemplifies also leads to her death. Butler argues that Antigone represents a form of feminist and sexual agency that is fraught with risk. Moreover, Antigone shows how the constraints of normative kinship unfairly decide what will and will not be a livable life. Butler explores the meaning of Antigone, wondering what forms of kinship might have allowed her to live. Along the way, she considers the works of such philosophers as Hegel, Lacan, and Irigaray. How, she asks, would psychoanalysis have been different if it had taken Antigone -- the "postoedipal" subject -- rather than Oedipus as its point of departure? If the incest taboo is reconceived so that it does not mandate heterosexuality as its solution, what forms of sexual alliance and new kinship might be acknowledged as a result? The book relates the courageous deeds of Antigone to the claims made by those whose relations are still not honored as those of proper kinship, showing how a culture of normative heterosexuality obstructs our capacity to see what sexual freedom and political agency could be. (shrink)

BackgroundThe biopharmaceutical industry operates at the intersection of life sciences, clinical research, clinical care, public health, and business, which presents distinct operational and ethical challenges. This setting merits focused bioethics consideration to complement legal compliance and business ethics efforts. However, bioethics as applied to a biopharmaceutical industry setting often is construed either too broadly or too narrowly with little examination of its proper scope.Main textAny institution with a scientific or healthcare mission should engage bioethics norms to navigate ethical issues (...) that arise from the conduct of biomedical research, delivery of clinical care, or implementation of public health programs. It is reasonable to assume that while bioethics norms must remain constant, their application will vary depending on the characteristics of a given setting. Context “specification” substantively refines ethics norms for a particular discipline or setting and is an expected, needed and progressive ethical activity. In order for this activity to be meaningful, the scope for bioethics application and the relevant contextual factors of the setting need to be delineated and appreciated. This paper defines biopharmaceutical bioethics as: the application of bioethics norms (concepts, principles, and rules) to the research, development, supply, commercialization, and clinical use of biopharmaceutical healthcare products. It provides commentary on this definition, and presents five contextual factors that need to be considered when applying bioethics norms to a biopharmaceutical industry setting: (1) dual missions; (2) timely and pragmatic guidance; (3) resource stewardship; (4) multiple stakeholders; and (5) operational complexity.ConclusionUnderstanding the scope of the biopharmaceutical enterprise and contextual factors of a biopharmaceutical industry setting is foundational for the application of bioethics norms. Establishing a common language and approach for biopharmaceutical bioethics will facilitate breadth and depth of discussion and subsequent implementation to benefit patients, the healthcare system and society. (shrink)

The pressing and universally relevant issue of euthanasia is debated in this volume. Euthanasia has become increasingly contentious as populations age, and medical and scientific advances continue to transform and extend life. Euthanasia - Choice and Death examines the key philosophical arguments that have underpinned thinking and practice up till now: the centrality of choice to our notion of the human being, and the challenge of changes to our concept of death in the face of medical, (...) scientific and technological advances. Gail Tulloch develops a conception of dignity that does not depend on religious assumptions and can promote a broad ethical consensus in a liberal democracy. Examination of landmark cases and the approaches adopted by key countries - the U.S.A., the U.K., the Netherlands, and Australia - ground the book. (shrink)

While unicellular microbes such as phytoplankton (marine algae) have long been considered immortal unless eaten by predators, recent research suggests that under specific conditions entire populations of phytoplankton actively kill themselves; their assumed atemporality is being revised as marine ecologists recognize phytoplankton’s important role in the global carbon cycle. Drawing on empirical research into programmed cell death in marine microbes, this article explores how, in their study of microbial death, scientists change not only our understanding of microbial temporality, (...) but also reconstruct the relationship between life and death, biological individuality and assumptions about a natural teleology associated with bounded biological systems and genetic programmes. Reading this research together with a Derridean deconstruction of the limit between human and other animals with respect to death, this article explores how the deconstruction of individuality from within biology may suggest alternatives to our anthropocentric notion of time and embodiment. (shrink)

In a world of rapid technological advances, the moral issues raised by life and death choices in healthcare remain obscure. _Life and Death in Healthcare Ethics_ provides a concise, thoughtful and extremely accessible guide to these moral issues. Helen Watt examines, using real-life cases, the range of choices taken by healthcare professionals, patients and clients which lead to the shortening of life. The topics looked at include: * euthanasia and withdrawal of treatment * the persistent (...) vegetative state * abortion * IVF and cloning * life-saving treatment of pregnant women Clearly written and insightful, _Life and Death in Healthcare Ethics_ presupposes no prior knowledge of philosophy. It will be of interest to anyone confronting healthcare ethics for the first time, or seeking to develop his or her understanding of some core topics in the field. (shrink)

The advancement of Artificial Intelligence (AI) poses challenges in the field of bioethics, especially concerning issues related to life and death. AI has permeated areas such as health and research, generating ethical dilemmas and questions about privacy, decision-making, and access to technology. Life and death have been recurring human concerns, particularly in connection with depression. AI has created systems like Thanabots or Deadbots, which digitally recreate deceased individuals and allow interactions with them. These systems rely on (...) information generated by AI users during their lifetime, raising ethical and emotional questions about the authenticity and purpose of these recreations. AI acts as a mediator between life, death, and the human being, enabling a new form of communication with the deceased. However, this raises ethical issues such as informed consent from users and the limits of digital recreation. Companies offer services like the Digital Resurrection of deceased individuals and the generation of hyper-realistic avatars. Still, concerns arise about the authenticity of these representations and their long-term emotional impact. Interaction with Thanabots may alter perceptions of death and finitude, leading to a potential “postmortal society” where death is no longer viewed as a definitive end. Nevertheless, this raises questions about the value of life and the authenticity of human experiences. AI becomes a bridge between the living and the dead, partially replacing rituals and mystical beliefs. As technology advances, there will be a need for greater transparency in interacting with AI systems and ethical reflections on the role of these technologies in shaping perceptions of life and death. Ultimately, the question arises of whether we should allow the dead to rest in peace and how to balance the pursuit of emotional relief with authenticity and respect for the memory of the deceased. A deeper ethical consideration is needed on how AI alters traditional notions of life, death, and communication in contemporary society. In this research, an interdisciplinary approach was utilized to conduct a comprehensive systematic review of the recent academic literature, followed by a detailed analysis of two key texts. Central ideas were extracted, and recurring themes were identified. Finally, a reflective analysis of the findings was conducted, yielding significant conclusions and recommendations for future research. (shrink)

Dilemmas about resuscitation and life-prolonging treatment for severely compromised infants have become increasingly complex as skills in neonatal care have developed. Quality of life and resource issues necessarily influence management. Our Institute of Medical Ethics working party, on whose behalf this paper is written, recognises that the ultimate responsibility for the final decision rests with the doctor in clinical charge of the infant. However, we advocate a team approach to decision-making, emphasising the important role of parents and (...) nurses in the process. Assessing the relative burdens and benefits can be troubling, but doctors and parents need to retain a measure of discretion; legislation which would determine action in all cases is inappropriate. Caution should be exercised in involving committees in decision-making and, where they exist, their remit should remain to advise rather than to decide. Support for families who bear the consequences of their decisions is often inadequate, and facilitating access to such services is part of the wider responsibilities of the intensive care team. The authors believe that allowing death by withholding or withdrawing treatment is legitimate, where those closely involved in the care of the infant together deem the burdens to be unacceptable without compensating benefits for the infant. As part of the process accurate and careful recording is essential. (shrink)

In this paper, we develop a theoretical framework for understanding women leaders in working life. Our starting point is in statistics and earlier women-in-management literature, which show that women leaders represent a minority of the managerial population. We assume such underlying mechanisms causing discriminatory practices towards women leaders to exist which have become naturalized and invisible. Our concern is that everyone irrespective of gender should have a fair chance in career progression. This is both a moral and also an (...) economic challenge. The framework we develop in this paper is an alternative approach to studying women leaders compared to traditional women-in-management literature. It aims at revealing the "natural and taken-for-granted" cultural mechanisms behind discriminatory practices. Our framework is based on a critical discursive approach, which draws on ideas of how women''s leadership becomes symbolically represented and constructed in discursive practices. These symbolic constructions, which are mediated through language, often have an ideological loading which positions women leaders and builds their identities in ways that can help to legitimize unequal relations between the genders. However, our framework emphasizes the possibility of multiple discourses and a dynamic view of culture. The cultural constructions of women leaders are, thus, open to change. (shrink)

This volume meets the increasing interest in a range of philosophical issues connected with the nature and significance of life and death, and the ethics of killing. What is it to be alive and to die? What is it to be a person? What must time be like if we are to persist? What makes one life better than another? May death or posthumous events harm the dead? The chapters in this volume address these questions, and (...) also discuss topical issues such as abortion, euthanasia, and suicide. They explore the interrelation between the metaphysics, significance, and ethics of life and death, and they discuss the moral significance of killing both people and animals, and the extent to which death harms them. The volume is for all those studying the philosophy of life and death, for readers taking applied ethics courses, and for those studying ethics and metaphysics more generally. (shrink)

It seems to be widely assumed that the only effect of the Ghirardi-Rimini-Weber dynamical collapse mechanism on the `tails' of the wavefunction is to reduce their weight. In consequence it seems to be generally accepted that the tails behave exactly as do the various branches in the Everett interpretation except for their much lower weight. These assumptions are demonstrably inaccurate: the collapse mechanism has substantial and detectable effects within the tails. The relevance of this misconception for the dynamical-collapse theories is (...) debatable, though. (shrink)