We describe a number of conscientious objection cases in a liberal Western democracy. These cases strongly suggest that the typical conscientious objector does not object to unreasonable, controversial professional services—involving torture, for instance—but to the provision of professional services that are both uncontroversially legal and that patients are entitled to receive. We analyse the conflict between these patients' access rights and the conscientious objection accommodation demanded by monopoly providers of such healthcare services. It is implausible that professionals who voluntarily join (...) a profession should be endowed with a legal claim not to provide services that are within the scope of the profession's practice and that society expects them to provide. We discuss common counterarguments to this view and reject all of them. (shrink)

Background: The advent of AIDS brought about a group of patients unwilling to accept crucial aspects of the methodological standards for clinical research investigating Phase 1 drugs, surgeries or devices. Their arguments against placebo controls in trials, which depended-at the time-on the terminal status of patient volunteers led to a renewed discussion of the ethics of denying patients with catastrophic illnesses access to last-chance experimental drugs, surgeries or devices. Sources of data: Existing ethics and health policy literature on the topic (...) of access to experimental drugs. Areas of agreement: The positions of those arguing for or against free access to experimental drugs for terminally ill patients are irreconcilable. Areas of controversy: At stake are questions about the kinds of personal sacrifices society can reasonably expect patients in clinical trials to make to ensure statistically predictive results. These would benefit by necessity a much larger number of current and future patients-the conflict is about individual versus public interests. It is also about the question of whether or not the state can legitimately prevent patients with terminal illnesses from unfettered access to experimental drugs, surgeries or devices in order to motivate them to participate in clinical trials. We review the ethical arguments for and against the provision of access to Phase 1 agents for terminally ill patients. Growing points: Finding a compromise between providing free or no access to Phase 1 drugs for terminally ill patients. Areas timely for developing research: We ought to investigate means to increase access to experimental drugs for terminally ill patients without sacrificing necessary clinical trials' sounds scientific methods. (shrink)

Using the case of Ebola Virus Disease as an example, this paper shows why patients at high risk for death have a defensible moral claim to access unregistered medical interventions, without having to enrol in randomized placebo controlled trials.A number of jurisdictions permit and facilitate such access under emergency circumstances. One controversial question is whether patients should only be permitted access to UMI after trials investigating the interventions are fully recruited. It is argued that regulatory regimes should not prioritise trial (...) recruitment over patient access, even if this results in drug research and development delays.We describe how the moral duty to rescue impacts on others' duties to oblige patients seeking emergency access to unregistered medical interventions. The view that eligible patients are owed the provision of access to UMI regardless of their willingness to enrol in a randomised controlled trial is defended. (shrink)

ABSTRACTThis report on end‐of‐life decision‐making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters.Chapter 1 reviews what is known about end‐of‐life care and opinions about assisted dying in Canada.Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death.Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order.Chapter 4 reviews the (...) experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form.Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. (shrink)

Developing World Bioethics, Accepted Article.

The self seems to be a unitary entity remaining stable across time. Nevertheless, current theorizing conceptualizes the self as a number of interacting sub-systems involving perception, intention and action (self-model). One important function of such a self-model is to distinguish between events occurring as a result of one's own actions and events occurring as the result of somebody else's actions. We conducted an fMRI experiment that compared brain activation after an abrupt mismatch between one's own movement and its visual consequences (...) with an abrupt mismatch between one's own movement and somebody else's visually perceived hand movement. A right fronto-parietal network was selectively active during a sudden mismatch between one's own observed and performed hand action. (shrink)

Postcolonial criticism has repeatedly debunked the ostensible neutrality of the ‘world’ of world literature by pointing out that and how the contemporary world – whether conceived in terms of cosmopolitan conviviality or neoliberal globalization – cannot be understood without recourse to the worldly event of Europe’s colonial expansion. While we deem this critical perspective indispensable, we simultaneously maintain that to reduce ‘the world’ to the world-making impact of capital, colonialism, and patriarchy paints an overly deterministic picture that runs the risk (...) of unwittingly reproducing precisely that dominant ‘oneworldness’ that it aims to critique. Moreover, the mere potentiality of alternative modes of world-making tends to disappear in such a perspective so that the only remaining option to think beyond oneworldness resides in the singularity claim. This insistence on singularity, however, leaves the relatedness of the single units massively underdetermined or denies it altogether. By contrast, we locate world literature in the conflicted space between the imperial imposition of a hierarchically stratified world (to which, as hegemonic forces tell us, ‘there is no alternative’) and the unrealized ‘undivided world’ that multiple minor cosmopolitan projects yet have to win. It is precisely the tension between these ‘two worlds’ that brings into view the crucial centrality not of the nodes in their alleged singularity but their specific relatedness to each other, that both impedes and energizes world literature today and renders it ineluctably postcolonial. (shrink)

Research into the genetic component of some complex behaviors often causes controversy, depending on the social meaning and significance of the behavior under study. Research into sexual orientation—simplistically referred to as “gay gene” research—is an example of research that provokes intense controversy. This research is worrisome for many reasons, including the fact that it has been used to harm lesbians and gay men. Many homosexual people have been forced to undergo “treatments” to change their sexual orientation. Others chose to undergo (...) them to escape discrimination and social disapprobation. But there are other reasons to worry about such research. The very motivation for seeking an “origin” of homosexuality reveals homophobia. Moreover, such research may lead to prenatal tests that claim to predict for homosexuality. For homosexual people who live in countries with no legal protections these dangers are particularly serious. (shrink)

This volume is a result of a study on the analytical and hermeneutic tradition, focusing on the subject of language and understanding. The author presents a new positive context theory.

Atheists mistakenly think that faith is just a matter of belief without evidence. Many theologians, in particular, insist that this is a naive understanding of faith, and they describe more sophisticated or elaborate concepts of faith. One approach to defending religion claims that atheism itself depends on faith. If that can be demonstrated, then atheists are no better off than the religious, and it becomes just as arbitrary to deny the existence of the gods as to believe in them. The (...) claim that “faith” is something personal and modest is unconvincing when viewed in the light of history and contemporary political reality in many countries. Atheism is self‐refuting, as rational argument presumes the existence of god, and while this particular argument deserves its own discussion, the idea often seems simpler. (shrink)

In the past decades, professions have increasingly been called to account. Several authors have reported that this increased public professional accountability, in the form of showing that professional conduct meets predefined standards or rules, has had severe negative consequences for professionals, their clients and society, and call for ‘intelligent’ forms of accountability; forms of accountability that may inform a wider public about professional conduct but do not harm it. In this paper, we propose a form of ‘intelligent’ public professional accountability. (...) Taking Freidson’s notion of institutional ethics as a point of departure, we develop a form of accountability that seeks to account for the conditions required for professional conduct. The paper first discusses the current ‘dilemma of professional accountability,’ describes ‘ideal-type professional conduct’ and goes into the conditions it requires. Next, it shows what accounting for these conditions entails and that this form of accountability fits the criteria for intelligent accountability, as set by O’Neill Capital failure: rebuilding trust in financial services, Oxford University Press, Oxford, 2014). (shrink)

Access to public healthcare services for Belgium’s undocumented migrants is regulated through a parallel, administrative procedure within the legal framework of Urgent Medical Aid. This imposes several constraints on their access to healthcare services. Drawing on empirical-ethical methodologies, we show how this procedure impacts on the relationship between patients with undocumented status and healthcare workers. We use the concept of relational autonomy to show how the imposed legal constraints reduce the formal treatment options available to healthcare workers, but simultaneously lead (...) to informal care practices, and how the latter increase the discretionary power of the healthcare workers. We argue that in this context, provision becomes unpredictable and arbitrary, with undocumented migrants tending to value strong personal relations with one particular, trusted healthcare worker. Although this leads to increased dependence, it also increases patients’ options and autonomy by providing access to wider professional networks attached to that healthcare worker. (shrink)

It is much debated whether Aristotle’s conception of happiness includes all valuable goods or only intellectual activity of a certain kind . Our analysis of movement and activity yields a number of distinguishing features to which the eulogy for contemplation in EN X, 6-8 is referring. Moreover, good practice has the same ontological features as producing, certainly not a candidate for happiness. Man has many powers that can be actualised in their limit of perfection, but only one is an activity (...) and that is contemplation. So an analysis of the ontological basis of Aristotelian ethics leads to the conclusion that happiness must be understood along the lines of exclusivism. (shrink)