For decades, the discussion on children’s competence to consent to medical issues has concentrated around normative concerns, with little progress in clinical practices. Decision-making competence is an important condition in the informed consent model. In pediatrics, clinicians need to strike a proper balance in order to both protect children’s interests when they are not fully able to do so themselves and to respect their autonomy when they are. Children’s competence to consent, however, is currently not assessed in a standardized way. (...) Moreover, the correlation between competence to give informed consent and age in children has never been systematically investigated, nor do we know which factors exactly contribute to children’s competence. (shrink)

Although law is established on a strong presumption that persons younger than a certain age are not competent to consent, statutory age limits for asking children’s consent to clinical research differ widely internationally. From a clinical perspective, competence is assumed to involve many factors including the developmental stage, the influence of parents and peers, and life experience. We examined potential determining factors for children’s competence to consent to clinical research and to what extent they explain the variation in competence judgments.

BackgroundFor many decades, the debate on children’s competence to give informed consent in medical settings concentrated on ethical and legal aspects, with little empirical underpinnings. Recently, data from empirical research became available to advance the discussion. It was shown that children’s competence to consent to clinical research could be accurately assessed by the modified MacArthur Competence Assessment Tool for Clinical Research. Age limits for children to be deemed competent to decide on research participation have been studied: generally children of 11.2 (...) years and above were decision-making competent, while children of 9.6 years and younger were not. Age was pointed out to be the key determining factor in children’s competence. In this article we reflect on policy implications of these findings, considering legal, ethical, developmental and clinical perspectives.DiscussionAlthough assessment of children’s competence has a normative character, ethics, law and clinical practice can benefit from research data. The findings may help to do justice to the capacities children possess and challenges they may face when deciding about treatment and research options. We discuss advantages and drawbacks of standardized competence assessment in children on a case-by-case basis compared to application of a fixed age limit, and conclude that a selective implementation of case-by-case competence assessment in specific populations is preferable. We recommend the implementation of age limits based on empirical evidence. Furthermore, we elaborate on a suitable model for informed consent involving children and parents that would do justice to developmental aspects of children and the specific characteristics of the parent-child dyad.SummaryPrevious research outcomes showed that children’s medical decision-making capacities could be operationalized into a standardized assessment instrument. Recommendations for policies include a dual consent procedure, including both child as well as parents, for children from the age of 12 until they reach majority. For children between 10 and 12 years of age, and in case of children older than 12 years in special research populations of mentally compromised patients, we suggest a case-by-case assessment of children’s competence to consent. Since such a dual consent procedure is fundamentally different from a procedure of parental permission and child assent, and would imply a considerable shift regarding some current legislations, practical implications are elaborated. (shrink)

ABSTRACTInitial evaluations generalise to new contexts, whereas counter-attitudinal evaluations are context-specific. Counter-attitudinal information may not change evaluations in new contexts beca...

The study examines the ontological similarity between the concept of competitor orientation and questionable intelligence-gathering efforts. Respondents from the hotel industry were surveyed with self-administered questionnaires. Exploratory factor analysis was carried out to identify the structure underlying variables of market orientation and ethical judgment on questionable intelligence-gathering efforts. The results suggest that the surveyed hotel managers are unable to distinguish the legitimate tactics of competitor orientation from the questionable practice of industrial espionage.

Pedro Abelardo desarrolla un pensamiento ético, poco cercano a la filosofía moral posterior, que se estructura con base en varios conceptos, entre ellos la razón y la subjetividad moral. El primero, como poder discursivo sobre la vida moral y como razonamiento moral. Al respecto de la subjetividad m..

Grace Lee Boggs (1915–2015) was a philosopher and activist influenced by Hegel, Marx, Malcolm X, Martin Luther King, Jr., and her collaborators C. L. R. James and Jimmy Boggs. During her long career, she inspired a generation of young thinker-activists to establish institutions and practices in Detroit to promote community and justice. The article gives an overview of her life and accomplishments, discusses the social and political philosophy set forth in her book The Next American Revolution: Sustainable Activism for (...) the Twenty-first Century, and reviews the documentary about her by director Grace Lee, American Revolutionary: The Evolution of Grace Lee Boggs. (shrink)

“Doctors cure and nurses care” was a phrase used to differentiate between medicine and nursing. Even though rhetorically we may well agree that doctors and nurses have their equal share in caring, literature on caring so far has been produced mainly from the perspective of nursing. Now there is a book containing 11 essays on caring written or coauthored by seven medical doctors, two nurses, four social scientists, and two philosophers. The impressive list of authors is headed by the editors (...) of the volume, Leighton Cluff (medical doctor and gerontologist) and Robert Binstock (political scientist and gerontologist). The volume includes authors who are well known scholars active in the field of medical ethics as well as clinicians and educators in various areas of health care facilities. The foreword by Rosalynn Carter, wife of ex President Jimmy Carter, gives the book its …. (shrink)

continent. 1.4 (2011): 240—241. “Pirogenetico, Pirogenetico”, 2009 Installation composée de deux tables en métal et trois blocs d’obsidienne et leur moulages. © Coll.Centre Pompidou / Distr. RMN I'm not so sure that art is so ambiguous. I just think it's not linguistic. It's more full and complex than language— we can experience it but not explain it. —Jimmie Durham(1) Jimmie Duraham is an American artist of Cherokee descent. He’s a visual artist and a political activist for the American Indian Movement. (...) Pirogenetico pirogenetico (2009) was recently installed at the Centre Pompidou as part of their “New Presentation of the Contemporary Collections.” His work is replete with wild ideas shaped by a sage, unpretentious impulse and an automatic responsibility to history, particularly his own Cherokee history. Confident from instability, and free from pedagogical language, he strings form and words together that sharply pierce the atmosphere of ideology. Durham doesn’t follow a line and he doesn’t depend on the scaffold of language, but the work makes a remarkable point. Pirogenetico, pirogenetico is a collection of three obsidian rocks, cut and then cast as a double in German silver. Each threesome sits on its own low metal table, forming a diptych. The cut of the original follows the shattering nature of obsidian, which Durham undercuts and monumentalizes in the double. The derivative double and its mannered original: they are nearly too beautiful but still can’t deny the violence. If Durham’s irony, his edge, is obscured by the volume of his forms, it’s reactivated in a video on the adjacent wall where the obsidian cuts through a heart organ. Durham’s syntax is spare. He knows that language isn’t big enough to tell the story, reminding us, as Lacan stated, “I always speak the truth. Not the whole truth... because saying it all is impossible: words fail.”(2) In place of language Durham uses an alternative accuracy that compounds history with the present, a mashup of material things, a collision of aesthetics that shakes down conventional wisdom, replacing it with searing poetry. NOTES (1) Heyokamagazine. “ Jimmie Durham: The Pursuit of Happiness .” (2) Lacan, Jacques. Television: A Challenge to the Psychoanalytic Establishment . Ed. Joan Copjec. Trans. Dennis Hollier, Rosalind Kraus, and Annette Michelson. (New York: Norton, 1990). p. 18. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Wildman's Effing Theodicy:The Problem of Suffering, the Ground of Being, and the Worship of SuchnessDemian Wheeler (bio)I. Confronting Suffering: Fictional Gods, Monstrous Evils, and Ghostly WhisperersWesley J. Wildman—"the comparing inquirer,"1 "the man who receives too many emails,"2 "the most original, audacious, creative, encyclopedic, and integrative thinker working within and across the fields of philosophy, ethics, theology, and the scientific study of religion in our time"3—is now a novelist! His (...) recently published first novel, The Winding Way Home, is an astounding and achingly beautiful story about a family searching for healing in the face of unspeakable tragedy and crushing grief. Our protagonist is Jesse, a strangely familiar philosopher, polymath, and professor, whose six-year-old daughter, Becca, is abducted from her bedroom in the middle of the night. Needless to say, Becca's disappearance totally shatters the lives of Jesse, his beloved partner Alexandra, and their two boys, Matt and Josh.On the verge of a complete mental breakdown, and desperate to manage the anxiety, uncertainty, terror, and encroaching despair, Jesse begins to engage in a severe form of meditation, deliberately dwelling on images of what Becca might be enduring, however gruesome and devastating. He pictures her dead in the woods, sold to the highest bidder, imprisoned in an attic, abused physically and sexually, buried alive in a crate desperately praying to be rescued, treating each possible future "as a shard-like perspective on a fear-inducing, darkly humming [End Page 20] crystalline monstrosity." For Jesse, this visualization practice is an act of solidarity, not masochism, a way to love his precious little girl as she really is, no matter what she went through or is still going through. Anything less feels like a betrayal, like a "spineless retreat from the reality of Becca's life." Facing the brutal truth about Becca also becomes an integral part of his piety, his worship. As the saga unfolds, Jesse embarks on a weird but wild spiritual quest, a quest to see and surrender to the world in all its wonder and ambiguity, grace and threat, the world that gave him the greatest gift imaginable, Becca, a "beautiful, perfect little being," only to take her away and hand her over to a fate worse than death.4Later in the story, Jesse and Alexandra become foster parents to an abduction survivor named Maddy. Their worst nightmares about what probably happened to Becca actually did happen to Maddy. Stolen from her family at a young age and chained up in a cold, lonely basement, Maddy was subjected to years of torture, malnourishment, deprivation, disease, and rape, forced to bear the children of her captors. Shortly after Maddy and her kids move in, Jesse schedules a meeting with Father Jimmy, "his favorite delusional priest." Jesse admires and appreciates Father Jimmy's intelligence, lovingkindness, and nonjudgmental nature. But he is not bashful about challenging his "supernatural mumbo-jumbo."5 On this particular occasion, they gather to talk about the theological implications of Maddy's horrific life and whatever unthinkable horrors befell Becca. The conversation gets quite heated. Growing increasingly irate, Jesse asks Father Jimmy if he prays for Maddy, Becca, and other missing children and trusts in a God who permits their dreadful circumstances and could do something to ameliorate them. Father Jimmy nods in the affirmative and gently asks a question of his own: "Why would you be angry at a God you don't believe in?" Jesse thunders back:I'm not angry at your fictional God! … I'm angry at you. You worship and pray to a being who allowed Becca and Maddy to be raped and tortured, and in Becca's case probably murdered. And then you offer solace to me and my family in the form of prayers to change this deity's mind about what to do. As if that's supposed to make any of us feel better! Can't you see? You're commending to me a God whose behavior and decisions are so utterly appalling, so completely opposed to the good as I understand it, that I would devote my life to morally resisting this God's depravity... (shrink)

If it were followed by “I’m a president,” Richard Nixon’s televised denial (“I am not a crook”) would be tantamount to Jimmy McGill’s self-portrayal in Better Call Saul. Out of the crooked timber of humanity, an honest president or an ethical lawyer rarely emerges. They’re like needles in a haystack. Nevertheless, it’s worthwhile to search for these rare artifacts and, in the process, ask, “Why do so many lawyers (and presidents) fall from grace, transforming into morally bad or corrupt (...) actors?” The ability to be a good or ethical person can deteriorate over time. In their personal and professional lives, people can make consistently poor choices in their capacity as moral agents. In turn, they cultivate flawed habits or what are often referred to as vices. Jimmy McGill’s trajectory is, without a doubt, a harrowing story of moral decline. In some ways, his transformation into Saul Goodman resembles a trite story about how a profession, lawyering, corrupts its practitioners. On a deeper level, McGill’s journey involves a fundamental change in how he habitually interacts with his environment, a change of motivation and disposition that is, almost entirely, a change for the worse. To know the content of Jimmy’s character is to be familiar with his story, a story of moral decline and ethical failure. (shrink)

In this eleventh book of scilogs – called in-turns and out-turns –, one may find new and old questions and solutions, referring mostly to topics on Neutrosophy, but also Multispace, with miscellaneous addition of topics on Physics, Mathematics, or Sociology – email messages to research colleagues, or replies, notes about authors, articles, or books, spontaneous ideas, and so on. -/- Exchanging ideas with Prem Kumar Singh, Feng Liu, Nicolae Bălașa, Jimmy Quellet, Minodora Rușchița, Frank Gelli, A. R. Vătuiu, Victor (...) Christianto, Vladimir I. Rogozhin, Robert Neil Boyd, Akira Kanda, Stefan Spaarmann, Oliver Consa, Yabin Shao, Junle Zhuo, Nivetha Martin, Said Broumi, Jean Dezert, Erick González, Tomasz Witczak, B. De Baets, I. Couso, D. Dubois, L. Good, Mihaela Colhon, Atiqe Ur Rahman, Muhammad Saeed, Muhammad Ihsan, Edeline Nancy, Shawkat Alkhazaleh, Shazia Rana, Vasantha Kandasamy, Santanu Acharjee, Mohamed Al-Shmrani, Parimala Manie, Mehmet Unver, Murat Olgun, Adel Aleidhri, Akira Kanda, Ilanthenral Kandasamy, Mircea Zărnescu, R. Tayebi Khorami, Arsham Borumand Saeid, Maisam Jdid, M. Abobala, Riad Hamido, Rafael Rojas, Esmaeil Zarei, Faisal Khan, Rouzbeh Abbassi, Adel Al-Odhari, Henry Garrett, Ackbar Rezaei, Saeid Jafari, Karthika Muthusamy, Harish Garg, Huda E. Khalid, Gonca D. Güngör, Muslim A. Noah Zainal, Fakhry Asad Agusfrianto, Madeleine Al-Tahan, Mariam Hariri, Yudi Mahatma, Masoud Ghods, Marco Brigliadori, Luis Enrique Aponte Pérez, Amr Mohammed, M. Aslam (in order of reference in the book). (shrink)

In Roper v. Simmons (2005) the United States Supreme Court announced a paradigm shift in jurisprudence. Drawing specifically on mounting scientific evidence that adolescents are qualitatively different from adults in their decision-making capacities, the Supreme Court recognized that adolescents are not adults in all but age. The Court concluded that the overwhelming weight of the psychological and neurophysiological data regarding brain maturation supports the conclusion that adolescents are qualitatively different types of agents than adult persons. The Supreme Court further solidified (...) its position regarding adolescents as less than fully mature and responsible decisionmakers in Graham v. Florida (2010) and Miller v. Alabama (2012). In each case, the Court concluded that the scientific evidence does not support the conclusion that children under 18 years of age possess adult capacities for personal agency, rationality, and mature choice. This study explores the implications of the Supreme Court decisions in Roper v. Simmons, Graham v. Florida, and Miller v. Alabama for the “mature minor” standard for medical decision making. It argues that the Supreme Court’s holdings in Roper, Graham, and Miller require no less than a radical reassessment of how healthcare institutions, courts of law, and public policy are obliged to regard minors as medical decisionmakers. The “mature minor” standard for medical decision making must be abandoned. (shrink)

This collection addresses a post-WWII shift in the hierarchy of scientific explanations, where the highest goal moves from reductionism towards some ...

M. F. Burnyeat taught for 14 years in the Philosophy Department of University College London, then for 18 years in the Classics Faculty at Cambridge, 12 of them as the Laurence Professor of Ancient Philosophy, before migrating to Oxford in 1996 to become a Senior Research Fellow in Philosophy at All Souls College. The studies, articles and reviews collected in these two volumes of Explorations in Ancient and Modern Philosophy were all written, and all but two published, before that decisive (...) change. Whether designed for a scholarly audience or for a wider public, they range from the Presocratics to Augustine, from Descartes and Bishop Berkeley to Wittgenstein and G. E. Moore. Their subject-matter falls under four main headings: 'Logic and Dialectic' and 'Scepticism Ancient and Modern', which make up the first volume, with 'Knowledge' and 'Philosophy and the Good Life' contained in this, the second volume. The title 'Explorations' well expresses Burnyeat's ability to discover new aspects of familiar texts, new ways of solving old problems. In his hands the history of philosophy becomes itself a philosophical activity. (shrink)

In this paper we first give a survey of reductive cut-elimination methods in classical logic. In particular we describe the methods of Gentzen and Schütte-Tait from the abstract point of view of proof reduction. We also present the method CERES which we classify as a semi-semantic method. In a further section we describe the so-called semantic methods. In the second part of the paper we carry the proof analysis further by generalizing the CERES method to CERESD . In the generalized (...) version CERESD we admit general elimination rules which are based on the mere semantical truth of sentences. We construct complete cut-free LK-derivations originating from derivations potentially containing unproven lemmas. Finally we give a comparison of reductive methods and CERESD by presenting a general simulation result. (shrink)

The medieval Islamic philosophers held a certain conception of the divine unity that assumes the necessary existent to be both one and simple. The oneness of the necessary existent meant that it is the only necessary existent and its simplicity meant that it admits no composition whatsoever – it is pure essence and its essence is necessary existence. In The Incoherence of the Philosophers al-Ġazālī presents, with elaboration, an exposition of the philosophers' conception of the divine unity, several arguments for (...) its two components, and his critique of these arguments. In this paper I focus on six of the arguments attributed to the philosophers. Following the textual evidence, I reconstruct these arguments and offer two possible interpretations of them. The first interpretation, which I call the many-argument interpretation, sees one of the arguments as employing the simplicity of the necessary existent to establish its oneness and the other five arguments as invoking oneness to establish simplicity. The second interpretation, which I call the one-argument interpretation, doesn't offer a new reading for the first argument but sees the other five arguments as defending the simplicity of the necessary existent based on its basic concept. I argue for the superiority of the one-argument interpretation. Résumé Les philosophes de l'Islam classique ont une doctrine de l'unité divine selon laquelle l'existant nécessaire est à la fois unique et simple. Son unicité signifie qu'il est le seul existant nécessaire, sa simplicité qu'il n'admet aucune sorte de composition; il est pure essence et son essence est existence nécessaire. Dans la Destruction des Philosophes, al-Ġazālī présente avec force détails un exposé de la doctrine de l'unité divine des philosophes, plusieurs arguments en faveur de ses deux composantes, ainsi que sa critique de ces arguments. Je me concentre ici sur six des arguments qu'il attribue aux philosophes. En suivant les données textuelles, je reconstruis ces arguments et en propose deux interprétations possibles. La première, que j'appelle l'interprétation “à arguments multiples”, identifie l'un des arguments comme s'appuyant sur la simplicité de l'existant nécessaire pour établir son unicité, et les cinq autres comme s'appuyant sur son unicité pour établir sa simplicité. La seconde, que j'appelle l'interprétation “à argument unique”, conserve la première lecture du premier argument mais voit dans les cinq autres une défense de la simplicité de l'existant nécessaire fondée sur sa notion fondamentale. J'argumente en faveur de la supériorité de l'interprétation “à argument unique”. (shrink)

Next SectionCultural differences in end-of-life care and the moral disagreements these sometimes give rise to have been well documented. Even so, cultural considerations relevant to end-of-life care remain poorly understood, poorly guided, and poorly resourced in health care domains. Although there has been a strong emphasis in recent years on making policy commitments to patient-centred care and respecting patient choices, persons whose minority cultural worldviews do not fit with the worldviews supported by the conventional principles of western bioethics face a (...) perpetual struggle in getting their care needs met in a meaningful, safe, and healing way. In this essay, attention is given to exploring why cultural differences exist, why they matter, and how health care providers should treat them in order to reduce the incidence and impact of otherwise preventable harmful moral outcomes in end-of-life care. In addressing these questions, a novel application of the renowned terror management theory will be made. (shrink)

Dissociative style is mostly studied as a risk factor for dissociative pathology, but it may also reflect a fundamental characteristic of healthy information processing. Due to the close link between attention and working memory and the previous finding of enhanced attentional abilities with a high dissociative style, a positive relationship was also expected between dissociative style and verbal working memory span. In a sample of 119 psychology students, it was found that the verbal span of the high-dissociative group was about (...) half a word larger than of the medium and low-dissociative groups. It is suggested that dissociative style may be one of only very few individual differences that is directly relevant to consciousness research. (shrink)

There is an ancient and ambiguous philosophical doctrine that perception is passive. This can mean that the mind contributes nothing to the content of our sensory experience: its power of perception is a mere receptivity. In this sense the principle has often been questioned, and is indeed doubtful on empirical grounds, given one reasonable interpretation of what it would be for the mind to make such a contribution.

Television medical dramas sometimes depict medical professionalism and bioethical issues, but their nature and extent are unclear. The authors systematically analysed the bioethical and professionalism content of one season each of Grey's Anatomy and House M.D., two of the most popular current television medical dramas. The results indicate that these programmes are rife with powerful portrayals of bioethical issues and egregious deviations from the norms of professionalism and contain exemplary depictions of professionalism to a much lesser degree.