In debates about criteria for human death, several camps have emerged, the main two focusing on either loss of the "organism as a whole" (the mainstream view) or loss of consciousness or "personhood." Controversies also rage over the proper definition of "irreversible" in criteria for death. The situation is reminiscent of the proverbial blind men palpating an elephant; each describes the creature according to the part he can touch. Similarly, each camp grasps some aspect of the complex reality of death. (...) The personhood camp, in contrast to the mainstream "organism" camp, recognizes that a human organism can still be a biological living whole even without brain function. The mainstream camp, in contrast to the personhood camp, recognizes that a person can be permanently, even irreversibly unconscious, and still be a living person so long as his/her body is alive. The author proposes that hylomorphic dualism incorporates both these key insights. But to complete the picture of the entire "death elephant," a fundamental paradigm shift is needed to make sense of other seemingly conflicting insights. The author proposes a "semantic bisection" of the concept of death, analogous to the traditional distinction at the beginning of life between "conception" and "birth." To avoid the semantic baggage associated with the term "death," the two new death-related concepts are referred to as "passing away" (or "deceased") and "deanimation," corresponding, respectively, to sociolegal ceasing-to-be (mirror image of birth) and ontological/theological ceasing-to-be of the bodily organism (mirror image of conception). Regarding criteria, the distinguishing feature is whether the cessation of function is permanent (passing away) or irreversible (deanimation). If the "dead donor rule" were renamed the "deceased donor rule" (both acronyms felicitously being "DDR"), the ethics of organ transplantation from non–heart-beating donors could, in principle, be validly governed by the DDR, even though the donors are not yet ontologically "deanimated." Thus, the paradigm shift satisfies both those who insist on maintaining the DDR and those who claim that it has all along been receiving only lip service and should be explicitly loosened to include those who are "as good as dead." Even so, a number of practical caveats remain to be worked out for non–heart-beating protocols. (shrink)

A partir d'un « stock d'axiomes de toute théologie », J.-Y. Lacoste inscrit à son cahier des charges plusieurs tâches. La première consiste à montrer que « ses » vérités ne sont pas celles de tout le monde. La seconde est celle d'une « précision conceptuelle » inscrite dans la distinction de l'expérience et du langage par et dans lequel elle se dit. Enfin, comme troisième tâche, il entend accomplir une « mise en perspective » ou « mise en critique (...) », celle des instruments conceptuels utilisés. De ce fait, devraient apparaître les grandes lignes d'un protocole d'accord entre instances , capable d'aider à éviter des ornières assez habituelles, que ce soit celle de la sacralisation du Vorzeit , ou celle du flirt perpétuel avec la nouveauté chérie comme telle. Ces tâches étant évidemment solidaires, il n'est pas question pour J.-Y. Lacoste de les séparer dans son projet.Beginning with a « stock of axioms from all theology », J-Y Lacoste has a number of items on his list. The first is to show that « these » basic truths are not held by everyone. The second is that of a « conceptual precision » written in the distinction of experience and language by and in which it speaks . Finally, as a third task, he wants to accomplish a « putting in perspective » or « placing in review » of the conceptual tools used. From this there should appear the main lines of an agreement of protocol between matters capable of helping to avoid the fairly habitual ruts, whether it be that of the sacralization of the Vorzeit or that of the unending flirting with the darling novelity as such. Since these tasks are clearly tied together, there is no question for-J -Y Lacoste of separating them in his project. (shrink)

Les philosophes naturels du XVIIe siècle accordent une importance croissante aux faits nouveaux et singuliers construits par des démonstrations spectaculaires réalisées devant témoins. Cet essai tente de montrer comment cette évolution s’opère comme une synthèse de deux courants auparavant disjoints, d’un côté la pratique coopérative et informelle, critique sans être véhémente, de savants dont Mersenne constitue un bon exemple dans les années 1630, et de l’autre celle des alchimistes, remettant radicalement en cause les savoirs traditionnels tout en restant viscéralement attachés (...) au secret. On montrera comment le cercle parisien qui se réunit autour du même Mersenne au milieu du siècle pour débattre des expériences du vide réalise cette synthèse particulière. Mais dans une communauté érudite intéressée surtout à employer les faits expérimentaux comme matériau nouveau dans les disputes philosophiques, et pour laquelle la correspondance privée constitue la principale source d’information sous la forme de narrations circonstanciées par des témoins des événements singuliers survenus au cours de démonstrations expérimentales, le récit à la première personne apparaît comme une ressource superflue lorsqu’il s’agit de passer au format imprimé; Pascal, par exemple, recourt dans ses traités à une description des expériences se déployant sur un registre hypothétique et syllogistique qui exclut la narration directe. Le succès ultérieur des techniques matérielles et littéraires administrant la preuve en donnant à voir le protocole expérimental peut alors être mieux compris si l’on considère la parenté que celles-ci entretiennent avec les pratiques de la lecture publique traditionnelles dans les cercles érudits, proximité qui leur permet d’enrichir la signification et d’accroître la force de persuasion de l’expérience artificielle aux yeux des mêmes audiences. (shrink)

À l’heure où la médiation familiale connaît une médiatisation sans précédent en matière d’accompagnement social et familial avec, notamment, l’apparition d’un nouveau métier sanctionné par un diplôme d’État, l’auteur, pratiquant des médiations familiales depuis 1989, intervenant depuis 1987 dans un Espace Rencontre pour le maintien des relations enfant-parents à Bordeaux puis à Pau, et également conseiller conjugal et familial et psychothérapeute psychanalytique de couple, attire l’attention des professionnels du champ de la famille sur les limites de cette nouvelle forme d’accompagnement (...) du conflit conjugal et familial. C’est ainsi qu’au travers de son approche clinique psychanalytique du couple et de la famille, il indique ce qu’il considère comme des contre-indications à la médiation familiale, et sur la nécessité d’une vigilance extrême de chaque professionnel concerné à poser le mieux possible les limites de son intervention, au-delà de tout enjeu économique, idéologique ou militant. (shrink)

Pendant l’ete de 1928 Heidegger a offert un seminaire sur le troisieme livre de la Physique d’Aristote et donc sur l’explication aristotelicienne de la nature du mouvement. La derniere seance de ce cours, qui eut lieu le 25 juillet, est d’une grande importance parce que c’est a cette occasion que Heidegger va au livre neuf de la Metaphysique pour essayer de comprendre la notion ontologique qui est a la base de l’interpretation aristotelicienne du mouvement : l’energeia. Mais dans les protocoles (...) de ce seminaire qui se trouvent parmi les papiers de Heidegger et qui ont ete publies recemment dans le volume 83 de la Gesamtausgabe, la seance du 25 juillet se trouve absente. Ce fait a conduit l’editeur a conclure que le seminaire avait pris fin le 23 juillet, sans s’apercevoir donc que la conclusion du seminaire manquait. Il existe heureusement une transcription preservee parmi les papiers de l’etudiante de Heidegger, Helene Weiss, et accessible aujourd’hui dans les archives de l’universite de Stanford. Cette transcription montre que la derniere session eut bien lieu le 25 juillet et nous offre la lecture heideggerienne de Metaphysique IX qui ne se trouve pas dans la version de la Gesamtausgabe. C’est dans le contexte de cette lecture que Heidegger fait la declaration etonnante qui nous concerne ici : ≪Dans la derniere instance, la Metaphysique Θ revient a Platon ; la priorite de l’energeia est fondamentalement la meme chose que l’epekeina des Idees. ≫La première tâche que je me propose ici sera d’expliquer cette déclaration qui suggère une relation tres etroite, ou meme une identite, entre la notion aristotelicienne de l’energeia comme ayant une priorite vis‑a‑vis de la dunamis et la notion platonicienne de l’Idee du Bien comme etant epekeina de l’ousia. Pour cette explication je ferai appel non seulement au contexte du seminaire de 1928, mais aussi aux textes plus tardifs comme les Beitrage et les cours sur Nietzsche dans lesquels Heidegger semble presupposer et développer sa déclaration de 1928. Ma seconde tâche sera de comparer cette thèse heideggerienne a la tentative de Gadamer de surmonter l’opposition traditionnelle entre les ontologies de Platon et d’Aristote en faisant appel a l’idee du bien chez les deux. Cette tentative se trouve dans le texte Die Idee des Guten zwischen Plato und Aristoteles. La comparaison que j’entreprends ici va montrer certaines affinites entre les interpretations de l’Idee du Bien chez Heidegger et Gadamer, mais aussi de profondes differences qui vont determiner leurs differents projets philosophiques. (shrink)

Mime de bienveillance Incontestable au moins dans sa traduction plastique, la bienveillance n'est pas seulement dévolue au débat politique mais affirme sa préséance dans la plupart des protocoles verbaux au Japon. Sa présence efficace ne prend pas l'aspect d'un accueil ostentatoire : elle se présente plutôt comme la découverte ravie d'une convergence inaperçue jusque-là. On « tombe d'accord » selon l'heureuse expression française, en s'émerveillant de cette entente inopinée que tout avait pourtant - Etudes japonaises.

: Subpart D of 45 CFR 46 focuses on research involving children. Section 46.407 addresses research that is not otherwise approvable. The research is not otherwise approvable because either (1) it seeks to enroll healthy children, but offers no prospect of direct benefit and entails more than minimal risk; or (2) it seeks to enroll children with a disorder or condition, but offers no prospect of direct benefit and entails more than a minor increase over minimal risk. According to 46.407, (...) such research can be permissible if it is approved by a panel of experts. Prior to 2000, only two 407 panels had been convened, but in 2001, the Office for Human Research Protections received more than 20 protocols for 407 review. The first, entitled "Precursors to Diabetes in Japanese American Youth," serves here as a case study in human subject protections. (shrink)

According to major cognitive theories of emotional disorders cognitive biases are partly responsible for their onset and maintenance. The direct test of this assumption is possible only if experimental method capable of altering a given form of cognitive bias is available. The purpose of the study was to examine the effectiveness of a novel implicit memory bias training procedure based on the emotional version of the classical Sternberg’s short-term memory task with negative, neutral and positive words. 108 participants, who completed (...) the PANAS and the CES-D questionnaires, were randomly assigned to the control group, the No-Negative group, in which the target words in the Sternberg’s task were either positive or neutral but never negative or the Negative-New group in which the negative target words in the modified Sternberg’s task were always new. This training was followed by the recollection stage. Only one of the training protocols resulted in significant effects at the recall stage - individuals in the No-Negative group recalled more positive words and fewer negative words than those in the control group. These results show that it may be possible to experimentally induce memory bias characteristic of non-depressed individuals. (shrink)

Objective—Consultation of another physician is an important method of review of the practice of euthanasia. For the project “support and consultation in euthanasia in Amsterdam” which is aimed at professionalising consultation, a protocol for consultation was developed to support the general practitioners who were going to work as consultants and to ensure uniformity. Participants—Ten experts (including general practitioners who were experienced in euthanasia and consultation, a psychiatrist, a social geriatrician, a professor in health law and a public prosecutor) and the (...) general practitioners who were going to use the protocol. Evidence—There is limited literature on consultation: discursive articles and empirical studies describing the practice of euthanasia. Consensus—An initial draft on the basis of the literature was commented on by the experts and general practitioners in two rounds. Finally, the protocol was amended after it had been used during the training of consultants. Conclusions—The protocol differentiates between steps that are necessary in a consultation and steps that are recommended. Guidelines about four important aspects of consultation were given: independence, expertise, tasks and judgment of the consultant. In 97% of 109 consultations in which the protocol was used the consultant considered the protocol to be useful to a greater or lesser extent. Although this protocol was developed locally, it also employs universal principles. Therefore it can be of use in the development of consultation elsewhere. (shrink)

BackgroundRandomized controlled trials (RCTs) are often complex and expensive to perform. Less than one third achieve planned recruitment targets, follow-up can be labor-intensive, and many have limited real-world generalizability. Designs for RCTs conducted using cohorts and routinely collected health data, including registries, electronic health records, and administrative databases, have been proposed to address these challenges and are being rapidly adopted. These designs, however, are relatively recent innovations, and published RCT reports often do not describe important aspects of their methodology in (...) a standardized way. Our objective is to extend the Consolidated Standards of Reporting Trials (CONSORT) statement with a consensus-driven reporting guideline for RCTs using cohorts and routinely collected health data.MethodsThe development of this CONSORT extension will consist of five phases. Phase 1 (completed) consisted of the project launch, including fundraising, the establishment of a research team, and development of a conceptual framework. In phase 2, a systematic review will be performed to identify publications (1) that describe methods or reporting considerations for RCTs conducted using cohorts and routinely collected health data or (2) that are protocols or report results from such RCTs. An initial “long list” of possible modifications to CONSORT checklist items and possible new items for the reporting guideline will be generated based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statements. Additional possible modifications and new items will be identified based on the results of the systematic review. Phase 3 will consist of a three-round Delphi exercise with methods and content experts to evaluate the “long list” and generate a “short list” of key items. In phase 4, these items will serve as the basis for an in-person consensus meeting to finalize a core set of items to be included in the reporting guideline and checklist. Phase 5 will involve drafting the checklist and elaboration-explanation documents, and dissemination and implementation of the guideline.DiscussionDevelopment of this CONSORT extension will contribute to more transparent reporting of RCTs conducted using cohorts and routinely collected health data. (shrink)

The emergence of the new coronavirus at the beginning of 2020, considered a public health emergency due to its high transmission rate and lack of specific treatment, led many countries to adhere to social isolation. Although necessary, social isolation causes important psychological changes, negatively affecting the health of the population, including the older population. The aim of this study is to propose a 4-week, home-based physical exercise protocol for older people in social isolation and evaluate whether will promote positive changes (...) in psychological variables such as anxiety, mood, depression, and stress, and in the variables sleep, quality of life, and physical capacities in the older adults. The sample will be selected in a probabilistic way from individuals aged 60 years or more from the city of Itajaí. Of these, half will perform a home-based resistance training protocol, with 3 weekly sessions, for 4 consecutive weeks. For group allocation, patients will be randomized with a computer-generated 1:1 allocation to the physical exercise group or control group. Outcomes will be depressive symptoms, sleep quality, quality of life, stress, mood states, anxiety, and functional capacity, evaluated at baseline, after 4 weeks, and after 15 days of follow-up. This study will offer a home-based exercise protocol for older adults, with load progression and remote monitoring, thus filling a gap in the provision of PE in this population. The results will be able to identify possible improvements not only in physical health, but also in quality of life and mental health.Clinical Trial Registration: The trial registration was carried out in the Brazil Clinical Trials Registry.. (shrink)

Le P. D. M. De Petter, o.p., fondateur de cette revue dont il assuma la direction jusqu'à sa mort, survenue le 6 avril 1971, publia pendant sa vie divers articles qui ont suscité, à bon droit, l'intérêt du public philosophique. Ces études demeurent cependant fragmentaires par rapport à sa vision philosophique globale, telle qu'elle est exprimée dans ses cours non publiés. Elles ne reçoivent d'ailleurs leur pleine signification qu'à partir de cette vue d'ensemble. Le présent exposé a pour objectif d'initier (...) les lecteurs aux idées maîtresses de cette œuvre. Il n'a par conséquent d'autre prétention que de rendre fidèlement la pensée du P. De Petter. Il s'agit surtout de deux cours, qui sont étroitement liés : l'un d'anthropologie, l'autre de métaphysique. Le premier constitue le fondement du deuxième lequel, à son tour, complète le premier, en sorte que les deux forment une parfaite unité. De Petter révèle à travers ses cours une ligne de pensée très personnelle et originale. Sans doute en était-il conscient et il n'hésita pas à remettre en question toute la philosophie occidentale. Il y décelait une double erreur : d'une part une vision défectueuse et unilatérale de l'unité complexe de l'homme, d'autre part une interprétation insuffisante de l'ouverture humaine sur la réalité en soi et indépendante. En ce qui concerne le premier point, De Petter insiste sur le dualisme qui domine, quasiment sans contestation, toute la philosophie occidentale, et qui n'est contredit que par l'antidualisme des phénoménologues ; d'autre part il souligne les déficiences de cet antidualisme. Le dualisme n'a pas su rendre compte de l'unité humaine, tandis que l'antidualisme l'exagérait au point d'oublier la complexité de l'homme. En ce qui concerne le second point – l'ouverture humaine sur la réalité en soi – De Petter insiste sur le conceptualisme de toute la philosophie jusqu'à Kant. L'erreur de celui-ci consistait à considérer les concepts comme l'expression adéquate de la réalité elle-même, qu'ils tendaient à supplanter. Ensuite, il signale la réduction de l'être à l'être-pour-moi, prônée depuis Kant. Sur ce point également, la position de De Petter consiste à refuser les deux erreurs mentionnées. Aux phénoménologues, il imprunta tous les facteurs qui relativisent la connaissance humaine, mais à son avis l'affirmation de tout relativisme reste en deça de sa propre implication. Cette affirmation, en effet, prouve l'intentionalité foncière de la conscience sur la réalité même. C'est par cette intentionalité que la métaphysique devient possible. Celle-ci pourtant devra s'accorder au réalisme tel que De Petter le conçoit. Par ce réalisme il faut comprendre que la conscience humaine, à travers toutes les formes de relativité, vise l'absolu sans pouvoir y accéder. Dans cette ligne de pensée, la métaphysique ne fera que se rapprocher du mystère de la réalité toujours inaccessible. Sera-t-elle pour autant une métaphysique du silence ? Non pas. De Petter estime que le mystère de Dieu se montre – en tant que profondeur insondable – à travers l'insuffisance, la contingence ou le vide intérieur de notre monde. Signalons, pour terminer, que De Petter avance dans ses cours, une critique perspicace et profonde des thèses principales de l'anthropologie et de la métaphysique scolastiques. (shrink)

Hastings Center Report, Volume 51, Issue 5, Page 56-57, September‐October 2021.

Collingwood wrote at a time when positivism was the dominant philosophical influence in British philosophy. Central to Collingwood's philosophical project was the task of rehabilitation of metaphysics against the backdrop of the positivistic deconstruction of metaphysics. Collingwood's defence of metaphysics is much nuanced in the sense that while Collingwood does not sympathize with the grandiose conception of metaphysics associated with traditional metaphysics he is nonetheless keen to argue for the possibility of metaphysics in some form by reconceptualising metaphysics as a (...) science of absolute presuppositions. Thus his reform of metaphysics is an answer to positivism at the same time an attempt to tone down the claims of metaphysics such as to bring it in accord with scientific rationality. Yet it remains to be seen whether Collingwood's rehabilitation of metaphysics is successful, so far as the so-called absolute presuppositions do not have any ontological bearing with the domain of reality as it is in-itself but are exclusively grounded as structural features of human rationality, writ large. In this sense, Collingwood's initiative appears to suffer from similar difficulties that bedevil its Kantian predecessor in reforming metaphysics in terms of the claims of his Copernican revolution in epistemology. (shrink)

The International Federation of Gynecology and Obstetrics (FIGO) Committee for the Ethical Aspects of Human Reproduction and Women9s Health advises against tubal occlusion (TO) performed at the time of caesarean section (CS/TO) or following a vaginal delivery (VD/TO) if this sterilisation has not been discussed with the woman in an earlier phase of her pregnancy. This advice is neither in accordance with existing medical custom nor evidence based. Particularly in less-resourced locations, adherence to it would deny much wanted one-off sterilisation (...) opportunities to hundreds of thousands of women, many of whom have no reliable contraceptive alternative. To be sure, a well-timed discussion in pregnancy about a potential peripartum TO is preferable and, if conducted as a matter of course (as the Committee appears to promote), would represent an enormous improvement on current practice. Earlier counselling has the advantage that it results in fewer women who regret having rejected the CS/TO or VD/TO option. However, there is no evidence that earlier counselling leads to a smaller proportion of regretted sterilisations. Consequently, where early TO counselling has been impossible, forgotten or deliberately omitted on pronatalist, traditional, financial, cultural or religious grounds, offering a perinatal sterilisation belatedly and in an unbiased, culturally sensitive manner is often verifiably better than not presenting that option at all, notably where high parity and uterine scars are particularly dangerous. Belated counselling, as will be demonstrated in this paper, saves many lives. The Committee9s blanket rejection of belated counselling on perinatal sterilisation is therefore unjustified. (shrink)

A wide-ranging study of the central concepts in epistemology - belief, truth and knowledge. Professor Armstrong offers a dispositional account of general beliefs and of knowledge of general propositions. Belief about particular matters of fact are described as structures in the mind of the believer which represent or 'map' reality, while general beliefs are dispositions to extend the 'map' or introduce casual relations between portions of the map according to general rules. 'Knowledge' denotes the reliability of such beliefs as representations (...) of reality. Within this framework Professor Armstrong offers a distinctive account of many of the main questions in general epistemology - the relations between beliefs and language, the notions of proposition, concept and idea, the analysis of truth, the varieties of knowledge, and the way in which beleifs and knowledge are supported by reasons. The book as a whole if offered as a contribution to a naturalistic account of man. (shrink)

The coronavirus disease-2019 (COVID-19) has caused shortages of life-sustaining medical resources, and future waves of the virus may cause further scarcity. The Yale New Haven Health System developed a triage protocol to allocate scarce medical resources during the COVID-19 pandemic, with the primary goal of saving the most lives possible, and a secondary goal of making triage assessments and decisions consistent, transparent, and fair. We outline the process of developing the protocol, summarize the protocol, and discuss the major ethical challenges (...) encountered, along with our answers to the challenges. These challenges include (1) the role of age and chronic comorbidities; (2) evaluating children and pregnant patients; (3) racial, ethnic, and socioeconomic disparities in health; (4) prioritization of healthcare workers; and (5) balancing clinical judgment versus protocolized assessments.We conclude with a review of the limitations of our protocol and the lessons learned. We hope that a robust public discussion of such protocols and the ethical challenges they raise will result in the fairest possible processes, less need for triage, and more lives saved during future waves of the pandemic and similar public health emergencies. (shrink)

In this study, I use the Critical Realism perspective of power to explain how the Bitcoin protocol operates as a system of power. I trace the ideological underpinnings of the protocol in the Cypherpunk movement to consider how notions of power shaped the protocol. The protocol by design encompasses structures, namely Proof of Work and Trustlessness that reproduce asymmetrical constraints on the entities that comprise it. These constraining structures generate constraining mechanisms, those of cost effectiveness and deanonymisation, which further restrict (...) participating entities’ ‘power to act’, reinforcing others’ ‘power over’ them. In doing so, I illustrate that the Bitcoin protocol, rather than decentralising and distributing power across a network of numerous anonymous, trustless peers, it has instead shifted it, from the traditional actors (e.g., state, regulators) to newly emergent ones. (shrink)

Although education in the responsible conduct of research is considered necessary, evidence bearing on the effectiveness of these programs in improving research ethics has indicated that, although some programs are successful, many fail. Accordingly, there is a need for systematic evaluation of ethics education programs. In the present effort, we examine procedures for evaluation of ethics education programs from a multilevel perspective: examining both within-program evaluation and cross-program evaluation. With regard to within-program evaluation, we note requisite designs and measures for (...) conducting systematic program evaluation have been developed and multiple measures should be applied in program evaluation. With regard to cross-program evaluation, we argue that a meta-analytic framework should be employed where analyses are used to identify best practices in ethics education. The implications of this multilevel approach for improving responsible conduct of research educational programs are discussed. (shrink)

Introduction Currently, The nature and scope of Clinical Ethics Protocols in Madrid are not well understood.Objectives The main objective is to describe the features of ‘guideline/recommendation’ type CEPs that have been or are being developed by existing Clinical Ethics Committees in Madrid. Secondary objectives include characterisation of those CECs that have been the most prolific in reference to CEP creation and implementation and identification of any trends in future CEP development.Methods We collected CEPs produced and in process by CECs accredited (...) in the public hospitals in Madrid, Spain, from 1996 to 2008.Results CECs developed 30 CEPs, with 10 more in process. The most common topic is refusal of treatment . If CEPs addressing terminal illness, Do-Not-Resuscitate orders and advance directives are placed into a separate ‘ethical problems at the end of life’ category, this CEP subject emerges as the most common . There is a relationship between the age of the CEC and the development of CEPs . CECs now seem to be more likely to engage in CEP development.Conclusions The CECs in Madrid, Spain, have developed a significant number of CEPs and there is a trend towards continued development. The most frequent topics are ethical problems at the end of life and refusal of treatment by the patient. (shrink)

What does it look like when an organization tentatively steps away from an exclusively rules-based regime and begins to attend to both rules and principles? What insights and guidance can ethicists and ethical theory offer? This paper is a case study of an organization that has initiated such a transition. The American Institute of Certified Public Accountants has begun a turn toward the promotion of ethical principles and best practices by adding a “conceptual framework” to its existing Code of Professional (...) Conduct. This conceptual framework calls upon its members to intentionally increase their awareness of significant threats to their compliance with its rules of conduct and to establish safeguards to offset or eliminate those threats. To this end, each member is required to regard every questionable situation, circumstance, transaction or relationship by attempting to view it through the eyes of an imagined reasonable third party. This paper examines this protocol theoretically and practically. First, we frame this analysis within the principles and ethical concepts that inform the professional ethics of accountants. Second, we critique the AICPA’s long-standing rules-based approach to its Code. Third, we examine the new conceptual framework with a view toward its potential for the promotion of a more principles-based approach to the professional ethics of the accounting profession. Fourth, we give attention to the notion of the “reasonable and informed third party,” which has been embedded in the new conceptual framework, and consider how two schools of thought—Adam Smith’s modernist “impartial spectator” concept and Emmanuel Lévinas’ postmodern phenomenology in regard to “the Other”—may offer theoretical support and clarity for this epistemic exercise. Finally, we point out several ways in which the AICPA’s commitment to its new conceptual framework could be strengthened and enhanced. (shrink)

Tel qu’Arrien l’indique dans les Entretiens, le cours d’Épictète comprenait une partie technique, où l’apprentissage de la doctrine et des démonstrations était de mise, et une autre, à laquelle nous avons seulement accès, où le maître discutait plus librement avec des interlocuteurs de tous horizons sur des sujets d’ordre spécifiquement éthiques en interprétant la doctrine stoïcienne selon ses propres catégories conceptuelles. Cette deuxième séquence pédagogique interroge directement l’utilité de la première, et engage une réflexion plus large sur l’école philosophique, reprenant (...) la discussion traditionnellement menée entre stoïciens et académiciens sur la scholè. Épictète apporte ainsi un éclairage original sur le rôle, le sens et la fonction des pratiques scolaires à l’époque romaine, dans la perspective stoïcienne d’une vie philosophiquement authentique, en accord avec la nature. (shrink)

Discrepancies between the Uniform Determination of Death Act (UDDA) and the adult and pediatric diagnostic guidelines for brain death (BD) (the “Guidelines”) have motivated proposals to revise the UDDA. A revision proposed by Lewis, Bonnie and Pope (the RUDDA), has received particular attention, the three novelties of which would be: (1) to specify the Guidelines as the legally recognized “medical standard,” (2) to exclude hypothalamic function from the category of “brain function,” and (3) to authorize physicians to conduct an apnea (...) test without consent and even over a proxy’s objection. One hundred seven experts in medicine, bioethics, philosophy, and law, spanning a wide variety of perspectives, have come together in agreement that while the UDDA needs revision, the RUDDA is not the way to do it. Specifically, (1) the Guidelines have a non-negligible risk of false-positive error, (2) hypothalamic function is more relevant to the organism as a whole than any brainstem reflex, and (3) the apnea test carries a risk of precipitating BD in a non-BD patient, provides no benefit to the patient, does not reliably accomplish its intended purpose, and is not even absolutely necessary for diagnosing BD according to the internal logic of the Guidelines; it should at the very least require informed consent, as do many procedures that are much more beneficial and less risky. Finally, objections to a neurologic criterion of death are not based only on religious belief or ignorance. People have a right to not have a concept of death that experts vigorously debate imposed upon them against their judgment and conscience; any revision of the UDDA should therefore contain an opt-out clause for those who accept only a circulatory-respiratory criterion. (shrink)

Although episodic memory is a widely studied form of memory both in philosophy and psychology, it still raises many burning questions regarding its definition and even its acceptance. Over the last two decades, cross-disciplinary discussions between these two fields have increased as they tackle shared concerns, such as the phenomenology of recollection, and therefore allow for fruitful interaction. This editorial introduction aims to provide a comprehensive and up-to-date presentation of the main existing conceptions and issues on the topic. After delineating (...) Tulving’s chief theoretical import and multifaceted legacy, it goes on to chart the different attempts to capture the episodicity feature of memory according to three categories: a first approach aims to show the cognitive abilities required for a subject to episodically remember; the second defines episodicity as a stage-specific feature; the last explains episodicity in terms of the epistemological properties of episodic memory. This state of the art thereby sets the stage for the contributions of the present volume, which will be introduced in conclusion. (shrink)

Do the most celebrated works of Rousseau—more particularly his Discourse on Inequality, émile , and Control Social —present on the whole a coherent answer to the problems of Education and Society? My impression is that Rousseau has here been very much calumniated, owing to the incredible haste and superficiality with which his writings have generally been studied. Even sympathetic inquirers, like M. Schinz in his thorough and attractive work La Pensée de J. J. Rousseau , seem to be too easily (...) discouraged in the quest for unity. (shrink)

According to historical theories of biological function, a trait's function is determined by natural selection in the past. I argue that, in addition to historical functions, ahistorical functions ought to be recognized. I propose a theory of biological function which accommodates both. The function of a trait is the way it contributes to fitness and fitness can only be determined relative to a selective regime. Therefore, the function of a trait can only be specified relative to a selective regime. Apart (...) from its desirable pluralism, only this view of relational function can support the function/accident and function/malfunction distinctions commonly thought to be part of the concept of function. Furthermore, only relational function correctly characterizes the explanatory consequences of function attributions in evolutionary biology. (shrink)

AimsThis study evaluates a protocol for early, routine ethics consultation for patients on extracorporeal membrane oxygenation to support decision-making in the context of clinical uncertainty with the aim of mitigating ethical conflict and moral distress.MethodsWe conducted a single-site qualitative analysis of EC documentation for all patients receiving ECMO support from 15 August 2018 to 15 May 2019. Detailed analysis of 20 ethically complex cases with protracted ethics involvement identifies four key ethical domains: limits of prognostication, bridge to nowhere, burden of (...) treatment and system-level concerns. There are three subthemes: relevant contextual factors, the role of EC and observed outcomes. Content analysis of transcripts from interviews with 20 members of the multidisciplinary ECMO team yields supplemental data on providers’ perceptions of the impact of the early intervention protocol.ResultsLimited outcome data for ECMO, unclear indications for withdrawal, adverse effects of treatment and an obligation to attend to programme metrics present significant ethical challenges in the care of this patient population. Upstream EC mitigates ethical conflict by setting clear expectations about ECMO as a time limited trial, promoting consistent messaging among multiple services and supporting surrogate decision-makers. When ECMO becomes a ‘bridge to nowhere’, EC facilitates decision-making that respects patient values yet successfully sets limits on non-beneficial use of this novel therapy.ConclusionData from this study support the conclusion that ECMO poses unique ethical challenges that necessitate a standardised protocol for early, routine EC—at least while this medical technology is in its nascent stages. (shrink)

Ambivalence is a form of inner volitional conflict that we experience as being irresolvable without significant cost. Because of this, very few of us relish feelings of ambivalence. Yet for many in the Western philosophical tradition, ambivalence is not simply an unappealing experience that's hard to manage. According to Unificationists--whose view finds its historical roots in Plato and Augustine and is ably defended by contemporary philosophers such as Harry Frankfurt and Christine Korsgaard--ambivalence is a failure of well-functioning agency. The reasons (...) for this, we're told, are threefold. First, it precludes agents from resolving their wills in a way that is necessary for autonomy. Second, it precludes agents from fully affirming their live and, in particular, from fully affirming the choices they make. As a result, ambivalence robs them of an important source of meaning. Finally, ambivalence causes agents to act in self-defeating ways. In so doing, they act without integrity. Ambivalence is thus seen as a threat to a trio of important agential goods, and as a result, it imperils the best forms of human agency. -/- Against the Unificationists, D. Justin Coates argues that ambivalence does not preclude volitional resolution or normatively significant forms of affirmation. Nor does it guarantee self-defeat. Consequently, ambivalence as such is no threat to autonomy, meaning, or integrity. In assessing these arguments, ambivalence is also revealed to have an important role in securing the very goods that unificationists contend it undermines. The reason for this is that each of these goods requires the agent to be normatively competent. But normative competence itself, Coates argues, often leads agents to be ambivalent. The best forms of human agency are therefore shown to be not only compatible with ambivalence but as regularly requiring it. Ambivalence is thus not a volitional defect, but a crucial constituent of well-functioning agency. (shrink)

In a recent article in this journal our unit was accused of a number of errors of judgment in applying covert video surveillance (CVS) to infants and children suspected of life-threatening abuse. The article implied, that on moving from the Royal Brompton Hospital in London to North Staffordshire Hospital, we failed to present our work to the Research Ethics Committee (REC). We did send our protocol to the REC though we did not consider that, after a total of 16 patients (...) had been documented as being the subject of life-threatening abuse, this was research. The REC in Staffordshire agreed with us. We were also accused of undertaking work that should be pursued by the Police. We agree with this. However, unlike the Metropolitan Police the Staffordshire Police would not undertake CVS. We fail to agree that 'working together' with parents is necessarily practical or safe when trying to protect children from life-threatening abuse of this kind. (shrink)

This paper aims to conceptualize the phenomenology of attentional experience as ‘embodied attention.’ Current psychological research, in describing attentional experiences, tends to apply the so-called spotlight metaphor, according to which attention is characterized as the illumination of certain surrounding objects or events. In this framework, attention is not seen as involving our bodily attitudes or modifying the way we experience those objects and events. It is primarily conceived as a purely mental and volitional activity of the cognizing subject. Against this (...) view, the phenomenology of Maurice Merleau-Ponty shows that attention is a creative activity deeply linked with bodily movements. This paper clarifies and systematizes this view and brings it into dialogue with current empirical findings as well as with current theoretical research on embodied cognition. By doing this, I spell out three main claims about embodied attention: the transcendentalism of embodiment for attention, the bodily subjectivity of attention, and the creativity of embodied attention. (shrink)

Dans cet ouvrage rare et magistral, l’auteur, qui est un contemplatif cistercien, livre le fruit de quarante années de réflexion. Il s’appuie, du côté de l’Occident, sur les Pères et Docteurs de l’église les plus autorisés, tel saint Thomas, et, du côté de l’Orient, sur les maîtres révérés, comme Cankara et Ramakrishna. Le sous-titre de l’ouvrage dit bien le but de l’auteur : après avoir étudié le non-dualisme hindou – l’homme doit réaliser sa vraie nature par la compréhension intime qu’il (...) ne fait qu’un avec le Tout –, il pourra répondre à la question qui anime tout l’ouvrage : peut-on envisager légitimement un « non-dualisme « chrétien? Un livre qui compte dans les conversations qui se sont établies depuis plus de cinquante ans entre Orient et Occident. (shrink)

According to a widespread view in metaphysics and philosophy of science, all explanations involve relations of ontic dependence between the items appearing in the explanandum and the items appearing in the explanans. I argue that a family of mathematical cases, which I call “viewing-as explanations”, are incompatible with the Dependence Thesis. These cases, I claim, feature genuine explanations that aren’t supported by ontic dependence relations. Hence the thesis isn’t true in general. The first part of the paper defends this claim (...) and discusses its significance. The second part of the paper considers whether viewing-as explanations occur in the empirical sciences, focusing on the case of so-called fictional models. It’s sometimes suggested that fictional models can be explanatory even though they fail to represent actual worldly dependence relations. Whether or not such models explain, I suggest, depends on whether we think scientific explanations necessarily give information relevant to intervention and control. Finally, I argue that counterfactual approaches to explanation also have trouble accommodating viewing-as cases. (shrink)

Some argue that animals and non-human figures in the Zhuangzi help displace the significance of humans. According to others the Zhuangzi suggests a certain time of ‘animalism,’ asking us to be more like various types of fauna and flora that do not share our self-centeredness. In this paper the use of non-human characters in the Zhuangzi will be examined through a survey of traditional Chinese commentary, comparisons with the Lunyu, and placing the use of non-human characters within the larger context (...) of the Zhuangzi. Thus we find that while anti-anthropocentric and animalistic perspectives can be philosophized with the Zhuangzi, the text itself is not overly concerned with these subjects. Animals and non-human characters are mainly allegorical or metaphorical, allowing the Zhuangzito 1) make broadly applicable arguments; 2) playfully discuss ideas that may be unappealing at first glance, and; 3) create a distance that allows the text to resist ossification. (shrink)

Background While there are many guidelines on how to make ethical decisions at the end of life, there is little evidence regarding the quality of this sort of ethical guidelines. Objectives First, this study aims to demonstrate the conceptual transferability of the Appraisal of Guidelines for Research and Evaluation (AGREE) instrument for the quality assessment of ethical guidelines. Second, it aims to illustrate the status quo of the quality of guidelines on end-of-life decision-making by using the AGREE instrument in a (...) first practice test. Method The transferability of the AGREE instrument on the quality assessment of ethical guidelines is demonstrated by conceptual analysis. Guidelines on end-of-life decisions in medicine are identified through a systematic search in MEDLINE (from June 1999 to June 2009). The quality of all included guidelines was assessed with a slightly modified AGREE instrument. Results Of 103 guidelines identified, 34 were included as relevant. The majority of the guidelines analysed in this study were assessed as qualitatively insufficient in five out of six AGREE quality domains. A few guidelines demonstrated, however, that a high level of quality in accordance with the AGREE requirements is possible. Conclusion This review concludes that the quality of many ethical guidelines should and can be improved in all quality domains specified by the AGREE instrument. Furthermore, conceptual analysis indicates that a slightly modified AGREE instrument is transferable to the comprehensive evaluation of the quality of ethical guidelines. Nevertheless, future research is needed to improve the assessment of the presentation of the guidelines' normative basis. (shrink)