Background: Patients often are confronted with the choice to allow cardiopulmonary resuscitation (CPR) should cardiac arrest occur. Typically, informed consent for CPR does not also include detailed discussion about survival rates, possible consequences of survival, and/or potential impacts on functionality post-CPR. Objective: A lack of communication about these issues between providers and patients/families complicates CPR decision-making and highlights the ethical imperative of practice changes that educate patients and families in those deeper and more detailed ways. Design: This review integrates disparate (...) literature on the aftermath of CPR and the ethics implications of CPR decision-making as it relates to and is affected by informed consent and subsequent choices for code status by seriously ill patients and their surrogates/proxies within the hospital setting. Margaret Urban Walker’s moral philosophy provides a framework to view informed consent as a practice of responsibility. Ethical considerations: Given nurses’ communicative skills, ethos of care and advocacy, and expertise in therapeutic relationships, communication around DNAR decision-making might look quite different if institutional norms in education, healthcare, law, and public policy held nurses overtly responsible for informed consent in some greater measure. Findings: Analysis from this perspective shows where changes in informed consent practices are needed and where leverage might be exerted to create change in the direction of deeper and more detailed discussions about CPR survival rates and possible consequences of survival. (shrink)

Along the way, she calls upon us to recognize the mysteries that lie at the heart of our lives and the metaphysical reality that gives meaning to life.The ...

Some psychologists argue that in general we self-ascribe characteristics according to others' perceived reactions to us. In illustration michael argyle cites a case involving the self-Ascription of popularity. But popularity is what I here call a 'reaction-Determined characteristic, That is, A characteristic such that certain others' reacting to someone in a certain way is logically sufficient for his having it. The general import of cases involving such characteristics needs careful examination and I argue that in fact argyle's case does not (...) support the general thesis in question. I conclude that 'ordinary language' analysis is important for the evaluation of psychological data. (shrink)

Although the field of bioethics usually emphasizes ethical dilemmas arising from contemporary biomedical research, at another level the foundation of ethical judgments can be explored in the light of evolutionary biology. Two scientific approaches illuminate the relationships between human nature, social environments, and standards of ethical judgment: first, ethology and the observational study of nonhuman primates; second, evolutionary theory and new developments in the understanding of natural selection. Ethology shows that humans, like the species most closely related to us, are (...) naturally both cooperative and competitive. Evolutionary theory can "explain" cooperation at diverse levels of social organization , suggesting which forms of social cooperation are to be expected in specific cases. By focusing on the emotions underlying the sense of justice, moreover, an evolutionary approach can provide a more realistic assessment of the motivations and intentions underlying ethical controversies. Because individuals inevitably have competing claims as well as competing moral obligations, evolutionary bioethics thus teaches the need for balance and judgment. Emotions elicited by the all-too-human tendency to engage in moralistic aggression need to be balanced by reasoned judgment of the consequences of our own actions. The ethicist, no more or less than any other human, needs to be aware of the risks of deceptions and self-deception. Or, to put it more simply, an evolutionary bioethics leads back to the humility of the Socratic injunction: know thyself. Im allgemein üblichen Sinne befaßt sich Bioethik meist mit ethischen Problemstellungen, die durch die Fortschritte der biologischen Forschung hervorgerufen werden. Unter einem anderen Blickwinkel kann sie aber auch die Grundlage ethischer Urteile im Licht der Entwicklungsbiologie untersuchen. Zwei Wissenschaftszweige befassen sich mit dem Verhältnis zwischen der menschlichen Natur, dem sozialen Umfeld und den Standards für ethische Urteile; erstens, die Ethologie und Verhaltensstudien an nichtmenschlichen Primaten; zweitens, die Evolutionstheorie und neue Entwicklungen beim Verständnis der natürlichen Selektion. Die Ethologie zeigt, daß Menschen genauso wie die Tiere, die ihnen am nächsten verwandt sind, von Natur aus sowohl zur Kooperation als auch zur Konkurrenz miteinander neigen. Die Evolutionstheorie kann die verschiedenen Weisen von Kooperation auf den verschiedenen Ebenen sozialer Organisation "erklären" und dabei Hypothesen aufstellen, welche Formen sozialer Zusammenarbeit in spezifischen Fällen erwartet werden können. Soweit sie sich mit den Emotionen befaßt, die dem Sinn für Gerechtigkeit zugrunde liegen, kann die Evolutionstheorie darüber hinaus eine realistischere Einschätzung der Beweggründe und Intentionen vermitteln, die hinter ethischen Kontroversen stehen. Weil Individuen unvermeidlich konkurrierende Ansprüche, aber auch konkurrierende moralische Verpflichtungen haben, zeigt die evolutionäre Bioethik das Bedürfnis nach Ausgleich und Schlichtung. Die Emotionen, die durch die allzu menschliche Neigung zu Aggression im Namen der Moral hervorgerufen werden, rufen nach Ausgleich durch begründete Urteile über die Folgen unserer eigenen Handlungen. Der Ethiker muß sich, nicht mehr und nicht weniger als jeder andere Mensch, des Risikos von Täuschung und Selbsttäuschung bewußt sein. Oder, um es einfacher auszudrücken, evolutionäre Ethik führt zurück zu der Bescheidenheit der Sokratischen Forderung: Erkenne dich selbst. (shrink)

A commonplace in traditional historiography is the claim that an important aspect of the demise of Aristotelianism during the Scientific Revolution was a change in the concept of causality, a change which eliminated final causes from science. Projecting twentieth-century metaphysical presuppositions onto the ostensibly revolutionary thought of early modern natural philosophers, E. A. Burtt declared.

Based on talks provided under the title "The Christian religion & its philosophy".