Aim: Patients with advanced cancer need information about end-of-life treatment options in order to make informed decisions. Clinicians vary in the frequency with which they initiate these discussions.Patients and methods: As part of a long-term longitudinal study, patients with an expected 2-year survival of less than 50% who had advanced gastrointestinal or lung cancer or amyotrophic lateral sclerosis were interviewed. Each patient’s medical record was reviewed at enrollment and at 3 months for evidence of the discussion of patient wishes concerning (...) ventilator support, artificial nutrition and hydration , resuscitation and hospice care. A Kaplan–Meier analysis was also performed and 2-year survival calculated.Results: 60 cancer and 32 ALS patients were enrolled. ALS patients were more likely than cancer patients to have evidence of discussion about their wishes for ventilator support , ANH , DNR and hospice care . At 6 months, 91% of ALS patients were alive compared with 62% of cancer patients; at 2 years, 63% of ALS patients were alive compared with 23% of cancer patients .Conclusions: Cancer patients were less likely than ALS patients to have had documented advanced care planning discussions despite worse survival. This may reflect perceptions that ALS has a more predictable course, that advanced cancer has a greater number of treatment options, or differing views about hope. Nevertheless, cancer patients may be less adequately prepared for end-of-life decision-making. (shrink)

The hardest thing in appropriating [a] holistic natural law perspective is to recognise the invisible mean of judgement, which alone contains the limits of all things... The notion of mean and limits - so fundamental to ethics - calls for inner understanding that the nature of the mean cannot be defined 'a priori', because it involves an exercise of judgement, ethical judgement.

Mapping one's ignorance also has affective benefits. Wherever mastery of knowledge and skills creates professional status, especially in practices that give professional power over clients, there arises a natural pride that rests on what one knows, and a regrettable tendency for authority to develop arrogance. We know the effects: failure to listen, premature dismissal of relevant information, overreaching and overbearing professional conduct, mistakes and the denial of them, and so on. An explicit acknowledgement of ignorance may generate a corrective humility, (...) a desire to see rather than presume understanding, alertness to unforeseen consequences, and openness to alternative approaches. (shrink)

As the United States is currently prosecuting two wars, it is important to consider whether those wars, and the resulting noncombatantcasualties, can be morally justified. Such consideration can be initiated by considering some of Alan Donagan’s work in his book The Theory of Morality. In that book Donagan sets out to develop, as a philosophical system, that part of the common morality according to the Hebrew-Christian tradition, which does not depend on any theistic beliefs. According to that tradition it is (...) sometimes morally permissible to resort to war. This poses a problem because also part of the tradition is a near absolute prohibition on harming innocent people. Since innocent people die in war, there is a tension here.Donagan claims that this problem can be solved by assigning the blame for some such deaths to the aggressor, thereby permitting (some) resorts to war. This paper shows that this solution is inadequate; and defends a more plausible (and more traditional) justification for some innocent deaths. This justification is consistent with the system Donagan develops, and thus may have application in the consideration of the justification of the two wars currently being prosecuted by the United States. (shrink)

McGavin, PA The Holy Father often speaks without a prepared text, and it is amazing how accurately he reads in transcription. This was brilliantly so in Light of the World interviews. Even his brief words at pages 118-119 on condoms - so breathlessly and inaccurately treated in the media - are so cast as to withstand close scrutiny. It is with this recognition that I address his lack of precision and perception in speaking on the question of homosexuality and sacred (...) ordination. (shrink)

The article reveals the value and contribution of A.I. Vvedensky in the formation of Russian neo-Kantianism on the example of a systematic and integrated review of his research. The author reveals the significance of A.I. Vvedensky critical methodology for the subsequent development of Russian neo-Kantianism in the first third of the XX century. The method of “logicism” is designated as an integral part of criticism, which consists in the elimination of dogmatic foundations from philosophical discourse. In turn, the critical methodology, (...) understood as a theoretical tool for constructing a holistic picture of the world on the principles of science, serves as the basis for identifying the problems of the correlation of the rational and the irrational. The indicated problem in the works of A.I. Vvedensky becomes the beginning of the formation of Russian neo-Kantianism, which is opposed to dogmatism and religious and philosophical research. Developing a critical methodology, the Russian philosopher turns to the consideration of the role of philosophy in the formation of ideological foundations. The contents of the article consistently reveal the key provisions of the philosophy of A.I. Vvedensky, from raising the question of the methodological foundations of criticism to identifying the specifics of philosophy in relation to scientific disciplines, on the example of experimental psychology, based mainly on empirical methods. In conclusion, the article indicates the prospect of further comprehensive study of the works of A.I. Vvedensky in order to establish a reliable understanding of the development of the national philosophy of thought. (shrink)

Carter has shown that Bosanquet was not the conservative individualist as often supposed, and that he was not hostile to moderate socialism. Bosanquet's logic and metaphysics gives support to this view. But even here he was misunderstood. By over-emphasis on aspects of his philosophical logic, his metaphysics, and practical concerns, we have the most diverse views of what he meant. But taken altogether his whole work has a unity which reconciles collectivist and individualist principles in concrete liberty. The problem of (...) hiatus between Bosanquet's theoretical and practical concerns, which Carter notices, disappears when Bosanquet's philosophical logic is addressed. (shrink)

Objectives: This study attempts to analyse the ethical dilemmas arising from the microallocation of scarce health care resources, in terms of deontology and utilitarianism.Methods: A group of 395 people were interviewed in the region of Diadema, greater San Paulo, Brazil, while visiting patients in the only state hospital in town. Each interviewee was given a list of eight simulated emergencies . In each of the eight cases the interviewee had to choose which of the two patients described, both of whom (...) suffered from exactly the same problem, should receive the only hospital bed currently available. The differences between the hypothetical patients were as follows: age, gender, family dependency, and lifestyle. Each interviewee was asked to justify one of their responses. These responses were then analysed.Results: The results pointed to the co-existence of deontological and utilitarian orientations among the people interviewed. A tendency to give priority to the destitute was revealed throughout the research, contradicting the idea that society, valuing only productive people, wishes only such people to receive the most resources, thus maximising the benefits to be gained from resources. The results showed that people’s disapproval of the alcoholic was stronger than that of the nicotine abuser. (shrink)

The view of Deitz and Arrington that Wittgenstein's ordinary language philosophy allows behaviorism to use cognitive terms with a behavioristic system is disputed and an alternative is suggested.