The purpose of this paper is to propose a model of clinical-ethical decision making which will assist the health care professional to arrive at an ethically defensible judgment. The model highlights the integration between ethics and decision making, whereby ethics as a systematic analytic tool bring to bear the positive aspects of the decision making process. The model is composed of three major elements. The ethical component, the decision making component and the contextual component. The latter incorporates the relational aspects (...) between the provider and the patient and the organizational structure. The model suggests that in order to arrive at an ethically, justifiable sound decision one make reference to those three elements. (shrink)

This paper suggests that medical education should redirect resources to values education, specifically developing new strategies to improve the process of clarification of values. The author suggests using the values journal method which is based on a systematic record of students' personal value systems reflected in their stories and life experience; and on their responses to case presentation. Generating a personal values journal helps students define who they are, what their social and professional roles are, what their expectations are and (...) where they are going. Keeping values journals promotes students' decision-making capacity, and equips them with the necessary skills to teach their future patients how to generate their own value systems. The development of a well defined values journal is a preparatory stage for active participation in clinical conferences or group discussion, and for effective communal dialogue among the group's members. (shrink)

The moral justification of intellectual property is often called into question when placed in the context of pharmaceutical patents and global health concerns. The theoretical accounts of both John Rawls and Robert Nozick provide an excellent ethical framework from which such questions can be clarified. While Nozick upholds an individuals right to intellectual property, based upon its conformation with Lockean notions of property and Nozicks ideas of just acquisition and transfer, Rawls emphasizes the importance of basic liberties, such as an (...) individuals right to health, superceding such secondary rights as intellectual property rights. From a policy perspective, patent protection for pharmaceutical products necessarily entails the balancing of corporate intellectual property interests and public interests in healthcare. The moral dilemma that occurs when these two interests clash is not easily resolved. Aside from corporate and public interests, the state maintains an interest in creating and preserving policies that regulate the moral dilemma itself. This paper analyzes the economic and ethical factors surrounding the production and distribution of the anti-HIV medication, AZT. Potential policy implications and recommendations are also discussed. (shrink)

Having children is probably as old as the first successful organism. It is often done thoughtlessly. This book is an argument for giving procreating some serious thought, and a theory of how, when, and why procreation may be permissible.Rivka Weinberg begins with an analysis of the kind of act procreativity is and why we might be justifiably motivated to engage in it. She then proceeds to argue that, by virtue of our ownership and control of the hazardous material that (...) is our gametes, we are parentally responsible for the risks we take with our gametes and for the persons that develop when we engage in activity that allows our gametes to unite with others and develop into persons. Further argument establishes that when done respectfully, and in cases where the child's chances of leading a life of human flourishing are high, procreation may be permissible. Along the way, Weinberg argues that the non-identity problem is a curiously common mistake. Arguments intending to show that procreation is impermissible because life is bad for people and imposed on them without their consent are shown to have serious flaws. Yet because they leave us with lingering concerns, Weinberg argues that although procreation is permissible under certain conditions, it is not only a welfare risk but also a moral risk. Still, it is a risk that is often permissible for us to take and impose, given our high level of legitimate interest in procreativity. In order to ascertain when the procreative risk is permissible to impose, contractualist principles are proposed to fairly attend to the interests prospective parents have in procreating and the interests future people have in a life of human flourishing. The principles are assessed on their own merits and in comparison with rival principles. They are then applied to a wide variety of procreative cases. (shrink)

My dissertation investigates the requirements of procreative justice. The procreative justice problem is that parents' interest in procreation conflicts with children's interest in optimal birth conditions. Intergenerational reciprocity is the principle that adjudicates this conflict: reciprocity dictates that children demand no more of their parents' procreative practices than they themselves are willing to abide by as adults and dig parents only procreate in accordance with principles dig they would have wanted their own parents to have followed. I develop a Rawlsian (...) Contractualist theory, grounded in the view of justice as the principles that would result from self-interested rational choice under fair bargaining conditions, i.e. unbiased rational prudence over the course of a lifetime by agents who know that they will be born children and grow into adults who may want to procreate. ;This deliberation yields three principles: The Obvious Principle bans procreation that undermines the interests of both prospective parents and prospective children or involves risking/sustaining a major burden for the sake of a minor benefit. The Balance Principle permits procreation only when it would not be irrational for the prospective parent to accept for herself the very same risk her procreation imposes on her prospective child, in exchange for permission to procreate under these circumstances. The Motivation Restriction requires that procreation be at least partially, yet still prominently, motivated by a desire to raise, nurture, love, and care for one's future child once it is born. These principles are defended against rival principles and applied to a wide variety of cases. ;Stymied by metaphysical paradoxes and confusion about persons and existence, contemporary ethicists have struggled to formulate a sound theory of procreative justice that provides more than bare-bones consideration of children's interests. I argue that these efforts have failed. Whereas procreative liberty principles, including Feinberg's Birth Rights and Parfit's Non-Identity Problem principles, neglect children's interests, strictly paternalistic principles, e.g. Benatar's Asymmetry principle, neglect parental interests. My theory of procreative justice provides a much needed middle-ground position which promotes and protects the interests of prospective parents and children. (shrink)

There is renewed scholarly interest in studying the dynamics of constitutional revolutions and the explanations for the rise of constitutional courts around the world. At the same time, there is growing discussion of democratic backsliding and concern that democracies are exhibiting extremism, weakening of opposition forces and constitutional courts, and violations of civil and political rights that are pertinent to vibrant democracies. Scholars try to study both phenomena and understand the relationship between them. Israel is an important case study for (...) both agendas. This Article analyzes the jurisprudence of Aharon Barak, one of the greatest jurists of our time with a worldwide reputation for revolutionizing both Israeli constitutional law and comparative constitutional law. It explains the tactics and strategy used by Barak to revolutionize Israeli constitutional law on issues of reasonableness, proportionality, standing, justiciability, constitutional review, equality, and supra-constitutional law. It reveals how each revolution paved the way for the next. It offers explanations for the effectiveness of these judicially-led revolutions as well as possible bases for their legitimation. Barak was a common law judge and ultimately treated parliamentary sovereignty as a doctrine arising from common law and constrained by common law, though he never quite put it in these terms. The Article concludes with explanations for the political backlash experienced by the current Israeli Supreme Court that some have characterized as democratic backsliding. It argues that the Court contributes to the development of law as part of a dialog and interaction between the different branches of government. As the Court operates within these dynamics, it must understand and take into account the institutional, political, and social environments in which it operates to preserve legitimacy and achieve efficacy. Barak was a strategic player that laid foundations for an expansive judicial power, but his Court was very prudent in utilizing that power. His successors may have contributed unintentionally to the backlash against the Court by following Barak’s substantive jurisprudence, but not necessarily his prudent tactics and strategy. (shrink)

Philosophers concerned with procreative ethics have long been puzzled by Parfit’s Non-Identity Problem (NIP). Various solutions have been proposed, but I argue that we have not solved the problem on its own narrow person-affecting terms, i.e., in terms of the identified individuals affected by procreative decisions and acts, especially future children. Thus, the core problem remains unsolved. This is a nagging concern for all who hold the common intuition that actions that harm no one are permissible. I argue against Harmon’s (...) and Woodward’s direct, narrow person-affecting solutions, and in favor of a new solution to the NIP. My solution, or, rather, dissolution, is based on the argument that merely possible people, i.e., hypothetical people who could possibly, but will not actually, exist, are morally irrelevant. I show that the NIP only arises when we concern ourselves with merely possible people. Once we are careful to restrict our concerns to only those that do or will exist, the NIP is dissolved. (shrink)

Sperm donation is a widely accepted and increasingly common practice. In the standard case, a sperm donor sells sperm to an agency, waives his parental rights, and is absolved of parental responsibility. We tend to assume that this involves no problematic abandonment of parental responsibility. If we regard the donor as having parental responsibilities at all, we may think that his parental responsibilities are transferred to the sperm recipients. But, if a man creates a child accidentally, via contraception failure, we (...) tend to assume that the man does indeed have parental responsibilities. Assessing these contrasting conclusions requires a theory of parental responsibility. I analyze prevalent theories of what makes someone parentally responsible and show that none of these theories can withstand scrutiny. I propose a new theory of parental responsibility, which, I argue, is more plausible than the alternatives. My theory of parental responsibility is based on our ownership and control over hazardous materials, namely, our gametes. I show that neither my theory, nor the theories I reject, can support our contrasting intuitions. I conclude that sperm donors are fathers, with parental responsibility. I argue that the alternative conclusion, that neither sperm donors nor accidental fathers are parentally responsible for their resulting offspring, is less plausible. I then consider whether parental responsibility can be transferred and argue that it is far from clear that it can. Finally, I address objections and consider some practical implications of these views. (shrink)

Human life is absurd because it is too short relative to reasonable human purposes. In contrast to our absurd relationship to time, our relationship to space is not absurd. Although our lives are way too short for reasonable human purposes, we are adapted to our size and the space we have to live in relative to the space of the universe and relative to reasonable human purposes. Because the human lifespan is so short as to render human life absurd, human (...) life is also meaningless because absurdity presents an obstacle to meaningfulness. (shrink)

This paper investigates connections between procreative ethics and the ethics of suicide and euthanasia. While there are good reasons for distinguishing between lives worth starting and lives worth continuing, I argue that those reasons provide no reason for denying that there is a relationship between procreative and end of life ethics. Regarding euthanasia/assisted suicide, we might think it too demanding to ask parents to help euthanize their terminally ill, suffering child, but had the parents not procreated, thereby exposing their child (...) to life's risks, their child wouldn't need euthanizing. If you need help killing yourself, shouldn't your parents, who got you into life in the first place – without your consent – help you out of it? Yet knowing that your parents would help you kill yourself may increase your desire to die. A conundrum. Regarding suicide, the fact that we are forced into life should bolster the right to suicide, even for reasons that others might find wanting. The ways in which we are brought into life have moral implications for the ways in which we are entitled to get out of it. (shrink)

In formulating procreative principles, it makes sense to begin by thinking about whose interests ought to matter to us. Obviously, we care about those who exist. Less obviously, but still uncontroversially, we care about those who will exist. Ought we to care about those who might possibly, but will not actually, exist? Recently, unusual positions have been taken regarding merely possible people and the non-identity problem. David Velleman argues that what might have happened to you – an existent person – (...) often doesn't merit moral consideration since the alternative person one would have been had what might have happened actually happened is a merely possible person about whom one has no reason to care. He argues that his way of thinking can eliminate the non-identity problem. Caspar Hare argues that merely possible people have interests and are morally relevant. He argues that we can solve the non-identity problem by rejecting the view that merely possible people are morally irrelevant. Both Hare and Velleman argue that focusing on one's de dicto rather than on one's de re children can help us avoid the non-identity problem. I analyze the role that merely possible, nonexistent hypothetical entities ought to play in our moral reasoning, especially with regard to procreation. I refute both Velleman's and Hare's views and demonstrate the difficulties we encounter when we try to apply their views to common non-identity cases. I conclude with the common-sense view regarding who matters, morally: only those who do, did, or will exist. (shrink)

It seems we have some obligation to aid some others, but it's unclear why, to whom, and to what extent. Many consequentialists claim that we are obligated to help everyone to the marginal utility point but they do so without examining why we are obligated to aid others at all. I argue that we must investigate the basis of our duty to aid others in order to determine the nature and extent of our obligation. Although some consequentialists, notably, Kagan, Singer (...) and Unger, present arguments intended to justify some of consequentialism's most counter-intuitive demands, they take the less counter-intuitive demands for granted and justify the steeper demands on the basis of their relevant similarity to the more palatable ones. The result of this strategy is that many of consequentialism's steeper demands free-ride on a superficial similarity with less taxing demands. This allows consequentialism to broaden our obligations beyond the reach of justification. I examine three possible explanations of our duty to aid others, namely, intuition, fairness and self-interest, and argue that none of them justify consequentialism's runaway demands. (shrink)

BackgroundVaccination against human papillomavirus (HPV) is a pivotal tool for preventing a significant cause of cervical cancer. One particular culturally recognized context associated with negative attitudes toward the HPV vaccine is the religiousness of parents. However, relatively speaking, there remains a scarcity of studies that have focused specifically on religious groups, especially non-Christian groups. PurposeTo better understand the basis for members of an ultra-Orthodox Jewish community to object to the HPV vaccine and how such objections can and cannot be reduced, (...) thereby improving cultural competence—namely, the cultural understanding and ethical addressing of HPV vaccination refusal. MethodsThis qualitative study conducted semi-structured interviews with ten Israeli ultra-Orthodox mothers who are opposed to administering the HPV vaccine to their daughters. The content analysis addressed these results and extracted the major issues arising from these particular interviews. ResultsFour main novel insights were found pertaining to the negative stance toward HPV vaccination among mothers in an ultra-Orthodox Jewish community: (a) lack of knowledge about the HPV vaccine is not part of the reasoning against it; (b) rabbinical authority might have a lesser influence than expected for the moderation of HPV vaccine refusal; (c) complicated viewpoints regarding childhood vaccination may be the larger non-moderating context for HPV vaccination refusal; and (d) cultural competence is important for the ability to change the negative attitudes toward HPV vaccination. ConclusionsThe study may improve cultural competence regarding HPV vaccination and contribute to decreasing objections to the HPV vaccine in ultra-Orthodox communities. (shrink)

Life is pointless. That’s not okay. I show that. I argue that a point is a valued end and that, as agents, it makes sense for us to want our efforts and enterprises to have a point. Valued ends provide justifying reasons for our acts, efforts, and projects. I further argue that ends lie separate from the acts and enterprises for which they provide a point. Since there can be no end external to one’s entire life since one’s life includes (...) all of one’s ends, leading and living one’s life as a whole cannot have a point. Finally, I argue that since we live our lives and structure our living­a­human­life efforts both in parts and as a whole, it is fitting to be sad to recognize that leading and living a life is pointless. My discussion helps make sense of the literature that frequently talks around this topic but often does so vaguely and indirectly. (shrink)

The ArgumentIn this paper three canonical studies of the scientific revolution are subjected to narratological analysis. Underlying this analysis is the assumption that in any single product of historical writing it is possible to distinguish, for analytical purposes, between three levels of reference: the object of the text — the events; the representation of the events — the narrative; and the text in which a story is represented by means of narrative. Through texts one learns about historical events, but also (...) about the process of producing the texts. Techniques of representation are means of production of texts that represent, in addition to the events, also the producer and his or her authority. The distinction made for any specific text allows the reader to play the two levels against each other in order to create a space within which historical writing should be criticized. Such criticism may draw attention to the difficulty of controlling the meaning of historical stories, and to the need to analyze narrative structures in order to appreciate the ideological changes of historical texts. (shrink)

La Transición constituye una etapa clave en la configuración del presente histórico del alumnado y su comprensión, por ello, su inclusión en el proceso de enseñanza-aprendizaje adquiere un interés particular. El presente trabajo tiene como objetivo analizar cómo se articula la enseñanza de esta etapa histórica en los libros de texto. El marco de estudio se acota a los manuales de 2º de Bachillerato en Galicia, sobre los que se realiza un análisis didáctico e historiográfico. El estudio recoge, en el (...) campo didáctico, una falta generalizada de adaptación a las particularidades de la Historia del presente, sin apostar por un aprendizaje significativo. En el historiográfico se revela la misma carencia, así como la hegemonía del relato tradicional, caracterizado por el consenso y la Historia política, personalista, determinista y positiva, sin problematización ni alusión a las propuestas alternativas, el conflicto o la correlación de fuerzas. (shrink)

En este libro se recopilan escritos producidos por el profesor García Amado durante los últimos años. La temática es muy variada: teoría de la argumentación jurídica y de la decisión judicial, interpretación del Derecho, crítica del neoconstitucionalismo y examen de sus raíces doctrinales, debates a propósito de Kelsen y el positivismo, puesta en cuestión de la enseñanza del Derecho y de sus reformas actuales, reflexiones sobre tendencias del Derecho penal contemporáneo, balance de algunos autores y temas de la filosofía (...) política de nuestro tiempo, Derecho y cine, etc. Todo ello con el estilo habitual del autor polémico, provocativo y con cierta ironía e irreverancia. (shrink)

La expansión acelerada de tecnologías disruptivas como la Inteligencia Artificial Generativa y su aplicación progresiva a las distintas esferas de la sociedad han evidenciado las enormes potencialidades transformadoras que poseen, pero también los grandes riesgos que se derivan de su uso generalizado. Sobre esa base, el presente artículo analiza y reflexiona acerca del rol que deben tener los poderes públicos como únicas instituciones capaces de preservar la ética pública, los valores públicos y el bien común ante el desarrollo tecnológico. Con (...) ello, la creación de valor público y la preservación de una ética pública han de constituir un marco de referencia para situar las tecnologías disruptivas al servicio de la ciudadanía y construir una adecuada gobernanza pública. Esta propuesta reafirma, por consiguiente, la importancia de que los poderes públicos configuren un modelo eficaz de gobernanza social de esta tecnología disruptiva, lo que debería ser entendido como un aspecto prioritario en la agenda pública. Cualquier respuesta distinta de las instituciones públicas, ya sea pasiva, reactiva o inhibitoria, pondría en riesgo no solo la gestión de lo público, sino también la esencia misma del orden democrático representativo vigente. (shrink)

One might think that parental obligation to children ends with the end of childhood. I argue that if we consider why parents are obligated to their children, we will see that this view is false. Creating children exposes them to life’s risks. When we expose others to risks, we are often obligated to minimize damages and compensate for harms. Life’s risks last a lifetime, therefore parental obligation to one’s children does too. Grown children’s autonomy, and grown children’s independent responsibility for (...) some of their own problems, can sometimes limit what parental responsibility demands of parents but it doesn’t do away with the responsibility. I argue that my conclusions are not as counterintuitive as they might initially seem. I also consider the implications that parental obligation to grown children might have on the oft assumed obligation that grown children have to care for their parents. (shrink)

Name der Zeitschrift: Naharaim Jahrgang: 11 Heft: 1-2 Seiten: 13-23.

Life stinks. Mel Brooks knew it, David Benatar knows it,1 and so do I. Even when life does not stink so badly, there’s always the chance that it will begin to do so. Nonexistence, on the other hand, is odor free. Whereas being brought into existence can be harmful, or at least bad, nonexistence cannot be harmful or bad. Even if life is not clearly bad, it is at the very least extremely risky. David Benatar argues, somewhat notoriously, that since (...) it is better never to exist, one is harmed by being brought into existence and, therefore, procreation is likely always wrong and certainly always morally problematic. (shrink)

The ArgumentIn this paper, I argue that the most significant contribution of the Jesuits to early modern science consists in the introduction of a new “image of knowledge.”In contradistinction to traditional Scholasticism, this image of knowledge allows for the possibility of a science of hypothetical entities.This problem became crucial in two specific areas. In astronomy, knowledge of mathematical entities of unclear ontological status was nevertheless proclaimed certain. In theology, God's knowledge of the future acts of man, logically considered as future (...) contingents, was also proclaimed certain. In both cases the concept of certain knowledge of hypothetical entities was problematic and challenged a central premise of the accepted canons of logic, i.e., that the objects of true knowledge must be real objects.The main argument of this paper is that the practical orientation of the Jesuit cultural milieu enabled Jesuit scientists and theologians to ignore accepted logical considerations and to modify traditional Thomist images of knowledge. Nevertheless, this modification was not so radical as to change the contemporary organization of knowledge. This was due to the peculiar status of the Jesuits within the church establishment, which exposed them to harsh criticism and created a deep need for legitimation. Thus, the limitations of Jesuit scientific culture are accounted for in institutional, rather than in logical terms. (shrink)