This paper is aimed at assessing how power, control, and resistance come into play and how resistance counteracts power and control in police investigative interviewing. Considering that the Philippines was once a colony of the United States, it is essential to compare the two samples as the Philippine legal system is highly patterned after the American jurisprudence (Mercullo in JForensicRes 11:1–4, 2020). Highlighting the existing and emerging power relations between the police interviewer and the interviewee, the study employed Sacks, Schegloff, (...) and Jefferson’s ( Recuenco, A. (2022). Cops to undergo investigation retraining to improve conviction rate. Manila Bulletin. https://mb.com.ph/2022/07/21/cops-to-undergo-investigation-retraining-to-improve-conviction-rate/ ) Conversation Analysis (CA) and Fairclough’s (Ehrlich in Coulthard and Johnson (eds), The Routledge Handbook of Forensic Linguistics, Routledge, 2010) Critical Language Studies (CLS) as general frameworks. A total of 10 Philippine and American police interviews were examined. While the Philippine corpus was obtained from the Pasay City Police Station, Metro Manila, the American corpus was culled from forensicling.com, an open-access website containing forensic linguistic data. Findings revealed that power and control were employed by the police in both contexts with 109 evidential markers (50.7%) and 2,443 representative speech acts (63.3%) having the highest frequency of occurrence. What is striking is the fact that police officers in both Philippine and American contexts show power and control in their utterances to be able to achieve the goal of police interviewing, that is, to gather information and elicit voluntary responses from the interviewees. Through this study, it is hoped that interviewers will be able to explore a better system of the questioning process that may lead the interviewees to cooperate more with them and arrive at a more accurate information. (shrink)

Theoretical debates around the concept of self-deception revolve around identifying the conditions for a behavior to qualify as self-deception. Experiments 1 and 2 revealed that various candidate features—such as intent, belief change, and motive—are treated as sufficient, but non-necessary, conditions according to the lay concept of self-deception. This led us to ask whether there are multiple lay concepts, such that different participants endorse competing theories (the disagreement view), or whether individual participants assign partial weight to various features and consequently waver (...) in cases of middling similarity (the conflict view). In Experiment 3, by-participant regression models uncovered that most participants additively consider multiple characteristics of the prototype of self-deception, while only a minority of participants treat a characteristic (or a combination thereof) as necessary and sufficient. In sum, by disambiguating interpersonal disagreement and intrapersonal conflict in a within-subjects design, the present experiments indicate that the lay concept may primarily exhibit a prototype structure. In closing, we suggest that future research deploying this method may help to explain why experimental research on philosophical concepts often engenders partial support for competing theories. (shrink)

Many bioliberals endorse broadly consequentialist frameworks in normative ethics, implying that a progressive stance on matters of bioethical controversy could stem from outcome-based reasoning. This raises an intriguing empirical prediction: encouraging outcome-based reflection could yield a shift toward bioliberal views among nonexperts as well. To evaluate this hypothesis, we identified empirical premises that underlie moral disagreements on seven divisive issues (e.g., vaccines, abortion, or genetically modified organisms). In exploratory and confirmatory experiments, we assessed whether people spontaneously engage in outcome-based reasoning (...) by asking how their moral views change after momentarily reflecting on the underlying empirical questions. Our findings indicate that momentary reflection had no overall treatment effect on the central tendency or the dispersion in moral attitudes when compared to prereflection measures collected 1 week prior. Autoregressive models provided evidence that participants engaged in consequentialist moral reasoning, but this self-guided reflection produced neither moral “progress” (shifts in the distributions’ central tendency) nor moral “consensus” (reductions in their dispersion). These results imply that flexibility in people's search for empirical answers may limit the potential for outcome-based reflection to foster moral consensus. (shrink)

Studies show that research and development may not always benefit entrepreneurial firms. This paper focuses on the double-edged effect of R&D activities on attracting institutional investment in entrepreneurial firms. Based on a panel dataset of 700 listed entrepreneurial firms in ChiNext, we document: an inverted-U relationship between R&D intensity and future institutional investment, which we argue is evidence that institutional investors are concerned about R&D overinvestment; an inverted-U relationship between R&D capitalization and future institutional investment, which we argue shows suspicion (...) of the institutional investors towards high R&D capitalization. Furthermore, by splitting institutional investors into venture capitals and non-venture capitals, we confirm that VCs have higher acceptance of both R&D intensity and capitalization as VCs have more expertise to alleviate a certain level of risks. (shrink)

Quel bon vent, quel joli vent, ma vie m’appelle, ma vie m’attend French folk song 1. Presentists and Growing Block theorists appeal to ‘powerful intuitions’ when they defend their respective conceptions of time . Eternalists are prepared to go some length towards ‘reconciling’ the view from nowhen with at least some of these intuitions, or try to explain them away . Unaided intuitions may in fact underdetermine any particular metaphysical choice. One set of intuitions about time seems to have been (...) neglected, though, in spite of its power. These intuitions are the mirror image of those supporting the Growing Block theory , and they are modelled on a pre-reflective understanding of our own life. According to the intuitions, only the future and the present are real; the past isn’t. The present is the constantly eroding edge of the future, which thus shrinks incessantly. There is less and less future as the present proceeds. The obvious intuitive model of this view of time is our life; from which every day eats up a little bit. Smaller scale models are available in everyday life. As you are reading this text, you have less and less to read. You know it. You know that at some point you’ll finish, or stop, reading it. But a model is not enough to make a grand philosophical claim, and indeed the very existence of the model is the ground for a negative claim: a picture, it may be said, is holding you captive. The Future Shrinker has two tasks. The first is to show that the intuitive picture supporting the claim is robust and does not make implausible epistemological claims. The second task is to show that her theory is at least compatible with scientific lore, and at best a good way …. (shrink)

El propósito de esta investigación es hacer una relectura histórico-crítica de la Ética de la Liberación como ética de la vida. Este planteamiento se hace desde la memoria política crítica que permitirá ver la influencia que ella ha tenido con otras éticas que hoy pueden agruparse en torno al concepto de convivencia: la ética intercultural, la ética ecológica, la ética de la economía solidaria, la ética de una ciencia construida socialmente y de una tecnología al servicio de las personas, (...) la ética educativa como expresión de apertura y diálogo y no como adoctrinamiento, la ética religiosa separada de todo fanatismo, la ética civil más allá de todo militarismo, la ética del género más allá de toda exclusión. Lo que implica la necesidad de consolidar una ética de la convivencia, como eje central de la cultura y de la vida de los habitantes de América Latina que no es sólo necesario estudiar sino practicar. (shrink)

Cognitive diagnostic models show great promise in language assessment for providing rich diagnostic information. The lack of a full understanding of second language listening subskills made model selection difficult. In search of optimal CDM that could provide a better understanding of L2 listening subskills and facilitate accurate classification, this study carried a two-layer model selection. At the test level, A-CDM, LLM, and R-RUM had an acceptable and comparable model fit, suggesting mixed inter-attribute relationships of L2 listening subskills. At the item (...) level, Mixed-CDMs were selected and confirmed the existence of mixed relationships. Mixed-CDMs had better model and person fit than G-DNIA. In addition to statistical approaches, the content analysis provided theoretical evidence to confirm and amend the item-level CDMs. It was found that semantic completeness pertaining to the attributes and item features may influence the attribute relationships. Inexplicable attribute conflicts could be a signal of suboptimal model choice. Sample size and the number of multi-attribute items should be taken into account in L2 listening cognitive diagnostic modeling studies. This study provides useful insights into the model selection and the underlying cognitive process for L2 listening tests. (shrink)

Background: Notwithstanding near-universal agreement on the theoretical importance of truthfulness, empirical research has documented gaps between ethical norms and physician behaviors. Although prior research has explored situations in which physicians may not be truthful with patients, it has focused on contexts within specialty practice. In this article, we report on a qualitative study of truthfulness in primary care. Methods: We conducted a qualitative study during December 2014–March 2015 involving both focus groups and in-depth, semistructured interviews with 32 primary care physicians (...) from the Boston, MA, and Baltimore, MD, metro areas in three specialties: internal medicine, family practice, and pediatrics. Interviews and focus groups were led using a semistructured guide, which explored situations in which primary care physicians find it difficult to be honest with patients; factors shaping truthfulness; and rationales for truthful and untruthful communication. Results: While physicians described outright lying to patients as rare, other deviations from truthfulness were not uncommon, including slanting and deliberately withholding information. Physicians described a range of factors as influencing truthfulness, from patient-level characteristics such as educational background to societal considerations including avoiding unnecessary tests and procedures. Physicians described truthfulness as an ethical requirement, deviations from which required further justification. Perceived justifications included promoting patient well-being and avoiding harm. Conclusions: Our results suggest a potential need to augment opportunities for training in “everyday ethics” challenges, such as the appropriateness of deception in response to patient requests for inappropriate tests or pain medications. Furthermore, they indicate that, in various circumstances encountered in primary care, physicians perceive other moral duties as potentially in conflict with the duty of truthfulness. Further ethical analysis should focus on identifying when deviations from complete truthfulness do and do not serve patients' interests, to guide physicians in striking a reasonable balance among principles of medical ethics that may conflict with one another. (shrink)

En este trabajo realizo un examen crítico del reciente libro de Silvana Gabriela Di Camillo sobre la crítica de Aristóteles a la teoría platónica de las Ideas. El libro de Di Camillo es un trabajo muy serio cuya lectura recomiendo ampliamente. Sin embargo, considero que cuatro de las principales tesis que la autora defiende tienen varias dificultades y mi objetivo aquí es presentar argumentos detallados en contra de ellas: la interpretación de la distinción entre argumentos más y menos rigurosos del (...) tratado Sobre las Ideas; la tesis de que la separación es el blanco esencial de las críticas aristotélicas a las Ideas; la interpretación de las opciones que Platón tiene para responder al argumento del tercer hombre, y la tesis de que la separación de las Ideas debe entenderse como homonimia. In this paper I examine Silvana Gabriela Di Camillo's recent book on Aristotle's criticisms of Plato's theory of Ideas. Di Camillo's book is a very serious work that I highly recommend. Nevertheless, I consider that four of the main theses that the author defends face several difficulties and my aim here is to offer detailed arguments against them: the interpretation of the distinction between more and less accurate arguments of the treatise On Ideas; the thesis that separation is the essential target of Aristotle's criticisms against Plato's Ideas; the interpretation of the options available to Plato to reply to the third man argument; and the thesis that the separation of Ideas should be understood as homonymy. (shrink)

Background: Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. Objective: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to (...) study the determinant factors of moral distress and spiritual well-being in nurses. Research design: A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. Ethical considerations: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. Findings: Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress ( r = −.053, p =.462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. Discussion and conclusion: This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and spiritual well-being. (shrink)

RESUMEN: El presente texto pretende analizar la sociedad actual. En ella la tecnociencia tiene una presencia importante y ésta, a su vez, no es muy diferente con respecto a las demandas intelectuales, culturales y sociales del Barroco. Es decir, en la sociedad actual podríamos decir que sucede lo mismo, interesa más obtener resultados, que se nos asombre, más que comprender el cómo funciona o se realizan. Si bien, como aconteció en el Barroco, sectores de la sociedad emprendieron acciones para (...) dotar de más identidad y cultura a la sociedad e ir en contra de lo institucionalmente establecido. La sociedad actual, se puede decir que es una prolongación del barroco, y nos encontramos en el neobarroco. Este al igual que en el pasado se rebela contra el sistema que sólo está preocupado por la acumulación de dinero, así como contra la ausencia de libertad y, por tanto, contra la represión y la violencia institucionalizada. En definitiva, con este artículo se trata de dar una visión desde la hermenéutica de las similitudes del Barroco con nuestra sociedad actual. ABSTRACT: This paper aims to analyze current society, where techno-science has a major presence while at the same time not differing greatly from that of the Baroque era with respect to intellectual, cultural, and social demands. As in the Baroque era, we are today more interested in getting results than in understanding how things works or how things are done. Also as in the Baroque era, sectors of society are taking action to encourage more identity and culture in society and are going against what is institutionally established. Today we can say that our society is an extension of the Baroque, and that we are in the neo-Baroque era. As in the past, there is now a rebellion against a system that is only concerned with the accumulation of money, as well as a rebellion against the lack of freedom and therefore against repression and institutionalized violence. In short, this article aims to present, from the point of view of hermeneutics, similarities between our current society and that of the Baroque era. (shrink)

BackgroundThe Basal ganglia (BG) played a crucial role in the brain-level mechanisms of chronic pain disorders. However, the functional changes of BG in chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) are still poorly understood. This study investigated the BG subregions’ resting-state functional connectivity (rs-FC) in CP/CPPS patients compared with healthy controls.MethodsTwenty eight patients with CP/CPPS and 28 age- and education-matched healthy males underwent clinical measurements and 3T brain MR imaging, including T1-weighted structural images and resting-state functional imaging. The data were analyzed (...) by the seeded-based rs-FC analysis. Then, a machine learning method was applied to assess the feasibility of detecting CP/CPPS patients through the changed rs-FC.ResultsCompared with healthy males, patients presented decreased rs-FC between the BG subregions and right middle cingulate cortex, and correlated with pain (r = 0.51, p-uncorrected = 0.005) and urinary symptoms (r = –0.4, p-uncorrected = 0.034). The left superior temporal gyrus and right supramarginal gyrus showed decreased rs-FC with the BG subregions as well. The area under the receiver operating characteristic curve of 0.943 (accuracy = 80%, F1-score = 80.6%) was achieved for the classification of CP/CPPS patients and healthy males with support vector machine (SVM) based on the changed rs-FC.ConclusionThese findings provide evidence of altered BG subregions’ rs-FC in CP/CPPS, which may contribute to our understanding of the BG’s role in CP/CPPS. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:To Shape a New World: Essays on the Political Philosophy of Martin Luther King, Jr. ed. by Tommie Shelby and Brandon M. TerryErin R. PinedaTommie Shelby and Brandon M. Terry, editors. To Shape a New World: Essays on the Political Philosophy of Martin Luther King, Jr. Cambridge, MA: Harvard University Press, 2020. Pp. 464. Paperback, $20.00.In the summer of 2020, as cities across the globe erupted in protest (...) after the murder of George Floyd, references to Martin Luther King, Jr. abounded: while a familiar cast of politicians evoked his memory to scold riotous protestors, others issued King's rejoinder that "the riot is the language of the unheard" (King, "The Other America," 1967). Many such invocations no doubt smacked of the "ritual celebration" and "intellectual marginalization" [End Page 339] that, as Tommie Shelby and Brandon M. Terry observe, have long marked King's reception as a political thinker (2). But in another sense, the seemingly inevitable return to King points to the significant stakes of taking his thought seriously and the political danger of laying claim to interpretive mastery. Struggles over King's legacy and the terms of his thought are not just about King but form part of the discursive terrain on which struggles over the demands of racial justice and the means of transformative collective action are waged.Shelby and Terry's ambitious, illuminating volume, To Shape a New World, first published in 2018 (timed to mark the fiftieth anniversary of King's assassination) and released as paperback in 2020 (amidst the George Floyd uprisings), invites us to take King seriously in just this sense: with an acute sensitivity to the stakes and an embrace of an interpretive pluralism that refuses the certainty of a singular, definitive reading. The collection facilitates rigorous engagement with King's thought in its own time and place but also presses the question of what we ought to do with it in this current "age of impunity and mendacity," standing amid the "unraveling" edges of "American empire," as Cornel West puts it (331). In posing and answering this question across its fifteen essays, the collection seeks to do justice to King as both a political philosopher and a political activist—a religious and political thinker whose philosophies were worked out not only behind the pulpit or within the academy, but also (and perhaps primarily) in concert with others on the field of political action. Indeed, one of its primary contributions is to challenge mainstream presumptions about what counts as political philosophy—its boundaries as a genre as well as the spaces where we imagine political philosophizing to happen and the figures we position as its primary producers.The volume is organized into four sections. The first, "Traditions," is devoted to exploring some of King's diverse intellectual influences. Here, the emphasis is less on making the case for particular traditions as the essential ones, and more on exploring the use of different interpretive lenses for shedding new light on his ideas. Three essays put King in context with thinkers he directly engaged: Robert Gooding-Williams places him in conversation with W. E. B. Du Bois and Booker T. Washington to reveal the structure of King's account of dignity amid the constraints of racial injustice; Bernard Boxill shows how King's theory of civil disobedience builds on—and collectivizes—Frederick Douglass's account of comparative freedom; and Karuna Mantena explores the theory of nonviolent action that King, through figures like Benjamin Mays and Howard Thurman, adopted and adapted from Gandhi. In contrast, Paul Taylor argues that we should read King in the company of moral perfectionists Stanley Cavell and Christopher Lebron—as showing us how practices of self-criticism, self-transformation, and experimentation enable "citizens to remain dissatisfied with things as they stand" while remaining "open to the possibility that justice will require reconstructing both society and the self" (41).In the next section, contributors turn their attention to King's "Ideals"—the ethical and political imperatives that shape the ends and means of the struggle for a new world. Like Mantena, Martha Nussbaum reads King alongside Gandhi to focus on King's insistence on channeling righteous... (shrink)

Common symptoms of multiple sclerosis (MS) include motor impairments of the lower extremities, particularly gait disturbances. Loss of balance and muscle weakness, representing some peripheral effects, have been shown to influence these symptoms, however, the individual role of cortical and subcortical structures in the central nervous system is still to be understood. Assessing [18F]fluorodeoxyglucose (FDG) uptake in the CNS can assess brain activity and is directly associated with regional neuronal activity. One potential modality to increase cortical excitability and improve motor (...) function in patients with MS (PwMS) is transcranial direct current stimulation (tDCS). However, tDCS group outcomes may not mirror individual subject responses, which impedes our knowledge of the pathophysiology and management of diseases like MS. Three PwMS randomly received both 3 mA tDCS and SHAM targeting the motor cortex (M1) that controls the more-affected leg for 20 min on separate days before walking on a treadmill. The radiotracer, FDG, was injected at minute two of the 20 min walk and the subjects underwent a Positron emission tomography (PET) scan immediately after the task. Differences in relative regional metabolism of areas under the tDCS anode and the basal ganglia were calculated and investigated. The results indicated diverse and individualized responses in regions under the anode and consistent increases in some basal ganglia areas (e.g., caudate nucleus). Thus, anodal tDCS targeting the M1 that controls the more-affected leg of PwMS might be capable of affecting remote subcortical regions and modulating the activity (motor, cognitive, and behavioral functions) of the circuitry connected to these regions. (shrink)

Az etika és esztétika tükrében tűnnek fel a korunkra jellemző társadalmi és kulturális jelenségek, hálózatok és diskurzusok, olvasva Márfai Molnár László - ahogy ő nevezi - alkalmazott filozófiai írásait. Az összeállításban összesen tizenegy esszé kapott helyet. Az első (Kockázati tőke és kreativitás) azt az ellentmondást elemzi, amely a tudás vélt időtlensége, stabilitása és a valóság múlékonysága között feszül. A folytatásban a szerző kísérletet tesz az elmúlt időszak új kommunikációs modelljének a továbbgondolására; vizsgálja a virtuális hálózatok társadalomra, lokális tudásra és "offline" (...) intézményekre gyakorolt hatását; kifejti meglátásait azokról az új antropológiai modellekről, amelyek hatási kimutatható a kortárs pedagógiában; illetve a korunkban radikálisan megváltozott fogyasztásfogalom lehetséges következményeit, ennek etikai vonatkozásait gondolja át. A kötet második felében olyanokról esik szó, mint az internethasználó és hálózati közösségek etikájának eredete, önálló értékrendjének kialakulása; az internetes bolhapiac sajátosságai, jellemzői; Marcel Duchamp tevékenységének újraértelmezése néhány kortársi elmélet segítségével; a "gender studies" világszerte érvényesülő tényezővé válásának a következményei; Simone Weil filozófiáján belül a modernség demokráciaelméletének és személyiségfogalmának "misztikus-anarchista" kritikája; valamint a túlélés és megértés antropológiai összefüggései. A kiadvány felsőoktatási és szakgyűjtemények anyaga. (shrink)

El trabajo realiza un recorrido panorámico por las investigaciones axiológicas que su autor, José Ramón Fabelo Corzo, ha desarrollado por más de cuarenta años y expone cómo el enfoque dialéctico-complejo ha sido siempre herramienta básica de las mismas. Con ese fin se abordan las tres etapas por las que ha atravesado esa trayectoria investigativa, los propósitos diferenciados de ellas y, en cada caso, el uso de la dialéctica y la complejidad para la obtención de los resultados fundamentales alcanzados. Entre esos (...) resultados cabe mencionar los siguientes: 1.- el estudio de los procesos de reproducción valorativa de la realidad; 2.- la propuesta de una teoría pluridimensional de los valores; 3.- el registro de las particularidades propias de una axiología estética; 4.- la fundamentación de la comprensión de la vida como criterio fundamental de lo valioso. (shrink)

The “therapeutic misconception” describes a process whereby research volunteers misinterpret the intentions of researchers and the nature of clinical research. This misinterpretation leads research volunteers to falsely attribute a therapeutic potential to clinical research, and compromises informed decision making, therefore compromising the ethical integrity of a clinical experiment. We review recent evidence from the neurobiology of social cognition to provide a novel framework for thinking about the therapeutic misconception. We argue that the neurobiology of social cognition should be considered in (...) any ethical analysis of how people make decisions about participating in clinical trials. The neurobiology of social cognition also suggests how the complicated dynamics of the doctor-patient relationship may unavoidably interfere with the process of obtaining informed consent. Following this argument we suggest new ways to prevent or at least mitigate the therapeutic misconception. (shrink)

On 9 May 2005, the Israeli Ministry of Health issued guidelines spelling out the conditions under which sex selection by preimplantation genetic diagnosis for social purposes is to be permitted in Israel. This article first reviews the available medical methods for sex selection, the preference for children of a specific gender in various societies and the ethical controversies surrounding PGD for medical and social purposes in different countries. It focuses then on the question of whether procreative liberty or parental responsibility (...) should be the centre of attention in this context. Finally, the article critically examines the new Israeli guidelines and their implications for the women undergoing the necessary medical treatments, for the children born as a result, for other members of the family and for society in general. (shrink)

In the United Kingdom women have access to termination of pregnancy for maternal reasons until 24 weeks’ completed gestation, but it is accepted practice for children born at or beyond 25 weeks’ gestation to be treated according to the child’s perceived best interests even if this is not in accordance with parental wishes. The authors present a case drawn from clinical practice which highlights the discomfort that parents may feel about such an abrupt change in their rights over their child, (...) and argue that parents should have greater autonomy over treatment decisions regarding their prematurely born children. (shrink)

Teaching medical ethics by the case method may be enriched by adding to the principles-and-rules approach to practical reasoning modes of inquiry and interpretation that engage the moral imagination.

While I am inclined to agree that in most cases a choice to become pregnant and bring to birth a child is an irrational choice, unlike Professor Häyry,1 I believe that choosing to do so is far from being necessarily immoral. In fact I will argue that it is often these irrational choices which make human life the valuable commodity many of us believe it is.Häyry argues that not only is the choice to have children always an irrational choice, but (...) also it is necessarily an immoral choice. Thus, for Häyry “human reproduction is fundamentally immoral”.1 He claims it is important to point out to prospective parents that their urge to have children is irrational. From this, he argues, it follows that once this is accepted the use of advance technologies to assist conception should be reassessed, and furthermore, the irrationality and immorality of having children should become a legitimate part of guidance given to those expressing a wish to have children.According to Häyry the reason it is irrational and immoral to choose to bring to birth a child is that “having a child can always realistically lead to the worse possible outcome, when the alternative is not having a child”.1 He argues that when people consider having children they are faced with the choice between deciding not to have children and thus harming or benefiting no-one , or having children where this life may be good or bad, and thus the value of this choice can be …. (shrink)

Gasping respiration in the dying patient is the last respiratory pattern prior to terminal apnoea. The duration of the gasping respiration phase varies; it may be as brief as one or two breaths to a prolonged period of gasping lasting minutes or even hours. Gasping respiration is very abnormal, easy to recognise and distinguish from other respiratory patterns and, in the dying patient who has elected to not be resuscitated, will always result in terminal apnoea.Gasping respiration is also referred to (...) as agonal respiration and the name is appropriate because the gasping breaths appear uncomfortable and raise concern that the patient is suffering and in agony. Enough uncertainty exists about the influence of gasping respiration on patient wellbeing, that it is appropriate to assume that the gasping breaths are burdensome to patients. Therefore, gasping respiration at the end of life should be treated.We propose that there is an ethical basis, in rare circumstances, for the use of neuromuscular blockade to suppress prolonged episodes of agonal respiration in the well-sedated patient in order to allow a peaceful and comfortable death. (shrink)

Background In Switzerland, right-to-die organisations assist their members with suicide by lethal drugs, usually barbiturates. One organisation, Dignitas, has experimented with oxygen deprivation as an alternative to sodium pentobarbital. Objective To analyse the process of assisted suicide by oxygen deprivation with helium and a common face mask and reservoir bag. Method This study examined four cases of assisted suicide by oxygen deprivation using helium delivered via a face mask. Videos of the deaths were provided by the Zurich police. Dignitas provided (...) protocol and consent information. Results One man and three women were assisted to death by oxygen deprivation. There was wide variation in the time to unconsciousness and the time to death, probably due to the poor mask fit. Swiss law prevented attendants from effectively managing the face mask apparatus. Purposeless movements of the extremities were disconcerting for Dignitas attendants, who are accustomed to assisting suicide with barbiturates. None of the dying individuals attempted self-rescue. Conclusions The dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted suicide. Oxygen deprivation with a face mask is not acceptable because leaks are difficult to control and it may not eliminate rebreathing. These factors will extend time to unconsciousness and time to death. A hood method could reduce the problem of mask fit. With a hood, a flow rate of helium sufficient to provide continuous washout of expired gases would remedy problems observed with the mask. (shrink)

Background: There is little research into medical students’ or doctors’ attitudes to abortion, yet knowing this is important, as policy makers should be aware of the views held by professionals directly involved in abortion provision and changing views may have practical implications for the provision of abortion in the future. Methods: We surveyed 300 medical students about their views on abortion, their beliefs about the status of the fetus and the rights of the mother, their attitude towards UK law and (...) their willingness to be involved in abortion provision as qualified doctors. Results: 62% of medical students were pro-choice, 33% pro-life and 7% undecided. Students’ views correlated with gender, year of study and holding a religious belief. Their beliefs about abortion, the status of the fetus and the rights of women significantly correlated with their attitudes towards the UK law and their willingness to be involved in abortion provision. Students’ willingness to be involved in abortion provision was related to their views on abortion, the extent of participation required, the circumstances of the pregnancy and the stage of pregnancy. Conclusions: The percentage of pro-choice students was lower than that found in research on general practitioners’ attitudes to abortion. It is unclear whether this is because students become more pro-choice as they progress through their medical career or because there is genuinely a change in attitudes to abortion. (shrink)

This dissertation is an attempt to show that, and how, an inter-species morality of compassion may be grounded reasonably in a phenomenology of body. It provides a literature survey of relevant works and authors, largely drawn from the modern European traditions of philosophic existentialism, phenomenology, and hermeneutics . The ontology and axiology presupposed by a somatically based bioethic are outlined in advance of the latter's presentation . Relevance of the embodied bioethic to actual affairs is demonstrated through exercises in practical (...) philosophy . An extended summary, as well as comparisons with other positions or outlooks and suggestions for further reflection or research, are also supplied . Appropriate propaedeutics, furnishing preliminary context for the project, can be found in the introduction. (shrink)