Abstract:The ethical principle of autonomy requires physicians to respect patient autonomy when present, and to protect the patient who lacks autonomy. Fulfilling this ethical obligation when a patient has a communication impairment presents considerable challenges. Standard methods for evaluating decision-making capacity require a semistructured interview. Some patients with communication impairments are unable to engage in a semistructured interview and are at risk of the wrongful loss of autonomy. In this article, we present a general strategy for assessing decision-making capacity in (...) patients with communication impairments. We derive this strategy by reflecting on a particular case. The strategy involves three steps: (1) determining the reliability of communication, (2) widening the bandwidth of communication, and (3) using compensatory measures of decision-making capacity. We argue that this strategy may be useful for assessing decision-making capacity and preserving autonomy in some patients with communication impairments. (shrink)

Concept of ethics in Ādi-Granth, Sikh canon.

This article must open with a Warning. In face of the positive information which the sciences supply, the philosophical contribution to this problem will seem disappointingly negative, or at least mine will do so. For I shall insist, and I think we can only rightly insist, that the philosopher is not yet in a position to produce a satisfactory positive theory of the relation between mind and body. And I shall annoy many of you further by insisting that the old-fashioned (...) “dualism” has not really been disproved. However, even if you do not agree with me, it is at any rate a good general piece of advice that, when we are confronted with a philosophical view which has maintained its ground for a very long time but seems to ourselves or to our generation very unreasonable, we should look specially carefully to find the positive grounds which have made so apparently unplausible a doctrine seem true to so many competent thinkers. (shrink)

At least for those who uphold the rationality of morality, ethics and practical reason are not two distinct topics: an ethically sound agent is one whose practical reason functions as it should. Take, for instance, the greatest historical figures. Aristotle claimed that no virtue of character can exist without practical wisdom—the excellence of practical, deliberative reason. And Kant thought that the categorical imperative, the ultimate moral principle that governs a good will, was at the same time the fundamental principlof practical (...) reasoning because the will simply ispractical reason. Even before any philosophical theory of the connection between acting well and the exercise of a rational power is in view, our moral practices strongly suggest that there is one. For we take it for granted that, in an important range of cases, when an agent fails to act as she should, something has gone awry with the agent and not just with her acts, and, furthermore, that the agent herself may be held responsible for this. In calling an agent who acts unethically "irrational," we are saying these two things. (shrink)

There are few examples in the literature of objective measures for the assessment of donor willingness. The author describes the scoring system in use at his own renal transplant unit which has brought objectivity to the process of determining the willingness of living related donors. In this system, a total score to determine the degree of willingness or unwillingness is calculated based on responses to a series of questions. The author believes that with minor modifications this system could be implemented (...) by transplant units in different countries and cultures to screen out donors who are acting under duress. (shrink)

Estudio sistemático sobre la imagen y sus complejas relaciones con el lenguaje verbal, partiendo de una crítica al logocentrismo en su vertiente racionalista -que reduce el conocimiento y el pensamiento al discurso lingüístico- para desembocar en una teoría de la representación. El autor sostiene que la imagen va más allá de la representación al tornarse presencia, basándose en el examen de pensadores clásicos y teóricos actuales que han abordado cuestiones afines. Propone una teoría de la imagen que no se ciñe (...) sólo a lo visual, sino que reconoce las dimensiones no visuales de lo imaginal: "el principal objetivo de este libro es contribuir a la construcción de una filosofía de la imagen. Hoy en día es ya una necesidad urgente contar con un aparato conceptual que nos permita afrontar las distintas modalidades de lo imaginal, que aparecen en ámbitos tan diversos como la intimidad psicológica, la ciencia, la filosofía, la comunicación masiva, la religión, la educación, la propaganda o el arte". (shrink)