One of the most recent controversies to arise in the field of bioethics concerns the ethics for the Groningen Protocol: the guidelines proposed by the Groningen Academic Hospital in The Netherlands, which would permit doctors to actively euthanise terminally ill infants who are suffering. The Groningen Protocol has been met with an intense amount of criticism, some even calling it a relapse into a Hitleresque style of eugenics, where people with disabilities are killed solely because of their handicaps. The purpose (...) of this paper is threefold. First, the paper will attempt to disabuse readers of this erroneous understanding of the Groningen Protocol by showing how such a policy does not aim at making quality-of-life judgements, given that it restricts euthanasia to suffering and terminally ill infants. Second, the paper illustrates that what the Groningen Protocol proposes to do is both ethical and also the most humane alternative for these suffering and dying infants. Lastly, responses are given to some of the worries expressed by ethicists on the practice of any type of non-voluntary active euthanasia. (shrink)

The need to make young scientists aware of their social responsibilities is widely acknowledged, although the question of how to actually do it has so far gained limited attention. A 2-day workshop entitled “Prepared for social responsibility?” attended by doctoral students from multiple disciplines in climate science, was targeted at the perceived needs of the participants and employed a format that took them through three stages of ethics education: sensitization, information and empowerment. The workshop aimed at preparing doctoral students to (...) manage ethical dilemmas that emerge when climate science meets the public sphere (e.g., to identify and balance legitimate perspectives on particular types of geo-engineering), and is an example of how to include social responsibility in doctoral education. The paper describes the workshop from the three different perspectives of the authors: the course teacher, the head of the graduate school, and a graduate student. The elements that contributed to the success of the workshop, and thus make it an example to follow, are (1) the involvement of participating students, (2) the introduction of external expertise and role models in climate science, and (3) a workshop design that focused on ethical analyses of examples from the climate sciences. (shrink)

Searle has recently used two adaptations of his Chinese room argument in an attack on connectionism. I show that these new forms of the argument are fallacious. First I give an exposition of and rebuttal to the original Chinese room argument, and then a brief introduction to the essentials of connectionism.

Ethics instructors often use cases to help students understand ethics within a corporate context, but we need to know more about the impact a case-based pedagogy has on students’ ability to make ethical decisions. We used a pre- and post-test methodology to assess the effect of using cases to teach ethics in a finance course. We also wanted to determine whether recent corporate ethics scandals might have impacted students’ perceptions of the importance and prevalence of ethics in business, so we (...) used in-depth case studies of several of the major scandals (e.g., Enron, Tyco, Adelphia). Our results are somewhat surprising since studying ethics scandals positively impacts students’ ethical decision making and their perceptions of the ethics of businesspeople. (shrink)

This essay explores some concerns about the quality of informed consent in patients whose autonomy is diminished by fatal illness. It argues that patients with diminished autonomy cannot give free and voluntary consent, and that recruitment of such patients as subjects in human experimentation exploits their vulnerability in a morally objectionable way. Two options are given to overcome this objection: (i) recruit only those patients who desire to contribute to medical knowledge, rather than gain access to experimental treatment, or (ii) (...) provide prospective subjects the choice to participate in standard doubleblind study or receive the experimental treatment. Either option would guarantee that patients in desperate conditions are given a more meaningful choice and a richer freedom, and thus a higher quality of informed consent, than under standard randomized trials. (shrink)

There are many reasons to worry about shame in moral development. Shame can be employed for bad ends, such as manipulation and making others feel powerless. Shame is often associated with denial and hiding behaviors, social phobia, and anxiety. It is also not a motivation suitable for performing virtuous actions. This article argues that, nevertheless, well-ordered shame plays an indispensable and constructive role, as part of a mixed-methods approach in the development of moral character. This article assesses various reasons why (...) shame has fallen out of favor among Western moral educators and demonstrates why each of these reasons falls short of providing a compelling case against employing shame. It defends shame on epistemic and virtue developmental grounds. Moreover, it proposes ways to employ shame in character education, while mitigating potential damages and avoiding the concerns raised by social scientists. (shrink)

The legalisation of physician assisted suicide in Oregon and physician assisted death in the Netherlands has revitalised the debate over whether and under what conditions individuals should be able to determine the time and manner of their deaths, and whether they should be able to enlist the help of physicians in doing so. Although the change in the law is both dramatic and recent, the basic arguments for and against have not really changed since the issue was debated by Glanville (...) Williams and Yale Kamisar nearly 50 years ago. In this paper, the author argues in favour of Kamisar’s consequentialist framework. Any change in law and social policy should not be based solely on individual cases, heart wrenching though these may be. Instead, we need to assess the need for PAS, and weigh this against the risks of mistake and abuse. (shrink)

This perceptive study of John Case, teacher of philosophy at Oxford from the mid-1560s until his death in 1600 and author of expositions of Aristotle which became standard textbooks of the time, focuses on his intellectual and cultural milieu and reveals.

“Medicalization” has been a contentious notion since its introduction centuries ago. While some scholars lamented a medical overreach into social domains, others hailed its promise for social justice advocacy. Against the backdrop of a growing commitment to health equity across the nation, this article reviews historical interpretations of medicalization, offers an application of the term to non-biologic risk factors for disease, and presents the case of housing the demonstrate the great potential of medicalizing poverty.

A Dutch medical student has the potentially more virulent Panton-Valentine leukocidin form of MRSA colonization yet shows no signs or symptoms of infection. More than a year ago, a routine MRSA screening of health care personnel providing care for MRSA-positive patients detected the colonization. Since then, the student has been treated intensively but unsuccessfully in an attempt to decolonize her. During this decolonization period, the medical student was barred from performing patient-related interventions, temporarily interrupting her medical residency. After initial treatment (...) with mupirocin nasal ointment and antibiotics proved ineffective, a more stringent hygiene regime was added that included hand, nose, hair, and body scrubbing with disinfecting soap. Additional precautions included simultaneous treatment of household members and disinfection of the family home. Despite these efforts, her MRSA status has remained positive. WIP guideline s bar any health care worker diagnosed with MRSA from performing patient-related interventions. Unable to complete the residency requirement of at least 1 year of patient care, the medical student was advised to pursue a career in another profession. (shrink)

Brock Macdonald1, Evi Vakiani2, Rhonda K Yantiss3, Jun Lee4, Robert S Brown Jr5, Samuel H Sigal61Division of Gastroenterology, Department of Medicine, University of California-San Francisco, San Francisco, CA, 2Department of Pathology, Memorial Sloan–Kettering Cancer Center, New York, NY, 3Department of Pathology and Laboratory Medicine, New York Weill Cornell Medical College, New York, NY, 4Division of Nephrology, Department of Medicine, Weill Cornell Medical College, New York, NY, 5Division of Gastroenterology, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, (...) NY, 6Division of Gastroenterology and Hepatology, Department of Medicine, New York University, New York, NY, USA: The use of sirolimus as an alternative to calcineurin inhibitors for posttransplant immunosuppression is associated with a variety of inflammatory conditions. In this report, we describe the case of a 34-year-old man who developed abnormal liver tests 6 years after live-donor kidney transplantation and 5 years after initiation of sirolimus-based immunosuppression. Elevated aminotransferase levels persisted after withdrawal of potentially hepatotoxic medications, and serologic evaluation for viral hepatitis, autoimmune disease, and genetic disorders was unrevealing. Liver biopsy revealed prominent hepatocellular injury associated with a mixed inflammatory infiltrate and liver tests normalized within 2 weeks of discontinuation of sirolimus. In this report, we review previous reports of sirolimus hepatotoxicity and propose a unifying hypothesis for the various inflammatory conditions that have been attributed to sirolimus.Keywords: sirolimus, immunosuppression, transplant, inflammatory conditions, hepatotoxicity. (shrink)

"In the 12 case studies in this treasure of a book, various authors examine the critical, direction-finding moments in the work of such individuals as Charles Darwin, Jean Piaget, Robert Burns Woodward, William James, Anais Nin, and others." --Virginia Quarterly Review.

'The problem of the twentieth-century is the problem of the color-line.' Originally published in 1903, The Souls of Black Folk is a classic study of race, culture, and education at the turn of the twentieth century. With its singular combination of essays, memoir, and fiction, this book vaulted W. E. B. Du Bois to the forefront of American political commentary and civil rights activism. The Souls of Black Folk is an impassioned, at times searing account of the situation of African (...) Americans in the United States. Du Bois makes a forceful case for the access of African Americans to higher education, memorably extols the achievements of black culture (above all the spirituals or 'sorrow songs'), and advances the provocative and influential argument that due to the inequalities and pressures of the 'race problem', African American identity is characterized by 'double consciousness'. This edition includes a valuable appendix of other writing by Du Bois, which sheds light on his attitudes and intentions. ABOUT THE SERIES: For over 100 years Oxford World's Classics has made available the widest range of literature from around the globe. Each affordable volume reflects Oxford's commitment to scholarship, providing the most accurate text plus a wealth of other valuable features, including expert introductions by leading authorities, helpful notes to clarify the text, up-to-date bibliographies for further study, and much more. (shrink)

Within bioethics as well as in broader clinical practice, support for transgender and gender‐questioning adolescent access to pubertal suppression has often relied heavily on the desire to prevent risky, self‐destructive, and suicidal behavior. We argue that framing justifications for access to puberty suppression in this way can actually be harmful to both individual patients as well as to the broader trans population. This justification for access to care makes such access precarious, limits its scope, and introduces perverse incentives to the (...) patient population that is being served. We go on to offer an alternative, positive defense of access to puberty‐blocking treatment for transgender youth grounded in the child's right to an open future. We argue that decisions related to pubertal suppression are both importantly weighty and potentially irreversible, and show why this justification is preferable to so‐called “informed consent” approaches. (shrink)

Alarm over the prospect that prenatal diagnostic techniques, which permit identification of fetal sex and facilitate abortion of healthy but unwanted female fetuses has led some to urge their outright prohibition. This article argues against that response. Prenatal diagnosis permits timely action to preserve and enhance the life and health of fetuses otherwise endangered, and, by offering assurance of fetal normality, may often encourage continuation of pregnancies otherwise vulnerable to termination. Further, conditions in some societies may sometimes render excusable the (...) inclination to abort certain healthy female fetuses. In places where abortion for fetal sex alone is recognised as unethical, however, medical licensing authorities already possess the power to discipline, for professional misconduct, physicians who prescribe or perform prenatal diagnosis purely to identify fetal sex, or those who disclose fetal sex when that is unrelated to the fetus's medical condition. (shrink)

The recent rapprochement between Science and Technology Studies and Political Science is induced by the broadened understanding of political action. The debate concerning the nature of ``the political'' produces an important question concerning the possibilities of an issue- or object-oriented focus for understanding political action. The purpose of this article is to contribute to this debate through an analysis of how relations between material and social entities are continuously recontextualized and decontextualized in social and political interaction. The authors discuss established (...) approaches to explain the concept of virtualization. Virtualization is then used in a case study on the implementation of manure regulation in East Fryslân, the Netherlands, to illustrate how cases or issues are virtualized in political decision making, which produces initial presumptions that carry conclusive weight. The authors conclude that a broad understanding of the political in both STS and PS can only be sustained through an understanding of how relations between social and material entities are continuously decontextualized and recontextualized in political and social interaction. (shrink)

Philosophy textbooks typically treat bioethics as a form of "applied ethics"-i.e., an attempt to apply a moral theory, like utilitarianism, to controversial ethical issues in biology and medicine. Historians, however, can find virtually no cases in which applied philosophical moral theory influenced ethical practice in biology or medicine. In light of the absence of historical evidence, the authors of this paper advance an alternative model of the historical relationship between philosophical ethics and medical ethics, the appropriation model. They offer two (...) historical case studies to illustrate the ways in which physicians have "appropriated" concepts and theory fragments from philosophers, and demonstrate how appropriated moral philosophy profoundly influenced the way medical morality was conceived and practiced. (shrink)

This paper argues that most conceptualizations of citizenship limit the purview of the discourse to static categories. ‘Citizenship’ is commonly seen as an ideal type, presuming a largely legal relationship between an inidividual and a single nation-state – more precisely only one type of nation-state, the advanced capitalist post-war model. Alternatively, we suggest a re-conceptualization of citizenship as a negotiated relationship, one which is subject therefore to change, and acted upon collectively within social, political and economic relations of conflict. This (...) dynamic process of negotiation takes place within a context which is shaped by gendered, racial and class structures and ideologies; it also involves international hierarchies among states. Citizenship is therefore negotiated on global as well as national levels. This conceptualization is demonstrated by way of identifying one particular set of experiences of negotiated citizenship, involving foreign domestic workers in Canada. As non-citizens originating from Third World conditions, this is a case involving women of colour workers, highly prone to abusive conditions, and under the direction of employers who are more affluent First World citizens and predominantly white women. Original survey data based on interviews with Caribbean and Filipino domestic workers in Canada are used to demonstrate the varied, creative and effective strategies of two distinctive groups of non-citizens as they attempt to negotiate citizenship rights in restrictive national and international conditions. (shrink)

To prepare for ethically challenging situations in the workplace, it is useful for students to explore their attitudes toward ethical issues and their own value systems. An experiential assignment to teach ethics in business programs is presented. This method allows instructors to incorporate a “stand alone” assignment in ethics into a course that focuses on another area in management. The assignment, student-developed case studies of ethical situations in the workplace, requires students to develop individual case studies in ethics drawing on (...) their workplace experiences to illustrate ethical principles. The assignment requires students to describe an ethical situation they encountered in the workplace, their relevant value systems, sources of information consulted, their role in the organization, and how they resolved the ethical situation, considering how their experiences since the time of the situation might influence analogous decision making today. To assess student learning, we used thematic analysis to evaluate the content of the case studies, and descriptive statistics to analyze responses to a post-assignment survey. Based on our analysis of the content of the case studies and student responses, this appears to be an effective learning tool to actively engage students in a consideration of, and discussion about, ethical issues in management, and to learn from the experiences of others. (shrink)

John Case , the most important English Aristotelian of the Renaissance period, has not yet received the attention he deserves. In his Lapis philosophicus , an exposition of Aristotle's Physics, is found a discussion of the relation of nature to art which parallels in many ways that formulated a few years later in the writings of Francis Bacon. Case argues, in a way more reminiscent of the works of Giambattista della Porta than of those of Aristotle, that the natural philosopher (...) can legitimately apply the productive arts in helping nature to fulfill her function. Moreover, while rejecting the excessive claims of the Paracelsians, Case does accept the transmutational claims of the alchemists. In the final analysis, his ‘Aristotelianism’ has been tempered by the tradition of Renaissance natural magic. Like many other Peripatetic thinkers of the period, Case shows himself to be an eclectic, drawing materials from a wide variety of sources and open to many of the new scientific tendencies then developing. (shrink)

There is currently a debate over whether cognitive architecture is classical or connectionist in nature. One finds the following three comparisons between classical architecture and connectionist architecture made in the pro-connectionist literature in this debate: (1) connectionist architecture is neurally plausible and classical architecture is not; (2) connectionist architecture is far better suited to model pattern recognition capacities than is classical architecture; and (3) connectionist architecture is far better suited to model the acquisition of pattern recognition capacities by learning than (...) is classical architecture. If true, (1)-(3) would yield a compelling case against the view that cognitive architecture is classical, and would offer some reason to think that cognitive architecture may be connectionist. We first present the case for (1)-(3) in the very words of connectionist enthusiasts. We then argue that the currently available evidence fails to support any of (1)-(3). (shrink)

Individuals’ propensity not to override the first answer that comes to mind is thought to be a crucial cause behind many failures in reasoning. In the present study, we aimed to explore the strategies used and the abilities employed when individuals solve the cognitive reflection test, the most widely used measure of this tendency. Alongside individual differences measures, protocol analysis was employed to unfold the steps of the reasoning process in solving the CRT. This exploration revealed that there are several (...) ways people solve or fail the test. Importantly, 77% of the cases in which reasoners gave the correct final answer in our protocol analysis, they started their response with the correct answer or with a line of thought which led to the correct answer. We also found that 39% of the incorrect responders reflected on their first response. The findings indicate that the suppression of the first answer may not be the only crucial feature of reflectivity in the CRT and that the lack of relevant knowledge is a prominent cause of the reasoning errors. Additionally, we confirmed that the CRT is a multi-faceted construct: both numeracy and reflectivity account for performance. The results can help to better apprehend the “whys and whens” of the decision errors in heuristics and biases tasks and to further refine existing explanatory models. (shrink)

Over the past five centuries, those who translate the Greek New Testament for English readers have increasingly found it appropriate to do so without recourse to a human soul. This is not simply a case of linguistic slippage, but the consequence of sustained exploration of the social‐historical milieu within which the New Testament writers lived and wrote. This chapter explains three areas of inquiry. First, the significance of historical inquiry for situating the New Testament materials more securely within their first‐century (...) milieu as a prophylactic against colonizing New Testament perspectives, in this case, with foreign assumptions about theological anthropology. Second, the significance of sociocultural forms of inquiry, including medical anthropology and social psychology, for shaping our understanding of humanity in the New Testament world. Third, a rereading of New Testament texts that served previously as taken‐for‐granted illustrations of the New Testament's anthropological dualism. (shrink)

A case study concerning a 27-year-old African American female with sickle cell anemia who requests specific medication is presented. Hospital team members should do their best to treat the patient and form their judgments based on her clinical data and medical and social history.

Book reviewed in this article: In That Case: Medical Ethics in Everyday Practice. By Alastair Campbell and Roger Higgs. Medical Genetics Casebook: A Clinical Introduction to Medical Ethics Systems Theory. By Colleen D. Clements. Cases in Bioethics from the Hastings Center Report. Edited by Carol Levine and Robert M. Veatch. Hastings‐on‐Hudson.

A general practitioner (GP) recounts events which unfolded after visiting a patient at home. She was found to be suffering from an entirely curable clinical condition which was worsening as a result of refusal to accept effective medical treatment. The effects upon a grown-up son of the patient's refusal, and the increasing burden of care falling upon local district nursing services, were factors which influenced the GP's thinking and decision making.

Neuronal aggregates involved in conscious awareness are not evenly distributed throughout the CNS but comprise key components referred to as the neural network correlates of consciousness (NNCC). A critical node in this network is the posterior cingulate, precuneal, and retrosplenial cortices. The cytological and neurochemical composition of this region is reviewed in relation to the Brodmann map. This region has the highest level of cortical glucose metabolism and cytochrome c oxidase activity. Monkey studies suggest that the anterior thalamic projection likely (...) drives retrosplenial and posterior cingulate cortex metabolism and that the midbrain projection to the anteroventral thalamic nucleus is a key coupling site between the brainstem system for arousal and cortical systems for cognitive processing and awareness. The pivotal role of the posterior cingulate, precuneal, and retrosplenial cortices in consciousness is demonstrated with posterior cingulate epilepsy cases, midcingulate lesions that de-afferent this region and are associated with unilateral sensory neglect, observations from stroke and vegetative state patients, alterations in blood flow during sleep, and the actions of general anesthetics. Since this region is critically involved in self reflection, it is not surprising that it is similarly a site for the NNCC. Interestingly, information processing during complex cognitive tasks and during aversive sensations such as pain induces efforts to terminate self reflection and result in decreased processing in posterior cingulate and precuneal cortices. (shrink)