The ethical issues around decision making on behalf of infants have been illuminated by two empirical research studies carried out in Scotland. In-depth interviews with 176 medical and nursing staff and with 108 parents of babies for whom there was discussion of treatment withholding/withdrawal, generated a wealth of data on both the decision making process and the management of cases. Both staff and parents believe that parents should be involved in treatment limitation decisions on behalf of their babies. However, whilst (...) many doctors and nurses consider the ultimate responsibility too great for families to carry, the majority of parents wish to be the final arbiters. We offer explanations for the differences in perception found in the two groups. The results of these empirical studies provide both aids to ethical reflection and guidance for clinicians dealing with these vulnerable families. They demonstrate the value of empirical data in the philosophical debate. (shrink)

Representatives from eight European countries compared the legal, ethical and professional settings within which decision making for neonates takes place. When it comes to limiting treatment there is general agreement across all countries that overly aggressive treatment is to be discouraged. Nevertheless, strong emphasis has been placed on the need for compassionate care even where cure is not possible. Where a child will die irrespective of medical intervention, there is widespread acceptance of the practice of limiting aggressive treatment or alleviating (...) suffering even if death may be hastened as a result. Where the infant could be saved but the future outlook is bleak there is more debate, but only two countries have tested the courts with such cases. When it comes to the active intentional ending of life, the legal position is standard across Europe; it is prohibited. However, recognising those intractable situations where death may be lingering and unpleasant, Dutch paediatricians have reported that they do sometimes assist babies to die with parental consent. Two cases have been tried through the courts and recent official recommendations have set out standards by which such actions may be assessed. (shrink)

Dilemmas about resuscitation and life-prolonging treatment for severely compromised infants have become increasingly complex as skills in neonatal care have developed. Quality of life and resource issues necessarily influence management. Our Institute of Medical Ethics working party, on whose behalf this paper is written, recognises that the ultimate responsibility for the final decision rests with the doctor in clinical charge of the infant. However, we advocate a team approach to decision-making, emphasising the important role of parents and nurses in the (...) process. Assessing the relative burdens and benefits can be troubling, but doctors and parents need to retain a measure of discretion; legislation which would determine action in all cases is inappropriate. Caution should be exercised in involving committees in decision-making and, where they exist, their remit should remain to advise rather than to decide. Support for families who bear the consequences of their decisions is often inadequate, and facilitating access to such services is part of the wider responsibilities of the intensive care team. The authors believe that allowing death by withholding or withdrawing treatment is legitimate, where those closely involved in the care of the infant together deem the burdens to be unacceptable without compensating benefits for the infant. As part of the process accurate and careful recording is essential. (shrink)

Background The consistency of codes governing disclosure of terminal illness to patients and families in Islamic countries has not been studied until now. Objectives To review available codes on disclosure of terminal illness in Islamic countries. Data source and extraction Data were extracted through searches on Google and PubMed. Codes related to disclosure of terminal illness to patients or families were abstracted, and then classified independently by the three authors. Data synthesis Codes for 14 Islamic countries were located. Five codes (...) were silent regarding informing the patient, seven allowed concealment, one mandated disclosure and one prohibited disclosure. Five codes were silent regarding informing the family, four allowed disclosure and five mandated/recommended disclosure. The Islamic Organization for Medical Sciences code was silent on both issues. Conclusion Codes regarding disclosure of terminal illness to patients and families differed markedly among Islamic countries. They were silent in one-third of the codes, and tended to favour a paternalistic/utilitarian, family-centred approach over an autonomous, patient-centred approach. (shrink)

It is difficult to reconcile claims about the Father's role as the progenitor of Trinitarian Persons with commitment to the equality of the persons, a problem that is especially acute for Social Trinitarians. I propose a metatheological account of the doctrine of the Trinity that facilitates the reconciliation of these two claims. On the proposed account, ‘Father’ is systematically ambiguous. Within economic contexts, those which characterize God's relation to the world, ‘Father’ refers to the First Person of the Trinity; within (...) theological contexts, which purport to describe intra-Trinitarian relations, it refers to the Trinity in toto-thus in holding that the Son and Holy Spirit proceed from the Father we affirm that the Trinity is the source and unifying principle of Trinitarian Persons. While this account is solves a nagging problem for Social Trinitarians it is theologically minimalist to the extent that it is compatible with both Social Trinitarianism and Latin Trinitarianism, and with heterodox Modalist and Tri-theist doctrines as well. Its only theological cost is incompatibility with the Filioque Clause, the doctrine that the Holy Spirit proceeds from both the Father and the Son—and arguably that may be a benefit. (shrink)

The doctrine of the Trinity developed in response to a range of theological interests, among them the project of reconciling claims about the divinity of Christ with monotheism and massaging Christian doctrine into the ambient (largely Platonic) philosophical framework of the period. More recently the Trinity doctrine has been deployed to promote normative claims concerning human nature, human relationships and social justice. During the past two decades analytic philosophers of religion have increasingly engaged with the doctrine. There are, however, a (...) number of foundational questions that have not been addressed in the philosophical literature. The Trinity: A Philosophical Investigation considers the competing accounts of the Trinity doctrine, whether orthodox or heterodox, and aims to respond to objections and explicate their motivations and entailments. (shrink)

Mounting evidence suggests that endorsement of psychological continuity and the afterlife increases with age. This developmental change raises questions about the cognitive biases, social representations, and cultural input that may support afterlife beliefs. To what extent is there similarity versus diversity across cultures in how people reason about what happens after death? The objective of this study was to compare beliefs about the continuation of biological and psychological functions after death in Tanna, Vanuatu, and the United States. Children, adolescents, and (...) adults were primed with a story that contained either natural or supernatural cues. Participants were then asked whether or not different biological and psychological processes continue to function after death. We predicted that across cultures individuals would be more likely to endorse the continuation of psychological processes over biological processes and that a theistic prime would increase continuation responses regarding both types of process. Results largely supported predictions; U.S. participants provided more continuation responses for psychological than biological processes following both the theistic and non-theistic primes. Participants in Vanuatu, however, provided more continuation responses for biological than psychological processes following the theistic prime. The data provide evidence for both cultural similarity and variability in afterlife beliefs and demonstrate that individuals use both natural and supernatural explanations to interpret the same events. (shrink)

In its original expression as a medical value confidentiality may have been absolute; this concept has become eroded by patient consent, legal actions and change in the climate of public opinion. In particular requirements arising out of legal statutes and common law judgements have greatly modified the confidentiality of the doctor-patient relationship in societies deriving their law from English origins. Despite this, confidentiality remains a value which the physician must strive to preserve. He cannot however do this without considering its (...) effect upon possible innocent third parties. (shrink)

Dion is a human person, Lefty is his left foot, and Theon is Lefty-Complement, a proper part of Dion. Lefty is annihilated and Dion survives left-footless. After Lefty’s annihilation Theon, if he survives, occupies the same region as Dion. I suggest that this scenario be understood as a fusion case in which Dion and Theon, initially overlapping but distinct, are identical after Lefty’s annihilation and propose an account of proper names that allows us to say that Dion and Theon have (...) ‘become identical’ without commitment to occasional identity or other controversial metaphysical doctrines. The proposed solution employs the semantics developed by Wolfgang Schwarz to address the ‘paradox of occasional identity’, posed by puzzle cases of fission, to deal with the problem of Dion and Theon, a body-minus puzzle. (shrink)

In Spring 2008 I went textbook-free. I linked all and only the readings for my Contemporary Analytic Philosophy course to the class website, along with powerpoints, handouts and external links to online resources.

According to many orthodox Christian theologies Jesus is not merely sinless but impeccable: he not only did not sin but could not. This is puzzling because one can only sin by doing something else and, prima face, Jesus can do actions that you or I could do by which we would sin. I suggest that appearances to the contrary, Jesus cannot do a variety of actions that a merely human duplicate could do. His doing sinful actions is compossible with a (...) range of empirical facts about his physical abilities and circumstances of the sort we ordinarily take into account in assessing what a person can do, but not with a wider range of theological facts concerning his divinity. Like Tim, Lewis’s time-traveler, who can kill Grandfather relative to facts about his immediate circumstances and abilities but not relative to a wider range of facts, Jesus ‘can’ in the ordinary sense sin, though he will not, but relative to a wider range of facts which obtain in virtue of his divinity, cannot. (shrink)

Before and during the times of Confucius and Aristotle, the concept of friendship had very different implications. This paper compares Confucius’ with Aristotle’s thoughts on friendship from two perspectives: xin 信 and le 乐. The Analects emphasizes the xin as the basis of friendship. Aristotle holds that there are three kinds of friends and corresponding to them are three types of friendship. In the friendship for the sake of pleasure, there is no xin; in the legal form of friendship for (...) the sake of utility, xin is guaranteed by law; and in the moral form of friendship for the sake of utility, xin is guaranteed by morality; in the friendship for the sake of virtue, xin is an indispensable part. Both thinkers believe friends can bring joy to human life. According to Confucius, it is the joy of rendao 仁道, whereas for Aristotle, it is the joy of Reason. There are many commonalities and differences between the two. The commonalities reveal some inner links between Confucian rendao and Aristotelian Reason. It seems that the differences between rendao and Reason are the differences between moral reason and logical reason. The comparative study is helpful for us to understand the two masters’ ethics, politics and philosophy. (shrink)

Pursuant to the Doctrine of Consumer Sovereignty, we believe that tobacco companies should be compelled to disclose their ingredients so that the public health community can make more informed recommendations in order to protect consumer autonomy and sovereignty. However, a recent decision by the First Circuit precludes such a disclosure since it would be unduly burdensome to the industry, while granting only minimal gains to the public. We argue that many of the Court’s key claims rest on a misunderstanding of (...) the science and chemistry of tobacco products. In our view, a mandatory disclosure of ingredients would more effectively protect the public interest, whilst posing minimal burdens on the tobacco industry. (shrink)

Critics suggest that without some "objective" account of well-being we cannot explain why satisfying some preferences is, as we believe, better than satisfying others, why satisfying some preferences may leave us on net worse off or why, in a range of cases, we should reject life-adjustment in favor of life-improvement. I defend a subjective welfarist understanding of well-being against such objections by reconstructing the Amartya Sen's capability approach as a preferentist account of well-being. According to the proposed account preference satisfaction (...) alone—possible as well as actual—is of value. States of affairs contribute to well-being because and to the extent that they satisfy actual or nearby possible preferences, and are fruitful, that is, compatible with a range states that satisfy further actual or nearby possible preferences. The proposed account solves the problem of adaptive preference. Individuals whose preferences are "deformed" are satisfied with fruitless states of affairs, which constrain their options so that they are incapable of satisfying a wide range of nearby possible preferences—preferences they "could easily have had." Recognizing the value of capabilities as well as actual attainments allows us to explain why individuals who satisfy "deformed" or perverse preferences may not on net benefit from doing so. More fundamentally, it explains why some states are, as Sen suggests, bad, awful or gruesome while others are good, excellent or superb without appeal to any objective account of value. (shrink)

One hears increasingly from philosophers that statistical inference is a technical study that is well in control by statisticians and should be left to them; and one hears, increasingly, from mathematical statisticians that all this talk about interpretations of probability is so much philosophical frosting that is utterly irrelevant to the serious business of producing mathematical statistics. "The more interpretations of probability there are, the wider the scope of applications of our purely mathematical theories." The point of this paper is (...) to present, in detail, a situation in which an individual with given degrees of belief, given evidence, and given values, will have three different and contrary courses of action recommended to him, each according to one of the three most popular interpretations of probability. (shrink)

Biological research on aggression is increasingly consulted for possible answers to the social problems of crime and violence. This paper reviews some contrasting approaches to the biological understanding of behavior-behavioral genetic, social-environmental, physiological, developmental-as a prelude to arguing that approaches to aggression are beset by vagueness and imprecision in their definitions and disunity in their measurement strategies. This vagueness and disunity undermines attempts to compare and evaluate the different approaches empirically. Nevertheless, the definitions reveal commitments to particular metaphysical views concerning (...) behavior. Alternative understandings of aggression suggest even different research approaches than those most commonly found in the literature. (shrink)

The value of autonomy is generally stated to be of prime importance in relation to health care. Arising out of this, rights of the patient to and in health care have been extensively discussed and stated, and have found expression in law. There have been minimal statements of the rights of others involved in health care, such as caregivers, and minimal discussion of duties and responsibilities in relation to rights claimed and conferred. The author suggests that no claim to rights (...) in health care should now be accepted without consideration of related duties and responsibilities. (shrink)