Organ donation after the circulatory determination of death requires the permanent cessation of circulation while organ donation after the brain determination of death requires the irreversible cessation of brain functions. The unified brain-based determination of death connects the brain and circulatory death criteria for circulatory death determination in organ donation as follows: permanent cessation of systemic circulation causes permanent cessation of brain circulation which causes permanent cessation of brain perfusion which causes permanent cessation of brain function. The relevant circulation that (...) must cease in circulatory death determination is that to the brain. Eliminating brain circulation from the donor ECMO organ perfusion circuit in thoracoabdominal NRP protocols satisfies the unified brain-based determination of death but only if the complete cessation of brain circulation can be proved. Despite its medical and physiologic rationale, the unified brain-based determination of death remains inconsistent with the Uniform Determination of Death Act. (shrink)

This three-part analysis of modernity assesses the impact that Western thought and philosophy has had on today's world. Making use of neglected research from the fringes of academia, "Anatomyzing Divinity" traces the circuitous path of occult wisdom from China, India, Egypt and the Hellenistic world to Byzantium and beyond. At the heart of the book is an investigation of the life and thought of G. W. Leibniz, the man who invented calculus and laid the groundwork for binary code, which in (...) turn made computers possible. Leibniz's roots, Kelley shows, lay in the Frankish metaphysical tradition, and thus have little in common with some of his contemporaries' materialism. Along the way, sidelights are turned on 1) the occult basis of Western political systems, as well as 2) the alchemical basis of much Western philosophy and theology. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Philosophy and Rhetoric 35.2 (2002) 138-152 [Access article in PDF] Respecting the Rupture: Not Solving the Problem of Unity in Plato's Phaedrus James L. Kastely Plato's Phaedrus is a particularly instructive example of the double nature and status of rhetoric, for it embodies a tension at the heart of rhetoric. The first half of the dialogue presents three examples of rhetorical practice, while the second develops a theoretical (...) justification of rhetoric as an art. Thus, the dialogue would seem to offer a productive negotiation of the practice/theory tension. What makes the dialogue interesting, however, is the fact that this negotiation does not occur. The dialogue does not bring theory and practice into a harmonious relation, for there is a troubling discontinuity between its two halves, and rhetorical practice feels fractured. The exploration of eros that had occupied the first half of the dialogue is abandoned before the beginning of the second half, and then, following a logic that is at best associational, Socrates and Phaedrus explore the standards that should govern the practice of rhetoric. The infelicity of this transition raises a question: why did Plato structure the Phaedrus in such a way that it emphasized the dissonance between the two halves of the dialogue? To pose the question this way, however, is to go in a direction different from many of the best contemporary interpretations of the dialogue, which either argue that the dialogue is unified (Griswold 164) or suggest that the dissonance between its two halves reflects a shift in Plato's approach to philosophy (Kahn 373; Nehamas 352). In contrast, I will argue that the rupture in the dialogue is thematically purposive, for it points to an inescapable schism within rhetoric that makes rhetoric philosophically interesting.Socrates' second speech, his palinode to Eros, is a rhetorical tour de force that closes the first half of the dialogue. The importance of the palinode, however, is not limited to its role as an exemplary rhetorical performance, [End Page 138] for it also plays a crucial role in resolving the problem of erotic madness that organizes the intellectual drama of the first half. It would seem reasonable to expect that such an important and powerful moment in the dialogue would, at the very least, play a significant role in the philosophical discussion that composes the dialogue's second half. But that doesn't happen. While Socrates does refer to the palinode in his theoretical discussion of rhetoric, he makes little use of it, and, more important, he is silent on the subject of eros. Both the dramatic organization of the second half of the dialogue and its theoretical discussion cooperate to turn the rhetorical triumph of the palinode into a problem. Why has eros been abandoned as a philosophic topic, and what does this abandoning imply about the erotically grounded rhetoric that Socrates practiced and defended?To make matters worse, Socrates himself dismisses the palinode as a serious effort. He characterizes the speech as little more than a pleasant game, one that is not without value only because "these two certain forms (of gathering and dividing) were stated by chance" (265c). Far from viewing the palinode as possessing philosophical significance, Socrates appears to value it principally for its being a so-so example of a work of rhetoric that has been shaped by dialectic. While it is hard not to take Socrates' dismissal of the seriousness of the speech as partially disingenuous (just prior to his dismissal, he refers to the palinode as serious and reverent [265b]), he also does seem to mean what he says. Whether he is being straightforward or ironic does not finally matter because in either case the problem that occupies him and Phaedrus in the first half has disappeared from the dialogue. And that creates a problem: for if the philosophic issues of the first half of the dialogue drop out, then the dialogue is not coherent.This incoherence is especially troubling given Socrates' explicit endorsement of coherence as an important rhetorical value. In fact, when he begins his... (shrink)

The distinction between the "permanent" (will not reverse) and "irreversible" (cannot reverse) cessation of functions is critical to understand the meaning of a determination of death using circulatory–respiratory tests. Physicians determining death test only for the permanent cessation of circulation and respiration because they know that irreversible cessation follows rapidly and inevitably once circulation no longer will restore itself spontaneously and will not be restored medically. Although most statutes of death stipulate irreversible cessation of circulatory and respiratory functions, the accepted (...) medical standard is their permanent cessation because permanence is a perfect surrogate indicator for irreversibility, and using it permits a more timely declaration. Therefore, patients properly declared dead in donation after circulatory death (DCD) protocols satisfy the requirements of death statutes and do not violate the dead donor rule. The acronym DCD should represent organ "donation after circulatory death" to clarify that the death standard is the permanent cessation of circulation, not heartbeat. Heart donation in DCD does not retroactively negate the donor's death determination because circulation has ceased permanently. (shrink)

Notwithstanding these wise pronouncements, my project here is to characterize the biological phenomenon of death of the higher animal species, such as vertebrates. My claim is that the formulation of “whole- brain death ” provides the most congruent map for our correct understanding of the concept of death. This essay builds upon the foundation my colleagues and I have laid since 1981 to characterize the concept of death and refine when this event occurs. Although our society's well-accepted program of multiple (...) organ procurement for transplantation requires the organ donor first to be dead, the concept of brain death is not merely a social contrivance to permit us to obtain the benefits of organ procurement. Rather, the concept of whole- brain death stands independently as the most accurate biological representation of the demise of the human organism. (shrink)

Mental health professionals rightfully experience significant anxiety regarding their duty to protect when working with potentially dangerous individuals. This work dispels myths and provides readers with a resource addressing the situations where a duty to protect may apply.

Among the old and new controversies over brain death, none is more fundamental than whether brain death is equivalent to the biological phenomenon of human death. Here, I defend this equivalency by offering a brief conceptual justification for this view of brain death, a subject that Andrew Huang and I recently analyzed elsewhere in greater detail. My defense of the concept of brain death has evolved since Bernard Gert, Charles Culver, and I first addressed it in 1981, a development that (...) paralleled advances in intensive care unit treatment. The century‐old concept of the organism as a whole provides the fundamental justification for the equivalency of brain death and human death. In our technological age, in which increasing numbers of components and systems of an organism can be kept alive, and for longer intervals, the permanent cessation of functioning of the organism as a whole is the phenomenon that best corresponds to its death. (shrink)

Over the past quarter century, organ donation after the circulatory determination of death (DCD) has grown in acceptance and prevalence throughout the world (Domínguez-Gil et al. 2021). Notwithstan...

I consider the role of cognitive modeling in cognitive science. Modeling, and the computers that enable it, are central to the field, but the role of modeling is often misunderstood. Models are not intended to capture fully the processes they attempt to elucidate. Rather, they are explorations of ideas about the nature of cognitive processes. In these explorations, simplification is essential—through simplification, the implications of the central ideas become more transparent. This is not to say that simplification has no downsides; (...) it does, and these are discussed. I then consider several contemporary frameworks for cognitive modeling, stressing the idea that each framework is useful in its own particular ways. Increases in computer power (by a factor of about 4 million) since 1958 have enabled new modeling paradigms to emerge, but these also depend on new ways of thinking. Will new paradigms emerge again with the next 1,000‐fold increase? (shrink)

Scepticism about ought simpliciter is the view that there is no such thing as what one ought simpliciter to do. Instead, practical deliberation is governed by a plurality of normative standpoints, each authoritative from their own perspective but none authoritative simpliciter. This paper aims to resist such scepticism. After setting out the challenge in general terms, I argue that scepticism can be resisted by rejecting a key assumption in the sceptic’s argument. This is the assumption that standpoint-relative ought judgments bring (...) with them a commitment to act in accordance with those judgments. Instead, I propose an alternative account of our normative concepts according to which only ought simpliciter judgments commit one to acting in accordance with those judgments. In addition to answering the sceptical challenge, the proposal offers an independently motivated account of what makes a concept normatively authoritative. (shrink)

Abstract:Disturbing cases continue to be published of patients declared brain dead who later were found to have a few intact brain functions. We address the reasons for the mismatch between the whole-brain criterion and brain death tests, and suggest solutions. Many of the cases result from diagnostic errors in brain death determination. Others probably result from a tiny amount of residual blood flow to the brain despite intracranial circulatory arrest. Strategies to lessen the mismatch include improving brain death determination training (...) for physicians, mandating a test showing complete intracranial circulatory arrest, or revising the whole-brain criterion. (shrink)

The concept of whole‐brain death is under attack again. Scholars are arguing that the concept of brain death per se—regardless of the focus on “higher,” “stem” or “whole”—is fundamentally flawed. These scholars have identified what they believe are serious discrepancies between the definition and criterion of brain death, and have pointed out that medical professionals and lay persons remain confused about its meaning. Yet whole‐brain death remains the standard for determining death in much of the Western world and its defenders (...) believe this concept best maps onto our everyday conception of death. (shrink)

Thomas Hurka has recently proposed a utilitarian theory which would effect a compromise between Average and Total utilitarianism, the better to deal with issues in population ethics. This Compromise theory would incorporate the principle that the value which an extra happy person contributes to a possible world is a decreasing function of the total population of that world: that happy people are of diminishing marginal value. In spite of its initial plausibility I argue against this principle. I show that the (...) Compromise theory is actually no improvement over the two original versions of utilitarianism; in particular, it is subject to almost all the objections which are fatal to Average utilitarianism, and more besides. And I attempt to dispell the appearance that intuition supports the Compromise theory as against Total utilitarianism, by arguing that the latter's Repugnant Conclusion, when properly understood, is not intuitively unacceptable. Total utilitarianism remains a plausible ethical theory, while both the Average and the Compromise theories should be definitely rejected. (shrink)

The study of human intelligence was once dominated by symbolic approaches, but over the last 30 years an alternative approach has arisen. Symbols and processes that operate on them are often seen today as approximate characterizations of the emergent consequences of sub- or nonsymbolic processes, and a wide range of constructs in cognitive science can be understood as emergents. These include representational constructs (units, structures, rules), architectural constructs (central executive, declarative memory), and developmental processes and outcomes (stages, sensitive periods, neurocognitive (...) modules, developmental disorders). The greatest achievements of human cognition may be largely emergent phenomena. It remains a challenge for the future to learn more about how these greatest achievements arise and to emulate them in artificial systems. (shrink)

Nair-Collins and Joffe (2023) highlighted the noncongruence between the language of the Uniform Determination of Death Act (UDDA) and the accepted brain death bedside testing standard by showing th...

The overall purpose of this paper is to clarify the physical meaning and epistemological status of the term 'measurement' as used in quantum theory. After a review of the essential logical structure of quantum physics, Part I presents interpretive discussions contrasting the quantal concepts observable and ensemble with their classical ancestors along the lines of Margenau's latency theory. Against this background various popular ideas concerning the nature of quantum measurement are critically surveyed. The analysis reveals that, in addition to internal (...) mathematical difficulties, all the so-called quantum theories of measurement are grounded in unjustifiable, classical presuppositions. (shrink)

The relationship between emotional arousal and long-term memory is addressed in two experiments in which subjects viewed either a relatively emotionally neutral short story or a closely matched but more emotionally arousing story and were tested for retention of the story 2 weeks later. Experiment 1 provides essential replication of the results of Heuer and Reisberg and illustrates the common interpretive problem posed by the use of different stimuli in the neutral versus emotional stories. In Experiment 2, identical slides were (...) used in both the neutral and arousal stores. Two different stories were created by varying the narration that accompanied each slide. In both experiments, subjects who viewed the arousal story both experienced a greater emotional reaction to the story than did the subjects who viewed the neutral story, and subsequently exhibited enhanced memory for the story. Subjects in Experiment 2 who viewed the arousal story also recalled more slides than did the subjects who viewed the neutral story. This effect was greatest for story phase 2, the phase in which the emotional slide narration occurred. Because this enhanced retention of the story slides cannot be explained by any differences in the slides themselves, the results provide new evidence to support the contention that emotional arousal influences long-term memory in normal human subjects. (shrink)

Ariane Lewis provided an insightful review of several controversial cases of death by neurologic criteria (“brain death”) in the UK, focusing on Archie Battersbee, a boy whose tragic illness provok...

Among the collective as well as individual responsibilities of nurses as professionals is that of maintaining and improving the quality of nursing care. In exchange for monopoly status and professional authority to control nursing practice, the profession is charged with the responsibility of meeting the nursing care needs of the community. If one claims, as I do, that one of the collective responsibilities of nurses is maintenance of high nursing standards, we must examine what action is required of nurses who (...) find themselves in work contexts in which standards and practice are deficient. Specifically, is the strike weapon one that may or even ought to be used? In this essay, answers to the following two questions are advanced: (a) What conditions must obtain for it to be (morally) right for nurses in a particular health care facility to strike? (b) Does their collective responsibility with regard to nursing standards and practice ever entail that a group of nurses has a (moral) duty to strike? The essay concludes with a consideration of how one balances the collective responsibility to maintain and improve the quality of nursing care with an individual nurse's responsibility to her/his own patients. CiteULike Connotea Del.icio.us What's this? (shrink)

Abstractabstract:The disclosure of the Name of God in Exodus 3 as YHWH has had a long history of effects in Christian tradition. The Name (YHWH) is based on ancient Hebraic notions of Being and figures prominently in the development of Christian ontotheology. Exodus 3 also figures prominently in current debates about ontotheology. This essay seeks to contribute to the discussion of ontotheology by interpreting Exodus 3 and the theology of the Name of God in light of Pure Land Buddhist teachings (...) and practices regarding the Name of the Buddha understood as the nembutsu. The nembutsu, as developed in the teachings of Shinran and Tan Luan, will be placed in comparison with various readings of Exodus 3, including Talmudic and modern Jewish readings of this text. The work of comparison leads to affirmations of both similarity and differences, most notably Christian faith, understood as obedience to divine command, and shinjin, understood as the mind of Amida Buddha arising in the practitioner of the nembutsu. (shrink)