Is it possible to donate unpaired vital organs, foreseeing but not intending one’s own death? We argue that this is indeed psychologically possible, and thus far agree with Charles Camosy and Joseph Vukov in their recent paper on “double effect donation.” Where we disagree with these authors is that we see double-effect donation not as a morally praiseworthy act akin to mar- tyrdom but as a morally impermissible act that necessarily disrespects human bodily integrity. Respect for bodily integrity goes beyond (...) avoiding the aim to kill; not all side effects of deliberate bodily interventions can be outweighed by intended benefits for another even if the subject fully consents. It is not any necessary intention to kill or harm another or oneself that makes lethal donation/harvesting illicit but the more immediate intention to accept or perform surgery on an (innocent) person combined with the foresight of lethal harm and no health-related good for him or her. Double-effect donation falls foul of the first condition of double-effect reasoning in that the immediate act is wrong in itself. We argue further that the wider effects of such don- ation would be socially disastrous and corrupting of the medical profession: doctors should retain a sense of nonnegotiable respect for bodily integrity even when they intervene on willing subjects for the benefit of others. (shrink)

Innovation is a key driver of care provision in assisted reproductive technologies (ART). ART providers offer a range of add‐on interventions, aiming to augment standard in vitro fertilization protocols and improve the chances of a live birth. Particularly in the context of commercial provision, an ever‐increasing array of add‐ons are marketed to ART patients, even when evidence to support them is equivocal. A defining feature of ART is hope—hope that a cycle will lead to a baby or that another test (...) or intervention will make a difference. Yet such hope also leaves ART patients vulnerable in a variety of ways. This article argues that previous attempts to safeguard ART patients have neglected how the use of add‐ons in commercial ART can exploit patients’ hopes. Commercial providers of ART should provide add‐ons only free of charge, under a suitable research protocol. (shrink)

Is the “act itself” of separating a pregnant woman and her previable child neither good nor bad morally, considered in the abstract? Recently, Maureen Condic and Donna Harrison have argued that such separation is justified to protect the mother’s life and that it does not constitute an abortion as the aim is not to kill the child. In our article on maternal–fetal conflicts, we agree there need be no such aim to kill (supplementing aims such as to remove). However, we (...) argue that to understand “abortion” as performed only where the death of the child is intended is to define the term too narrowly. Respect for the mother, the fetus, and the bond between them goes well beyond avoiding any such aim. We distinguish between legitimate maternal treatments simply aimed at treating or removing a damaged part of the woman and illegitimate treatments that focus harmfully on the fetal body and its presence within the mother’s body. In obstetrics as elsewhere, not all side effects for one subject of intervention can be outweighed by intended benefits for another. Certain side effects of certain intended interventions are morally conclusive. (shrink)

The purpose of the study was to compare the visuospatial decision-making error scores related to the perception of biological motion of individuals categorized as field dependent or field independent. A sample of 69 participants aged 18-27 years that included 33 males and 36 females completed the experiment. Cognitive style was assessed using the Group Embedded Figure Test. Perception of biological motion was evaluated using two different point-light stimuli developed from video images of a ballet dancer’s performance of a correct and (...) incorrect turn in the fifth position. The results showed that individuals classified as field independent made significantly fewer visuospatial processing errors. The findings are considered and discussed in relation to theoretical perspectives associated with both cognitive processing and cognitive style. (shrink)

Background Cancer patients are at risk of developing blood clots in their veins - venous thromboembolism - which often takes the form of a pulmonary embolism or deep vein thrombosis. The risk increases with advanced disease. Evidence based treatment is low molecular weight heparin by daily subcutaneous injection. The aim of this research is to explore the barriers for doctors in the UK when diagnosing and treating advanced cancer patients with VTE. Method Qualitative, in-depth interview study with 45 doctors. Doctors (...) were from three specialties: oncology, palliative medicine and general practice, with a mixture of senior and junior staff. Framework analysis was used. Results Doctors opinions as to whether LMWH treatment was ethically appropriate for patients who were symptomatic from VTE but at end of life existed on a shifting continuum, largely influenced by patient prognosis. A lack of immediate benefit coupled with the discomfort of a daily injection had influenced some doctors not to prescribe LMWH. The point at which LMWH injections should be stopped in patients at the end of life was ambiguous_._ Some perceived ‘overcaution’ in their own and other clinicians’ treatment of patients_._ Viewpoints were divergent on whether dying of a PE was considered a “good way to go”. The interventionalism and ethos of palliative medicine was discussed. Conclusions Decisions are difficult for doctors to make regarding LMWH treatment for advanced cancer patients with VTE. Treatment for this patient group is bounded to the doctors own moral and ethical frameworks. (shrink)

Cooperation in evil or wrongdoing is one of the most perplexing areas in bioethics, both for those working in the field and those seeking their advice. The papers collected in this book are written by philosophers, theologians and lawyers who have studied these problems and / or by those who have faced these problems in their own work in law, healthcare and research, and political campaigning. The volume includes both general treatments of the subject of cooperation and conscientious objection, and (...) more specific treatments of topics such as voting to improve unjust laws, research on fetal / embryonic cells, and care of suicidal patients. The book is offered as a guide to a field which is both of academic interest and of personal concern to those who face cooperation problems in their own life and work. Contributors include: Bishop Donal Murray, Bishop Anthony Fisher OP, Jane Adolphe, Mike Delany, John Finnis, Luke Gormally, Colin Harte, Cathleen Kaveny, Richard Myers, Charlie O'Donnell, Alexander Pruss, Neil Scolding and Helen Watt. (shrink)

Light and darkness transform city buildings into surreal structures: an ordinary gray concrete building in plain daylight changes at night into a mysterious monolith or, under a blue-tinted lens, into an ethereal edifice. Swedish artist Carl Michael von Hausswolff harnessed these transformative powers of light to create a powerful spectacle that presents Chicago architecture from a wholly original perspective in this collection of striking photographs. Red Empty is the latest in a series of urban-centered works spanning from Bangkok to Santa (...) Fe in which von Hausswolff set 1000-watt red spotlights against the architecture of run-down, abandoned buildings to generate spectral real-world monochromes. His images explore intermediate realms through these otherworldly images—worlds traced by psychic residue that rewrite the history of particular sites. Red Empty is a compelling visual work that transforms Chicago architecture into sculptures of light, shadow, and stone. (shrink)

In the last decade several prominent critics have charged that invocation of representations is not only not essential for cognitive science, but should be avoided. These claims have been followed by counterarguments demonstrating that the notion certainly is important in explanations of cognitive phenomena. Analyzing some important contributions to the debate, Anthony Chemero has argued that representationalists still need to explain the significance of the notion once there is an available formal account of a system and has, accordingly, challenged (...) representationalists to provide such an explanation. This paper's first part explains why the representationalist should take an interest in Chemero's challenge. It discusses William Bechtel 's account of the representational structure of the Watt Governor, which, among other things, was motivating Chemero to question the relevance of a representational account once a dynamical one is available. The second part contains the answer to Chemero's challenge. It is motivated by the thought that only a representational account of the Watt Governor with a comparable level of detail could possibly add explanatory value to a dynamical account. However, accepting the account also means that it becomes difficult to understand dynamical and representational accounts as rivals. Instead, it would be more adequate to speak of a dynamical account of the representational structure. (shrink)

A cross-species affective neuroscience strategy for understanding the primary-process (basic) emotions is defended. The need for analyzing the brain and mind in terms of evolutionary stratification of functions into at least primary (instinctual), secondary (learned), and tertiary (thought-related) processes is advanced. When viewed in this context, the contentious battles between basic-emotion theorists and dimensional-constructivist approaches can be seen to be largely nonsubstantial differences among investigators working at different levels of analysis.

Non-Identity arguments have a pervasive but sometimes counter-intuitive grip on certain key areas in ethics. As a result, there has been limited success in supporting the alternative view that our choices concerning future generations can be considered harmful on any sort of person-affecting principle. However, as the Non-Identity Problem relies overtly on certain metaphysical assumptions, plausible alternatives to these foundations can substantially undermine the Non-Identity argument itself. In this paper, I show how the pervasive force and nature of Non-Identity arguments (...) rely upon a specific adoption of a theory of modality and identity and how adopting an alternative account of modality can be used to reject many conclusions formed through Non-Identity type arguments. By using Lewis’s counterpart-theoretic account to understand ways we might have been, I outline the basis of a modal account of harm that incorporates a person-affecting aspect. This, in turn, has significant implications for ethical decision-making in areas such as reproductive choice and the welfare of future generations. (shrink)

The Liverpool Care Pathway for the Dying has recently been the topic of substantial media interest and also been subject to the independent Neuberger Review. This review has identified clear failings in some areas of care and recommended the Liverpool Care Pathway be phased out. I argue that while the evidence gathered of poor incidences of practice by the Review is of genuine concern for end of life care, the inferences drawn from this evidence are inconsistent with the causes for (...) the concern. Seeking to end an approach that is widely seen as best practice and which can genuinely deliver high quality care because of negative impressions that have been formed from failing to implement it properly is not a good basis for radically overhauling our approach to end of life care. I conclude that improvements in training, communication, and ethical decision-making, without the added demand to end the Liverpool Care Pathway would have resulted in a genuine advance in end of life care. (shrink)

This article reconstructs Henri Bergson’s argument at the beginning of the second chapter of his Essai sur les données immédiates de la conscience for his view that every idea of number involves sp...

Built in the centre of Copenhagen, and noted for its equestrian stairway, the Rundetaarn, was intended as an astronomical observatory. Part of a complex of buildings that once included a university library, it affords expansive views of the city in every direction, towering above what surrounds it. The metaphor of the towering figure, who sees what others might not, whose vantage point allows him to visualize how things fit together, and who has an earned-stature of respect and authority, fits another (...) Danish stalwart, Hans Vilhelm Hansen, whose contributions to the fields of informal logic and argument theory have earned the gratitude of his colleagues, and inspired this collection of essays, written to express the appreciation of its authors and of the many, many colleagues they represent. (shrink)

Biological sex should be “acknowledged” and “accepted”—but which responses to gender dysphoria might this preclude? Trans-identified people may factually acknowledge their biological sex and regard transition as purely palliative. While generally some level of self-deception and even a high level of nonlying deception of others are sometimes justified, biological sex is important, and there is a nontrivial onus against even palliative, nonsexually motivated cross-dressing. The onus is higher against co-opting the body, even in a minor and/or reversible way, to make (...) a false communication concerning one’s sex. Hardest to defend is the destruction of sexual–reproductive functions and causally downstream functions such as lactation: due to the transcendent nature of sexual–reproductive functions, an appeal to the “principle of totality” here is misplaced. This is not to say that social, and milder medical, transition is absolutely excluded even for severe unmanageable dysphoria, nor that subsequent to any transition, detransition is necessarily required. (shrink)

This paper examines the potential for abstracting propositions – an as yet untested way of defending the realist thesis that propositions as abstract entities exist. I motivate why we should want to abstract propositions and make clear, by basing an account on the neo-Fregean programme in arithmetic, what ontological and epistemological advantages a realist can gain from this. I then raise a series of problems for the abstraction that ultimately have serious repercussions for realism about propositions in general. I first (...) identify problems about the number of entities able to be abstracted using these techniques. I then focus on how issues of language relativity result in problems akin to the Caesar problem in arithmetic by exposing circularity and modal concern over the status of the criterion of identity for propositions. (shrink)

The standard by which we apply decision-making for those unable to do so for themselves is an important practical ethical issue with substantial implications for the treatment and welfare of such individuals. The approach to proxy or surrogate decision-making based upon substituted judgement is often seen as the ideal standard to aim for but suffers from a need to provide a clear account of how to determine the validity of the proxy's judgements. Proponents have responded to this demand by providing (...) the truth-conditions for the substituted judgement in terms of counterfactual reasoning using a possible worlds semantics. In this paper, I show how these underpinnings fail to support the substituted judgement approach as a reasonable standard for decision-making. Firstly, I show how this counterfactual element has been poorly interpreted. I then explain how various accounts have failed to reflect problems and limitations associated with providing an interpretation of their truth-conditions using counterfactuals. Finally, I argue that, even when we attend to the initial problems of providing a counterfactual analysis, it still deeply problematic as a means of determining the validity of substituted judgements for two main reasons. Firstly, making determinate judgements as to the truth-value of these judgements will often not be possible and, secondly, there is a strong requirement when interpreting many counterfactual claims to charitably accede to their being true. I conclude that substituted judgements, as interpreted through counterfactual reasoning and possible worlds semantics, do not therefore provide an adequate standard for surrogate decision-making. (shrink)

IntroductionExtended decision -making through the use of proxy decision -makers has been enshrined in a range of International Codes, Professional Guidance and Statute,For example, the UK Mental Capacity Act section 9.1; The General Medical Council ; the US National Guardianship Association ; Nuffield Council on Bioethics ; CIOMS-WHO section 6. Court cases such as Re Quinlan in the US have also contributed to establishing the groundings for the legal status of the proxy, albeit in terms of who might be suitable (...) as a proxy in cases where there was no clear appointment of them by a still competent individual. and is now widely seen as a useful means through which we can exercise control over decisions that affect our lives when we have lost capacity to make these decisions for ourselves.I will here limit myself to discussion of proxy consent for adults appointed prior to the loss of competence by the person they are acting as proxy for. The issue of p. (shrink)

I have argued in other work that emotion, attentional functions, and executive functions are three interpenetrant global state variables, essentially differential slices of the consciousness pie. This paper will outline the columnar architecture and connectivities of the PAG (periaqueductal gray), its role in organizing prototype states of emotion, and the re-entry of PAG with the extended reticular thalamic activating system (“ERTAS”). At the end we will outline some potential implications of these connectivities for possible functional correlates of PAG networks that (...) are just starting to be mapped. Overall, we will look at many lines of evidence that PAG should be conceptualized as a peri-reticular structure that has a foundational role in emotion, in generating the meaningful organization of behavior by the brain through prototype emotional states, and in allowing the various emotional systems to globally influence and tune both the forebrain and brainstem. Finally, we address implications of these concepts for what is currently understood about consciousness, underlining the need for somewhat more humility within consciousness studies about our current level of understanding of consciousness in the brain, combined with a deeper appreciation of the intrinsic connections between emotion and consciousness. One hopes that more concerted empirical interest in structures underneath the thalamus, combined with a deeper appreciation for the fundamental role that organismic and social value must have in bootstrapping awareness in the developing brain, would begin more widely to influence the fundamental lines of neuroscientific research in both emotion studies and consciousness studies. (shrink)

The term “value of life” can refer to life’s intrinsic dignity: something nonincremental and time-unaffected in contrast to the fluctuating, incremental “value” of our lives, as they are longer or shorter and more or less flourishing. Human beings are equal in their basic moral importance: the moral indignities we condemn in the treatment of e.g. those with dementia reflect the ongoing human dignity that is being violated. Indignities licensed by the person in advance remain indignities, as when people might volunteer (...) their living, unconscious bodies for surrogacy or training in amputation techniques. Respect for someone’s dignity is significantly impacted by a failure to value that person’s very existence, whatever genuine respect and good will is shown by wanting the person’s life to go well. Valuing and respecting life is not, however, vitalism: there can be good and compelling reasons for eschewing some means of prolonging life. (shrink)

The King Report on Corporate Governance (1994) evoked unprecedented interest in corporate governance in South Africa. This does not mean that corporate governance was not an issue of concern before the release of this historical report. To the contrary, corporate governance in its broader sense has been at stake since the inception of the first publicly owned companies in South Africa. This article intends to give an overview of corporate governance in South Africa. It starts by making a distinction between (...) broad and narrow conceptions of corporate governance. Before applying this distinction to the practice of corporate governance in South Africa, a brief overview of the corporate landscape in South Africa is provided. Then the South African situation with regard to broad and narrow corporate governance respectively is analysed. The article ends with a discussion of the review of corporate governance that currently is in the making in South Africa. Throughout the article both the financial and ethical dimensions of corporate governance is attended to. (shrink)

We clarify options for conceptualizing equity, or what we refer to as justice, in resource allocation. We do this by systematically differentiating, expounding, and then illustrating eight different substantive principles of justice. In doing this, we compare different meanings that can be attributed to “need” and “the capacity to benefit”. Our comparison is sharpened by two analytical tools. First, quantification helps to clarify the divergent consequences of allocations commended by competing principles. Second, a diagrammatic approach developed by economists Culyer and (...) Wagstaff offers a visual and conceptual aid. Of the eight principles we illustrate, only two treat as relevant both a person’s initial health state and a person’s CTB per resource unit expended: allocate resources so as to most closely equalize final health states and allocate resources so as to equally restore health states to population norms. These allocative principles ought to be preferred to the alternatives if one deems relevant both a person’s initial health state and a person’s CTB per resource unit expended. Finally, we examine some possibilities for conceptualizing benefits as relative to how badly off someone is, extending Parfit’s thought on Prioritarianism. Questions arise as to how much intervention effects accruing to the worse off count for more and how this changes with improving health. We explicate some recent efforts to answer these questions, including in Dutch and British government circles. These efforts can be viewed as efforts to operationalize need as an allocative principle. Each effort seeks to maximize in the aggregate quanta of effect that are differentially valued in favor of the worst off. In this respect, each effort constitutes one type of Prioritarianism, which Parfit failed to differentiate from other types. (shrink)

Abortion for life-limiting foetal anomaly is often an intensely painful choice for the parents; though widely offered and supported, it is surprisingly difficult to defend in ethical terms. Abortion on this ground is sometimes defended as foetal euthanasia but has features which sharply differentiate it from standard non-voluntary euthanasia, not least the fact that any suffering otherwise anticipated for the child may be neither severe nor prolonged. Such abortions may be said to reduce suffering for the family including siblings – (...) a consideration rarely stated so explicitly in defences of postnatal euthanasia – or for the woman who must in any case face the eventual loss of her baby, and for whom the abortion is seen as therapeutic in minimising pain. Finally, the abortion may be said to constitute the cessation of morally optional life support on the part of the woman, and/or to be a ‘social’ choice she is entitled to make, whether or not this in fact promotes her interests or those of her child. These defences need honest exploration: the intense parental suffering caused by the choice to end an often much-wanted pregnancy should not preclude but rather encourage the question whether this choice can indeed be ethically proposed to couples, especially compared with the neonatal palliative care (‘perinatal hospice’) approach so well received by parents who experience it. (shrink)

Should there be a female age limit on public funding for assisted reproductive technology (ART)? The question bears significant economic and sociopolitical implications and has been contentious in many countries. We conceptualise the question as one of justice in resource allocation, using three much-debated substantive principles of justice—the capacity to benefit, personal responsibility, and need—to structure and then explore a complex of arguments. Capacity-to-benefit arguments are not decisive: There are no clear cost-effectiveness grounds to restrict funding to those older women (...) who still bear some capacity to benefit from ART. Personal responsibility arguments are challenged by structural determinants of delayed motherhood. Nor are need arguments decisive: They can speak either for or against a female age limit, depending on the conception of need used. We demonstrate how these principles can differ not only in content but also in the relative importance they are accorded by governments. Wide variation in ART public funding policy might be better understood in this light. We conclude with some inter-country comparison. New Zealand and Swedish policies are uncommonly transparent and thus demonstrate particularly well how the arguments we explore have been put into practice. (shrink)

In the context of two examples from child conversation the author exemplifies the kinds of attributional process that can be uncovered through detailed examination of interaction. Although these processes implicate an orientation to psychological states by the child their specification does not depend on claims regarding the child’s cognitive processes. Nevertheless this specification can have a bearing on the adequacy of theories of cognitive processes, by locating competences that such theories should be able to account for. These issues are related (...) to research on ‘theory of mind’, discursive psychology and Vygotskyan psychology. (shrink)

The article outlines the diverse willed and unwilled developments which have attenuated international human rights discourse so that it still cannot be used to hold governments to account for their failures to respect the economic and social rights of their citizens. These developments range from geopolitical manoeuvres, through changed modes of enunciation , to the absence of appropriate governmentalist techniques for measuring economic and social compliance. It then questions and counters the doctrine of `justiciability' that is the discursive node of (...) this structure of impotence. It concludes by proposing a strategy for the development of a more truly cosmopolitan international human rights discourse. (shrink)

Was there a major change in Plato's views on the role and importance of law? It can be argued that he held in both 'Republic' and 'Laws' that law and administrators are essential to a state of the best kind, but legislators are not, since legislation has been done by the founders. This interpretation seems to be incompatible with passages in 'Statesman', in which the status and role of law appear to be positively downgraded. The appearance of a contradiction between (...) such passages and the insistence in 'Laws' on the importance of law is created by failure to recognize different uses of 'nomoi', as guiding rules of skill or as rules of law. What Plato says about the contrast between ideal and actual rulers commits him to the distinction, whether or not he had clearly formulated it for himself. An afterword recommends Plato's way of handling laws dealing with criminal attempt. (shrink)

Santayana, whose early writings are hostile to the Faustian spirit, used a quotation from IFaust, Part IID as epigraph to IThe Realm of SpiritD. This suggest a possible affinity of late Santayana, and aspects of Goethe. The speech of the Earth-Spirit in IFaustD has an amoralism similar to passages in IThe Realm of MattesD. A certain ironical, detached spirituality links the poet-sages as well. Each uses some of the symbolism of Christian dogma (e.g., the last chapter of IThe Realm of (...) SpiritD and the end of IFaust, Part IID) to convey the religious mystery of existence, but with no strict adherence to Christianity. (shrink)

Abstract Sam Peltzman has brought discipline and common sense to economic analyses of voting and representation. Yet his approach suffers, like that of other economists, from disciplinary provincialism and a singular devotion to econometrics as a research methodology. Political science offers alternative models and research methods that can enliven and deepen the political analyses of Peltzman and other economists.

Hope takes on a particularly important role in end of life situations. Sustaining hope can have considerable benefits for the quality of life and any prospect of a good death for the dying. However, it has proved difficult to adequately account for hope when dying, particularly in some of the more extreme end of life situations. Standard secular accounts of hope struggle to establish how the fostering of hope may be possible in such situations. This leads to a practical ethical (...) dilemma for those caring for the dying, the ‘paradox of hope’, whereby one can either help maintain the welfare of the dying by generating a misleading ‘false hope’ or maintain truthfulness and concede that hope is not possible. These two problems combine to leave individuals the prospect of dying in terrible circumstances facing only despair. To address this, I argue that we should look beyond standard intentional or dispositional accounts of hope in such cases and treat hope as a cluster concept. Rather than appeal to a unitary conception, what we precisely mean by ‘hope’ may therefore vary depending on the context of use. I outline an account of hope based on Marcel’s account of ‘absolute’ hope but offering an alternative, secular foundation based on solidarity that can explain how hope when dying in extreme circumstances is possible. Hence, where the more familiar accounts break-down in these circumstances, ‘hope talk’ may still be possible if it is seen as relying on this conception of hope. (shrink)