The first part of this paper examines the practice of informed treatment decisions in the protective medical system in China today. The second part examines how health care professionals in China perceive and carry out their responsibilities when relaying information to vulnerable patients, based on the findings of an empirical study that I had undertaken to examine the moral experience of nurses in practice situations. In the Chinese medical ethics tradition, refinement [jing] in skills and sincerity [cheng] in relating to (...) patients are two cardinal virtues that health care professionals are required to possess. This notion of absolute sincerity carries a strong sense of parental protectiveness. The empirical findings reveal that most nurses are ambivalent about telling the truth to patients. Truth-telling would become an insincere act if a patient were to lose hope and confidence in life after learning of his or her disease. In this system of protective medical care, it is arguable as to whose interests are being protected: the patient, the family or the hospital. I would suggest that the interests of the hospital and the family members who legitimately represent the patient's interests are being honoured, but at the expense of the patient's right to know. (shrink)

Advancements in early diagnosis and novel treatments for children with complex and chronic needs have improved their chances of survival. But many survive with complex medical needs and ongoing medical management in the setting of prognostic uncertainty. Their medical care relies more and more on preference-sensitive decisions, requiring medical team and family engagement in ethically challenging situations. Many families are unprepared as they face these ethical challenges and struggle to access relevant ethical resources. In this paper, Timmy’s narrative, situated in (...) the context of what is known about ethical challenges in the care of children with chronic critical illness (CCI), serves as a case study of the gap in available ethical resources to guide families in their approach to difficult decision making for children with significant medical complexity and CCI. Our author group, inclusive of parents of children with complex medical needs and medical professionals, identifies domains of ethical challenges facing families of children with CCI and we highlight the development of family/caregiver-oriented ethics resources as an essential expansion of pediatric bioethics. (shrink)

We thank the commentators for their thoughtful responses to our article.1 Due to space constraints, we will confine our discussion to just three key issues. The first issue relates to the central ethical conundrum for clinicians working with young people like Phoenix: namely, how to respect, value and defer to a person’s own account of their identity and what is needed for their well-being, while staying open to the possibility that such an account may reflect a work in progress. This (...) conundrum thus relates both to what will be beneficial for that person and what constitutes respecting their autonomy, and clinicians must dwell on these questions when deciding what forms of medical intervention to offer. D’Angelo,2 Lemma3 and Wren4 highlight the importance of considering Phoenix (or, indeed, any person pursuing gender-affirming interventions) as a ‘whole person in context’ (p5)2 prior to initiating treatment or care. In this way, they advocate for a process of ‘therapeutic exploration’ (p1),4 which includes taking sufficient time to explore Phoenix’s personhood with them so as to support them in achieving an ‘authentic self-discovery’ (p5).2 We agree with these authors that identity (including gender identity) development is a complex, life-long process that is influenced by biological, psychosocial and relational aspects, all of which may contribute to an individual’s desire to pursue gender-affirming interventions. To explore the various factors—both conscious and unconscious—that might be motivating Phoenix’s decision to pursue ongoing puberty suppression (OPS), D’Angelo,2 Lemma3 and Wren4 describe a comprehensive psychological approach to working with transgender (trans) and gender diverse (TGD) individuals and propose questions to guide such discussions. Consistent with this approach, we stipulated that Phoenix had undergone regular psychological counselling and that the psychologist had judged that ‘Phoenix’s distress is significant and enduring…not a symptom …. (shrink)

In this article, we analyse the novel case of Phoenix, a non-binary adult requesting ongoing puberty suppression to permanently prevent the development of secondary sex characteristics, as a way of affirming their gender identity. We argue that the aim of OPS is consistent with the proper goals of medicine to promote well-being, and therefore could ethically be offered to non-binary adults in principle; there are additional equity-based reasons to offer OPS to non-binary adults as a group; and the ethical defensibility (...) of facilitating individual requests for OPS from non-binary adults also depends on other relevant considerations, including the balance of potential benefits over harms for that specific patient, and whether the patient’s request is substantially autonomous. Although the broadly principlist ethical approach we take can be used to analyse other cases of non-binary adults requesting OPS apart from the case we evaluate, we highlight that the outcome will necessarily depend on the individual’s context and values. However, such clinical provision of OPS should ideally be within the context of a properly designed research study with long-term follow-up and open publication of results. (shrink)

La tension entre domination et resistance est au centre de la notion du pouvoir politique chez Hobbes. Or, celui-ci opere une mutation dans l'histoire de ces deux notions. La mutation intervenue dans la figure du gouvernant s'opere avec la notion de souverainete, c'est-a-dire avec la mise en place d'un concept uniquement politique du pouvoir, la rupture correlative intervenue dans la notion resistance consiste dans le passage du droit de resistance collectif du peuple au tyran a la notion de droit de (...) resistance individuel face au pouvoir quel qu'il soit. Sont abordes ensuite, les lieux de tension entre domination et resistance : la rebellion, la guerre civile, le droit de punir, le statut de la liberte et la guerre interetatique. Enfin, on trouvera une analyse de la lecture critique que Foucault fait de Hobbes. (shrink)

Contentious relations between Türkiye and Greece can be traced back centuries to conflicts such as Ottoman Turks conquering Istanbul which was the centre of the Byzantine Empire in 1453 and the 182...

Although many bioethicists have given attention to the special health issues of Africa and to the ethics of research on the continent, only a handful have considered these issues through the lens of African moral thought. The question has been for the most part neglected as to what a distinctively African moral perspective would be for the analysis and teaching of bioethics issues. To address the oversight, the authors of this paper describe embarking on a project aimed at incorporating African (...) moral perspective, values and philosophy into a teaching curriculum. The authors clarify the rationale for the project and discuss the strategies employed in Africanizing the bioethics curriculum. (shrink)

There are often said to be five main 'theories of truth': correspondence, coherence, pragmatic, redundancy, and semantic theories. The coherence theory of truth equates the truth of a judgment with its coherence with other beliefs. Different versions of the theory give different accounts of coherence, but in all its forms the point is to exhibit truth as an internal relation between beliefs. The pragmatic theory of truth is akin to a coherence theory of this Kantian kind. No coherence theorist need (...) deny the uncontentious claim that for a judgment to be true is for it to stand in a certain relationship, which can be called correspondence, with some state of affairs in the world. The conflict with the redundancy theory may be more apparent than real. For the redundancy theory is not a theory of what truth consists in, but a theory about the meaning of the words 'is true'. (shrink)

El Análisis del Discurso desempeña un papel importante en los estudios de Ciencias de la Información, no sólo como método de investigación, sino también como herramienta de reflexión que enriquece la práctica profesional. Proponemos mapear el uso del Análisis del Discurso en la investigación en Ciencias de la Información, ya que este mapeo permite identificar tendencias, lagunas y oportunidades de investigación, contribuyendo al avance del conocimiento en el campo. El objetivo de esta investigación es identificar estos enfoques del AD en (...) los artículos publicados en CI, y elaborar un análisis crítico del impacto que estos enfoques tienen en el campo de la Ciencia de la Información. Este estudio se clasifica como bibliográfico, con un enfoque cuantitativo-cualitativo, ya que se centra en la identificación de un objeto de estudio específico -artículos publicados- para reflexionar sobre el Análisis del Discurso en la Ciencia de la Información. La investigación muestra que las teorías del Análisis del Discurso aplicadas al campo de la Ciencia de la Información son significativas, ya que ofrecen numerosas posibilidades de investigación. (shrink)

A repackaged edition of the revered author's classic work that examines the four types of human love: affection, friendship, erotic love, and the love of God—part of the C. S. Lewis Signature Classics series. C.S. Lewis—the great British writer, scholar, lay theologian, broadcaster, Christian apologist, and bestselling author of Mere Christianity, The Screwtape Letters, The Great Divorce, The Chronicles of Narnia, and many other beloved classics—contemplates the essence of love and how it works in our daily lives in one of (...) his most famous works of nonfiction. Lewis examines four varieties of human love: affection, the most basic form; friendship, the rarest and perhaps most insightful; Eros, passionate love; charity, the greatest and least selfish. Throughout this compassionate and reasoned study, he encourages readers to open themselves to all forms of love—the key to understanding that brings us closer to God. (shrink)

On the occasion of the 50th anniversary of C. S. Lewis’s death, a special annotated edition of his Christian classic, The Screwtape Letters, with notes and excerpts from his other works that help illuminate this diabolical masterpiece. Since its publication in 1942, The Screwtape Letters has sold millions of copies worldwide and is recognized as a milestone in the history of popular theology. A masterpiece of satire, it offers a sly and ironic portrayal of human life and foibles from the (...) vantage point of Screwtape, a highly placed assistant to “Our Father Below.” At once wildly comic, deadly serious, and strikingly original, The Screwtape Letters comprises the correspondence of the worldly-wise devil Screwtape and his nephew Wormwood, a novice demon in charge of securing the damnation of an ordinary young man. For the first time, The Screwtape Letters will be presented in full-text accompanied by helpful annotations in a striking two-color format. These annotations will give fans a deeper, more nuanced understanding of the popular book, providing background information, explanations of terms, historical significance, and excerpts from Lewis’s other works that more fully explain the ideas in this volume. For both expert Lewis fans and casual readers, The Screwtape Letters: Annotated Edition will be a beautiful and insightful guide to a beloved classic. (shrink)

This is one of the seminal articles of the pragmatist tradition where C.S. Peirce sets out his doctrine of doubt and belief --and their relationship to inquiry and clarity of our concepts. Originally published in the Popular Science Monthly; and widely available in reprints and collections of Peirce's writings.

“Probably Peirce’s best-known works are the first two articles in a series of six that originally were collectively entitled Illustrations of the Logic of Science and published in Popular Science Monthly from November 1877 through August 1878. The first is entitled ‘The Fixation of Belief’ and the second is entitled ‘How to Make Our Ideas Clear.’ In the first of these papers Peirce defended, in a manner consistent with not accepting naive realism, the superiority of the scientific method over other (...) methods of overcoming doubt and ‘fixing belief.’” — Robert Burch, “Charles Sanders Peirce,” entry in the Stanford Encyclopedia of Philosophy (2021 revision) -/- “Pragmatist epistemologies often explore how we can carry out inquiries in a self-controlled and fruitful way. (Where much analytic epistemology centres around the concept of knowledge, considered as an idealised end-point of human thought, pragmatist epistemology centres around the concept of inquiry, considered as the process of knowledge-seeking and how we can improve it.) So pragmatists often provide rich accounts of the capacities or virtues that we must possess in order to inquire well, and the rules or guiding principles that we should adopt. A canonical account is Peirce’s classic early paper ‘The Fixation of Belief‘. Here Peirce states that inquiry is a struggle to replace doubt with “settled belief“, and that the only method of inquiry that can make sense of the fact that at least some of us are disturbed by inconsistent beliefs, and will subsequently reflect upon which methods of fixing belief are correct is the Method of Science, which draws on the Pragmatic Maxim described above. This contrasts with three other methods of fixing belief: i) refusing to consider evidence contrary to one’s favored beliefs (the Method of Tenacity), ii) accepting an institution’s dictates (the Method of Authority), iii) developing the most rationally coherent or elegant-seeming belief-set (the A Priori Method).“ — Catherine Legg, “Pragmatism,” entry in the Stanford Encyclopedia of Philosophy (2021 revision). (shrink)

C. S. Lewis takes us on a profound journey through both heaven and hell in this engaging allegorical tale. Using his extraordinary descriptive powers, Lewis introduces us to supernatural beings who will change the way we think about good and evil.

C. S. Lewis sets out to persuade his audience of the importance and relevance of universal values such as courage and honor in contemporary society.

C. S. Lewis sets out to disentangle this knotty issue but wisely adds that in the end no intellectual solution can dispense with the necessity for patience and ...

This paper takes the form of a critical discussion of Crispin Wright’s notion of entitlement of cognitive project. I examine various strategies for defending the claim that entitlement can make acceptance of a proposition epistemically rational, including one which appeals to epistemic consequentialism. Ultimately, I argue, none of these strategies is successful, but the attempt to isolate points of disagreement with Wright issues in some positive proposals as to how an epistemic consequentialist should characterize epistemic rationality.

Philosophers readily talk about merely verbal disputes, usually without much or any explicit reflection on what these are, and a good deal of methodological significance is attached to discovering whether a dispute is merely verbal or not. Currently, metaphilosophical advances are being made towards a clearer understanding of what exactly it takes for something to be a merely verbal dispute. This paper engages with this growing literature, pointing out some problems with existing approaches, and develops a new proposal which builds (...) on their strengths. (shrink)

Are there dispositions which not only do not manifest, but which could not manifest? We argue that there are dispositions to Ф in circumstances C where C is impossible, and some where Ф is impossible. Furthermore, postulating these dispositions does useful theoretical work. This paper describes a number of cases of dispositions had by objects even though those dispositions are not possibly manifest, and argues for the importance of these dispositions.

C. S. Lewis' article addresses a critically important issue on which Howard Ahmanson comments. Professor Oliver O'Donovan addresses the same issue in a sermon in Christ Church Oxford on Trinity Sunday 1997. We publish the three articles together in the year of the fiftieth anniversary of the independence of India and Pakistan and invite correspondence on the issues at stake. Eds.

Under what circumstances if ever ought we to grant that Artificial Intelligences (AI) are persons? The question of whether AI could have the high degree of moral status that is attributed to human persons has received little attention. What little work there is employs western conceptions of personhood, while non-western approaches are neglected. In this article, I discuss African conceptions of personhood and their implications for the possibility of AI persons. I focus on an African account of personhood that is (...) prima facie inimical to the idea that AI could ever be ‘persons’ in the sense typically attributed to humans. I argue that despite its apparent anthropocentrism, this African account could admit AI as persons. (shrink)