Objective: To evaluate feasibility of the guidelines of the Groupe Francophone de Réanimation et Urgence Pédiatriques for limitation of treatments in the paediatric intensive care unit .Design: A 2-year prospective survey.Setting: A 12-bed PICU at the Hôpital Jeanne de Flandre, Lille, France.Patients: Were included when limitation of treatments was expected.Results: Of 967 children admitted, 55 were included with a 2-day median delay. They were younger than others , had a higher paediatric risk of mortality score , and a higher paediatric (...) overall performance category score at admission ; all p<0.002. 34 children died. A limitation decision was made without meeting for 7 children who died: 6 received do-not-resuscitate orders and 1 received withholding decision. Decision-making meetings were organised for 31 children, and the following decisions were made: 12 DNROs , 4 withholding , with 14 withdrawing and 1 continuing treatment . After limitation, 21 children died and 10 survived . 13 procedures were interrupted because of death and 11 because of clinical improvement . Parents’ opinions were obtained after 4 family conferences , 3 days after inclusion. The first meeting was planned for 6 days after inclusion and held on the 7th day after inclusion; 80% of parents were immediately informed of the decision, which was implemented after half a day.Conclusions: GFRUPs procedure was applicable in most cases. The main difficulties were anticipating the correct date for the meeting and involving nurses in the procedure. Children for whom the procedure was interrupted because of clinical improvement and who survived in poor condition without a formal decision pointed out the need for medical criteria for questioning, which should systematically lead to a formal decision-making process. (shrink)

Prior to the nineteenth century, those who are now regarded as scientists were referred to as natural philosophers. With empiricism, science was claimed to be a superior form of knowledge to philosophy, and natural philosophy was marginalized. This claim for science was challenged by defenders of natural philosophy, and this debate has continued up to the present. The vast majority of mainstream scientists are comfortable in the belief that through applying the scientific method, knowledge will continue to accumulate, and that (...) claims to knowledge outside science apart from practical affairs should not be taken seriously. This is referred to as scientism. It is incumbent on those who defend natural philosophy against scientism not only to expose the illusions and incoherence of scientism, but to show that natural philosophers can make justifiable claims to advancing knowledge. By focusing on a recent characterization and defense of natural philosophy along with a reconstruction of the history of natural philosophy, showing the nature and role of Schelling’s conception of dialectical thinking, I will attempt to identify natural philosophy as a coherent tradition of thought and defend it as something different from science and as essential to it, and essential to the broader culture and to civilization. (shrink)

Bioethical Prescriptions collects F.M. Kamm's articles on bioethics -- revised for publication in book form -- which have appeared over the last 25 years and which have made her among the most widely-respected philosophers working in this field.

In his 2009 PSA Recent Ph.D. Award winning contribution to the bi-annual PSA Conference at Pittsburgh in 2008, C. Wu ̈thrich mounted an argument against struc- turalism about space-time in the context of the General Theory of Relativity, to the effect that structuralists cannot discern space-time points. An “abysmal embarrass- ment” for the structuralist, Wu ̈thrich judged. Wu ̈thrich’s characterisation of space-time structuralism is however incorrect. We demonstrate how, on the basis of a correct char- acterisation of space-time structuralism, it (...) is possible to discern space-time points in the GTR-structures under consideration. Thus Wu ̈thrich’s argument crumbles. (shrink)

This article focusses on the generality of the entities involved in a geometric proof of the kind found in ancient Greek treatises: it shows that the standard modern translation of Greek mathematical propositions falsifies crucial syntactical elements, and employs an incorrect conception of the denotative letters in a Greek geometric proof; epigraphic evidence is adduced to show that these denotative letters are ‘letter-labels’. On this basis, the article explores the consequences of seeing that a Greek mathematical proposition is fully general, (...) and the ontological commitments underlying the stylistic practice. (shrink)

Introduction: This study, the first of its kind in Iran, was to assess Iranian patients’ preferences for receiving information and participating in decision-making and to evaluate their satisfaction with how medical information is given to them and with their participation in decision-making at present. Method and materials: 299 of 312 eligible patients admitted to general internal medicine or surgery wards from May to December 2006 were interviewed according to a structured questionnaire. The questionnaire contained questions about patients’ preferences regarding four (...) domains of information and their participation in decision-making. Patients’ responses were measured on a visual analogue scale graded from 1 to 10. Results: The mean (SD) score for desire to receive information was 8.88 out of 10 (1.5) and for participation in medical decision-making was 7.75 out of 10 (3). The desire to receive information was greater in women than men (9.0 (1.5) vs 7.8 (1.4), p = 0.025). It was also correlated with their education (r = 0.2, p = 0.001) and their estimation of the severity of their own disease (r = 0.13, p = 0.027). The score for preference to participate in decision-making was higher in women than in men (7.95 (2.8) and 7.0 (3.2), respectively; β = 0.8, p = 0.022) and was negatively correlated with education (r = −0.14, p = 0.015). Discussion: This study shows that Iranian patients are highly interested in receiving information about their condition and participating in clinical decision-making. No predictive variable for such attitudes was found; therefore, the only way for the physician to recognise patients’ desire is to ask them explicitly. (shrink)

In this volume, F.M. Kamm explores how theories as well as hypothetical and practical cases help us understand rights and their limits. The book begins by considering moral status and its relation to having rights (including whether non-human animals have rights and what rights future persons have). The author then considers whether rights are grounded in duties to oneself, which duties are correlative to rights, and whether neuroscientific and psychological studies can help determine what rights we have. Kamm next investigates (...) the contours of the right not to be harmed by considering critiques of deontological distinctions, the costs that must be undertaken to avoid harming, and a proposal for permissibly harming someone (that allows for resisting the harm) in the Trolley Problem. Additional chapters cover possible implications of the Trolley Problem for such practical issues as correctly programming self-driving cars, providing medical treatments, and enacting redistributive economic policy. Kamm concludes the book by comparing the use of case-based judgments about extreme cases in moral versus aesthetic theory, and by exploring the significance of the right not to be harmed for morally correct policies in the extreme cases of torture and a pandemic. Where pertinent, Kamm considers the views of Derek Parfit, Tom Regan, Christine Korsgaard, Shelly Kagan, Ronald Dworkin, Amartya Sen, Allan Gibbard, Joshua Greene, Arthur Danto, and Judith Thomson, among others."--Provided by publisher. (shrink)

This paper explores ethical debates associated with the UK COVID-19 contact tracing app that occurred in the public news media and broader public policy, and in doing so, takes ethics debate as an object for sociological study. The research question was: how did UK national newspaper news articles and grey literature frame the ethical issues about the app, and how did stakeholders associated with the development and/or governance of the app reflect on this? We examined the predominance of different ethical (...) issues in news articles and grey literature, and triangulated this using stakeholder interview data. Findings illustrate how news articles exceptionalised ethical debate around the app compared to the way they portrayed ethical issues relating to ‘manual’ contact tracing. They also narrowed the debate around specific privacy concerns. This was reflected in the grey literature, and interviewees perceived this to have emerged from a ‘privacy lobby’. We discuss the findings, and argue that this limited public ethics narrative masked broader ethical issues. (shrink)

On philosophy, religion, and humanism; festschrift in honor of A. Sudiarja, a professor of philosophy of Sanata Dharma University, Yogyakarta, Indonesia.