In many jurisdictions in the United States and elsewhere, the law governing deadly force by police and civilians contains a notable asymmetry. Often civilians but not police are bound by the imminence requirement—that is, a necessary condition for justifying deadly force is reasonable belief that oneself or another innocent person faces imminent threat of grave harm. In U.S. law enforcement, however, there has been some shift toward the imminence requirement, most evident in the use-of-force policy adopted by the (...) Department of Justice in 2022. This article defends that shift and argues that the ethical case for the imminence requirement in policing is stronger than Shannon Brandt Ford suggests in a recent article. Though the imminence requirement’s impacts on policing and public safety require ongoing study, the principle of equality before the law and the Doctrine of Doing and Allowing both provide moral grounds for this requirement, especially given the lack of evidence that the status quo helps protect life. (shrink)

While the practice of organ donation after cardiac death has long been trending upwards in acceptance and use, it is still a highly controversial and practically inefficient method of organ procurement. One policy that has recently been proposed to try and alleviate some of the ethical and practical concerns with organ donation after cardiac death is the practice of imminent death organ donation. This type of live organ donation comes in patients at the end of their life who have decided (...) to withdraw life-sustaining treatment, but still want to ensure that their organs are donated and not wasted, which isn't always the case with organ donation after cardiac death. This paper then gives some ethical and practical reflections and recommendations regarding the potential implementation of this controversial practice into regular transplant practice and policy. (shrink)

This paper argues that there is a significant moral difference between force applied against (imminent) attackers on the one hand and force applied against “threatening” people who are not (imminent) attackers on the other. Given that there is such a difference, one should not blur the lines by using the term “self-defense” (understood as including other-defense) for both uses of force. Rather, only the former is appropriately called self-defense, while for the latter, following German legal terminology, the term “justifying defensive (...) emergency” will be used here. The two justifications are not governed by the same criteria and thus lead to different results. The paper will proceed by providing first, in section (1), a brief sketch of the contours of the self-defense justification, putting particular emphasis on the necessity criterion. On the account presented here, the necessity criterion of the self-defense justification is particularly harsh on the aggressor (and thus not to be interpreted as literally requiring the employment of “the mildest means”) and its applicability is only triggered by an (imminent) attack, not by other kinds of threats. Section (2) will then further explain the differences between self-defense and justifying defensive emergency. A particularly important difference is that people who are subjected to justified self-defense cannot permissibly defend themselves, while people who are subjected to (extremely harmful or even lethal) justified defensive emergency measures can. Thus, in this latter case we have a “moral equality” (of sorts) of the involved parties: they can permissibly use force against each other. Section (3) will list and defend some conditions that a successful argument against the imminence requirement of the self-defense justification has to satisfy. In the light of these conditions, sections (4) to (7) will discuss a number of objections that have been adduced against the imminence requirement as well as proposals that have been made in support of alternative accounts. It will be argued that all these objections and proposals fail. Section (8) will provide a number of thought experiments in support of the claim that the harsh necessity criterion of the self-defense justification is only triggered by imminence while force against non-imminent threats can be justified with the help of the justifying emergency exemption, as well as for the claim that the justifying emergency exemption puts the person using preventive force against non-imminent threats on a shorter leash and makes him liable to counter-measures. Section (9) will explain the rationale for tying the applicability of the harsh necessity criterion of the self-defense justification to imminent attacks. Section (10) will discuss some special cases and show why they do not undermine the normative validity of this tie. (shrink)

“Terminal sedation” refers to the use of sedation as palliation in dying patients with a terminal diagnosis. Although terminal sedation has received widespread legal and ethical justification, the practice remains ethically contentious, particularly as some hold that it foreseeably hastens death. It has been proposed that empirical studies show that terminal sedation does not hasten death, or that even if it may hasten death it does not do so in a foreseeable way. Nonetheless, it is clear that providing terminal sedation (...) in combination with the withholding or withdrawing of life-prolonging treatments such as fluid and nutrition can foreseeably hasten death significantly—what is here called early terminal sedation . There are ethical justifications for the use of sedation in palliative care and thus it would seem that ETS is an ethically and legally acceptable practice. However, what emerges from the literature is the repeated assertion that terminal sedation must be restricted to use in imminently dying patients—the “imminence condition”—and that therefore ETS is unacceptable. This restriction has taken on greater significance with the trend of palliative care to include the care of patients who are not imminently dying. This paper proposes to show that although there is widespread intuitive support for the imminence condition, it does not follow from the justifications for sedation as palliation, and that explicit arguments for the imminence condition are needed. (shrink)

De Bie et al. (2023) propose an organizing framework for different stages of human gestational development from conception to the viable premature. They also identify ethical considerations and con...

Based on Nathan Goldstein’s case report, “But I have a pacer…there is no point in engaging in hypothetical scenarios”: A Non-imminently Dying Patient’s Request for Pacemaker Deactivation, it is reasonable to conclude that it was, all-things-considered, ethically appropriate to grant the patient’s request to deactivate her pacemaker. Philosophically, and as a clinical bioethicist, I support the team’s decision to honor the patient’s request for pacemaker deactivation. However, it is worth exploring a bit further whether the distress on the part of (...) the outside hospital’s ethics committee and providers—who declined to honor the patient’s request for pacemaker deactivation—may actually track something of moral significance. Might their discomfort around deactivation be “truth-tracking” in moral terms? (shrink)

This article examines joint action initiatives among small- and medium-sized enterprises in the manufacturing industries in developing countries in the context of the ascendancy of corporate social responsibility and the proliferation of a variety of international accountability tools and standards. Through empirical fieldwork in the football manufacturing industry of Jalandhar in North India, the article documents how local cluster-based SMEs stay coupled with the global CSR agenda through joint CSR initiatives focusing on child labor. Probing further, however, also reveals patterns (...) of selective decoupling in relation to core humanitarian and labor rights issues. Through in-depth interviews with a wide range of stakeholders involved in the export-oriented football manufacturing industry of Jalandhar in North India, the article highlights the dynamics of coupling and decoupling taking place, and how developing country firms can gain credit and traction by focusing on high visibility CSR issues, although the plight of workers remains fundamentally unchanged. The authors revisit these findings in the discussion and concluding sections, highlighting the main research and policy implications of the analysis. (shrink)

The research literature suggests that physicians’ attitudes regarding disclosing a diagnosis of cancer have changed, from nondisclosure to full disclosure. Physicians’ attitudes towards disclosing a patient’s prognosis are likewise said to have changed, although not to the same degree.The aim of this study was to identify inherent challenges in communicating information about imminent death. It included one set of interviews with patients and another set with doctors, and subsequent discussions of ways to overcome obstacles to patients’ understanding their situation. Patients (...) were diagnosed with leukemia, myeloma, or lung cancer; the doctors were hematologists and lung oncologists. The two sets of interviews were analyzed separately using a content analysis model developed by Graneheim and Lundman. For each set of interviews, eight content areas were defined as belonging to an area of interest and scrutinized for the information they included regarding communicating prognoses to patients.The main finding was a discrepancy between patients’ desire to be fully informed regarding their prognosis and physicians’ reluctance to offer a prognosis until a patient had overt signs of approaching death. We conclude that existing guidelines for disclosure of bad news should be modified to encourage disclosure and discussion of uncertain prognostic information, unless a patient is clearly opposed to receiving such information or otherwise not a suitable partner for dialogue. (shrink)

Non-therapeutic research with imminently dying patients in intensive care presents complex ethical issues. The vulnerabilities of the imminently dying, together with societal disquiet around death and dying, contribute to an intuition that such research is beyond the legitimate scope of scientific inquiry. Yet excluding imminently dying patients from research hinders the advancement of medical science to the detriment of future patients. Building on existing ethical guidelines for research, we propose a framework for the ethical design and conduct of research involving (...) the imminently dying. To enable rapid translation to practice, we frame the approach in the form of eight ethical questions that researchers and research ethics committees ought to answer prior to conducting any research with this patient population. (1) Does the study hypothesis require the inclusion of imminently dying patients? (2) Are non-therapeutic risks and burdens minimised consistent with sound scientific design? (3) Are the risks of these procedures no more than minimal risk? (4) Are these non-therapeutic risks justified insofar as they are reasonable in relation to the anticipated benefits of the study? (5) Will valid informed consent be obtained from an authorised surrogate decision maker? (6) How will incidental findings be handled? (7) What additional steps are in place to protect families and significant others of research participants? (8) What additional steps are in place to protect clinical staff and researchers? Several ethical challenges hinder research with imminently dying patients. Nonetheless, provided adequate protections are in place, non-therapeutic research with imminently dying patients is ethically justifiable. Applying our framework to an ongoing study, we demonstrate how our question-driven approach is well suited to guiding investigators and research ethics committees. (shrink)

In this case report, we describe a woman with advancing dementia who still retained decisional capacity and was able to clearly articulate her request for deactivation of her implanted cardiac pacemaker—a scenario that would result in her death. In this case, the patient had the autonomy to make her decision, but clinicians at an outside hospital refused to deactivate her pacemaker even though they were in unanimous agreement that the patient had capacity to make this decision, citing personal discomfort and (...) a belief that her decision seemed out of proportion to her suffering. We evaluated her at our hospital, found her to have decision-making capacity, and deactivated her pacer resulting in her death about 9 days later. While some clinicians may be comfortable discussing patient preferences for device deactivation in patients who are imminently dying, we can find no reports in the literature of requests for device deactivation from patients with terminal diagnoses who are not imminently dying. (shrink)

Comment figurer visuellement les effets des bouleversements qui marquent notre entrée collective dans l’Anthropocène? Comment saisir l’imminence de ces transformations, sans verser dans une forme de voyeurisme de la catastrophe qui, en se soumettant aux formes du spectaculaire, stérilise toute forme d’action efficace au lieu de la favoriser? Peut-être en cherchant des images en creux, des images inquiètes, incomplètes, qui suscitent l’interrogation et l’exercice projectif de la pensée et de l’imagination : des images qui ne représentent pas les effets (...) des bouleversements, mais les laissent flotter à la lisière de la représentation. On voudrait ainsi définir les contours possibles d’un iconotexte de l’effondrement qui constitue un nouveau régime d’articulation du visible et du lisible, propre à l’imminence des transformations qui nous guettent. (shrink)

Respect for an individual’s autonomy determines that doctors should inform patients if their illness is terminal. This becomes complicated when the terminal diagnosis is recent and death is imminent. The authors examine the admission to paediatric intensive care of an adolescent with terminal respiratory failure. While fully ventilated, the patient was kept sedated and comfortable but when breathing spontaneously he was capable of non-verbal communication and understanding. Once resedated and reintubated, intense debate ensued over whether to wake the patient to (...) tell him he was going to die. The authors discuss the ethical arguments that surrounded their decision. (shrink)

In her 1971 essay “Lying in Politics,” Hannah Arendt reflects on the publication of top-secret materials contained in a massive study entitled “History of U.S. Decision-Making Process on Vietnam Policy,” a.k.a. the Pentagon Papers. As the title of her essay suggests, Arendt is concerned with the problem of political deception. However, it is not the lies that politicians may or may not tell that form the central theme of her essay. Instead, she focuses on what the Pentagon Papers tell us (...) about the role of ideological thinking and self-deception in the development of U.S. policy bearing on Vietnam. In particular,…. (shrink)

Different questions than the one originally posed need to be askedVince and Petros describe the heartrending situation of an adolescent boy who has been diagnosed with terminal respiratory failure and for whom no further beneficial medical treatments are available. All of the members of the healthcare team and the boy’s parents are in agreement that mechanical ventilation should be withdrawn with the expectation that the child will die shortly thereafter. Conflicting views arose, however, as to whether the boy’s sedation should (...) be lifted so that he could be informed of his impending death. The authors lay out the opposing arguments, for and against informing the child of his impending death, in some detail. Rather than specifically critiquing those arguments, I would like to comment on several ancillary issues that were not explored in the paper and, in doing so, point to some ways in which end of life decision making processes could perhaps be improved in the future.ADVANCE CARE PLANNINGThe analysis of this case highlights the potential value of ongoing and early introduction of discussions around death and dying with chronically and terminally ill persons, even when the person is a child . In the paper, we are given relatively few hints about the boy’s understanding of the nature of his disease . It is unclear what conversations took place with him during the …. (shrink)

The literature on the ethics of defensive harming frequently addresses imminent threats and threats of future harm; but it rarely addresses threats of continuing harm. Real-world cases of kidnapping, slavery, and domestic abuse can include threats of continuing harm. In cases such as these, the harm the victim suffers—and therefore proportionate defensive harm—depends upon both the magnitude and the duration of the harm threatened. Because continuing harms are, by definition, less than lethal, there is a _prima facie _sense in which (...) using lethal force to defend against threats of continuing harm is disproportionate. In this paper, I develop a conception of threats of continuing harm and apply that conception to individual cases of self-defense and to just war theory. Ultimately, I argue that violations of a victim’s right to freedom or autonomy can justify lethal defensive harm, but only if the harm threatened is of a sufficient duration. (shrink)

In this paper, I will provide a conceptual analysis of the term self-defense and argue that in contrast to the widespread “instrumentalist” account of self-defense, self-defense need not be aimed at averting or mitigating an attack, let alone the harm threatened by it. Instead, on the definition offered here, an act token is self-defense if and only if a) it is directed against an ongoing or imminent attack, and b) the actor correctly believes that the act token is an effective (...) form of resistance or the act token belongs to an act type that usually functions as a means to resist an attack. While resistance is effective in making the attack more difficult, it can often be overcome and therefore does not necessarily stop or mitigate the attack. This concept of self-defense, I shall argue, not only matches ordinary language use and plausible accounts of self-defense in the legal literature but also has important practical implications in helping to avoid confusions about necessity and proportionality. In particular, it avoids the notorious problem of the “knowingly helpless rape victim” whose futile struggle against the rapist (futile in terms of averting or mitigating harm) counter-intuitively could not count as justified self-defense on an instrumentalist account. (shrink)

Human obsolescence is imminent. We are living through an era in which our activity is becoming less and less relevant to our well-being and to the fate of our planet. This trend toward increased obsolescence is likely to continue in the future, and we must do our best to prepare ourselves and our societies for this reality. Far from being a cause for despair, this is in fact an opportunity for optimism. Harnessed in the right way, the technology that hastens (...) our obsolescence can open us up to new utopian possibilities and enable heightened forms of human flourishing. (shrink)

The imminent deployment of autonomous vehicles requires algorithms capable of making moral decisions in relevant traffic situations. Some scholars in the ethics of autonomous vehicles hope to align such intelligent systems with human moral judgment. For this purpose, studies like the Moral Machine Experiment have collected data about human decision-making in trolley-like traffic dilemmas. This paper first argues that the trolley dilemma is an inadequate experimental paradigm for investigating traffic moral judgments because it does not include agents’ character-based considerations and (...) is incapable of facilitating the investigation of low-stakes mundane traffic scenarios. In light of the limitations of the trolley paradigm, this paper presents an alternative experimental framework that addresses these issues. The proposed solution combines the creation of mundane traffic moral scenarios using virtual reality and the Agent-Deed-Consequences (ADC) model of moral judgment as a moral-psychological framework. This paradigm shift potentially increases the ecological validity of future studies by providing more realism and incorporating character considerations into traffic actions. (shrink)

The imminent demise of the nation-state in the face of global capitalism and supra-national agencies like the United Nations has often been predicted, yet in practice the death of the state seems unimaginable: indeed terrorist activity and corporate collapse have made states, if anything, more assertive in recent years, and the condition of 'statelessness' is regarded as pitiable and grave in the extreme. This volume, first published in 2003, offers a coherent survey of perceptions of the state, its history, its (...) theoretical underpinnings, and its prospects in the contemporary world. The coverage of the Western European experience is thorough and wide-ranging, with the greatest post-colonial democratic state, India, as a comparative example. The provocative and accessible contributions of a very distinguished and genuinely pan-European team of contributors ensure that States and Citizens provides a unique and valuable resource, of interest to students and teachers of the history of ideas, political theory and European studies. (shrink)

Patients who are imminently dying sometimes experience symptoms refractory to traditional palliative interventions, and in rare cases, continuous sedation is offered. Samuel H. LiPuma, in a recent article in this Journal, argues that continuous sedation until death is equivalent to physician-assisted suicide/euthanasia based on a higher brain neocortical definition of death. We contest his position that continuous sedation involves killing and offer four objections to the equivalency thesis. First, sedation practices are proportional in a way that physician-assisted suicide/euthanasia is not. (...) Second, continuous sedation may not entirely abolish consciousness. Third, LiPuma’s particular version of higher brain neocortical death relies on an implausibly weak construal of irreversibility—a position that is especially problematic in the case of continuous sedation. Finally, we explain why continuous sedation until death is not functionally equivalent to neocortical death and, hence, physician-assisted suicide/euthanasia. Concluding remarks review the differences between these two end-of-life practices. (shrink)

Are we in imminent danger of extinction? Yes, we probably are, argues John Leslie in his chilling account of the dangers facing the human race as we approach the second millenium. The End of the World is a sobering assessment of the many disasters that scientists have predicted and speculated on as leading to apocalypse. In the first comprehensive survey, potential catastrophes - ranging from deadly diseases to high-energy physics experiments - are explored to help us understand the risks. One (...) of the greatest threats facing humankind, however, is the insurmountable fact that we are a relatively young species, a risk which is at the heart of the 'Doomsday Argument'. This argument, if correct, makes the dangers we face more serious than we could have ever imagined. This more than anything makes the arrogance and ignorance of politicians, and indeed philosophers, so disturbing as they continue to ignore the manifest dangers facing future generations. (shrink)

In anticipation of an imminent "robot revolution," data-based answers are given to these questions: what is a robot; what impact will robots have on the work force; and what can we do about displaced workers?

Since the early 1980’s, with the clinical advent of in vitro fertilization resulting in so-called “test tube babies,” a wide array of ethical considerations and concerns regarding artificial womb technology (AWT) have been described. Recent breakthroughs in the development of extracorporeal neonatal life support by means of AWT have reinitiated ethical interest about this topic with a sense of urgency. Most of the recent ethical literature on the topic, however, pertains not to the more imminent scenario of a physiologically improved (...) method of neonatal care through AWT, but instead to the remote scenario of “complete ectogenesis” that imagines human gestation occurring entirely outside of the womb. This scoping review of the ethical literature on AWT spans from more abstract concerns about complete ectogenesis to more immediate concerns about the soon-to-be-expected clinical life support of what we term the fetal neonate or fetonate. Within an organizing framework of different stages of human gestational development, from conception to the viable premature infant, we discuss both already identified and newly emerging ethical considerations and concerns regarding AWT and the care of the fetonate. (shrink)

This paper offers an imminent interpretation of Kant's political teleology in the context of his response to Moses Mendelssohn in Theory and Practice III concerning prospects of humankind's moral progress. The paper assesses the nature of Kant's response against his mature political philosophy in the Doctrine of Right . In `Theory and Practice III' Kant's response to Mendelssohn remains incomplete: whilst insisting that individuals have a duty to contribute towards humankind's moral progress, Kant has no conclusive answer as to how (...) individuals might act on that duty. `Theory and Practice III' lacks a clear conception of the distinctness of political morality from the domain of virtue; Kant's resort to teleological argumentation is indicative of his lack of an account of instituting Right. The latter can be found in the Doctrine of Right —yet Kant's earlier teleological arguments contribute crucially to the development of his mature morality of Right. Key Words: inborn duty • moral progress • political teleology • principles of Right. (shrink)

In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats—or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the (...) broad middle terrain—and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the “manipulation” label and relabeling this space “nonargumentative]influence,” with two subtypes: “reason-bypassing” and “reason-countering.” Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to the surgery. (shrink)

BackgroundIn Saudi clinical settings, benevolent family care that reflects strongly held sociocultural values is commonly used to justify overriding respect for patient autonomy. Because the welfare of individuals is commonly regarded as inseparable from the welfare of their family as a whole, these values are widely believed to obligate the family to protect the welfare of its members by, for example, giving the family authority over what healthcare practitioners disclose to patients about their diagnoses and prognoses and preventing them from (...) making informed decisions about their healthcare.DiscussionFamily dominance over the healthcare decisions of competent patients is ethically problematic when the family prevent healthcare practitioners from disclosing diagnoses and prognoses to patients who have the capacity to consent and make decisions in their own best interests. Thus, the author holds that sociocultural values ought to be respected only when they do not prevent competent patients from knowing their diagnoses and prognoses or prevent them from making their own decisions.ConclusionHealthcare practitioners should not allow patients’ families to control what can or cannot be disclosed to competent patients. This is particularly important when patients are approaching death so that they may address their material and spiritual wishes—among other needs—as they prepare for death. Justification for this position is drawn from the Maqasid Al-Shariah-based Islamic bioethics approach, from which it is possible to argue that the harm of withholding diagnoses and prognoses from patients who are imminently dying outweighs the potential benefits. (shrink)

The dead donor rule (DDR) regulates current practice for vital organ donation, which means that organs may only be retrieved from people who are already dead (or brain dead). However, several authors criticize the DDR and argue that we should instead adopt a rule that allows us to retrieve vital organs before people are dead. They call this proposal organ donation euthanasia (ODE). While I am sympathetic to this proposal I do not think it goes far enough. In this paper, (...) I show that the key reasons put forward in favor of permitting ODE actually justify a more far‐reaching suggestion for regulation, permitting people to become living vital organ donors even when they are not about to die for other reasons. Further, I argue that only accepting imminently dying people as eligible donors for living vital organ donation would be objectionably paternalistic. (shrink)

Expecting the imminent triumph of religious and political absolutism Locke tries, in »A Letter concerning Toleration«, to define the true Christian and the true church. He invites his readers to differentiale between civil goverment and religious communities. A church is a voluntary association, the members of which are hold together by the common hope of salvation. In this association there is no need for power and force, which are necessary in civil government. Pursuing this theme in a subtile way Locke (...) develops the reformatorical doctrine of the two kingdoms. (shrink)