The development of clinical ethic support in the UK arguably brings with it a series of legal questions, which need to be addressed. Most particularly, these concern questions of due process and formal justice, which I argue are central to the provision of appropriate ethical advice. In this article, I will compare the UK position with the more developed system in the USA, which often provides a template for development in the UK. While it is not argued that the provision (...) of clinical ethics support in the UK will necessarily follow the path mapped in the USA, there are lessons that can be learned from the US experience – particularly in terms of attention to process – from which UK clinical ethics support service might well benefit. (shrink)

The new regulations on xenotransplantation pay insufficient attention to the broad ethical problems raised by this technique and that the abandonment of a national body with overall regulatory authority in this area is a mistake.Following reports from the Nuffield Council on Bioethics1 and, most importantly, the Advisory Group on the Ethics of Xenotransplantation2 , the UK Xenotransplantation Interim Regulatory Authority was established in 1997. The existence of a national body to govern xenotransplantation was deemed to be of critical importance by (...) the Kennedy report given the practical and ethical issues associated with xenotransplantation. Indeed, the Kennedy report recommended that ultimately UKXIRA should be placed on a statutory footing.2 The remit of UKXIRA was to advise the Secretary of State on particular applications, gather information on issues such as safety, and assess whether the preconditions identified by the Kennedy report had been met.3In December 2006, UKXIRA was quietly disbanded, and the Department of Health issued a statement of guidance, the terms of which now govern xenotransplantation in the UK. This document superseded procedures that had been in place since 1998, which had placed the overall regulation of applications to conduct xenotransplantation in the hands of UKXIRA and, ultimately, the Secretary of State.4 The revised guidance defines xenotransplantation as being: “… any procedure that involves the transplantation, implantation, or infusion into a human recipient of either live tissues or organs retrieved from animals, or, human body fluids, cells, tissue or organs that have undergone ex vivo contact with live non-human animal cells, tissues or organs.”5 . Given the range and nature of the procedures covered by the guidance, it is surprising, not to say a little worrying, that it is so …. (shrink)

As support for clinical ethics committees in the UK grows, care must be taken to define their function, membership and method of working and the status of their decisions.The modern practice of medicine raises a plethora of complex issues—medical, ethical and legal. Doctors and other healthcare professionals increasingly must try to resolve these and may sometimes have to do so in the face of contrary opinion expressed by patients and/or their surrogates. While clearly qualified in the medical arena, and although (...) there is now more ethics teaching in the medical curriculum, healthcare professionals are seldom qualified to adjudicate on ethical or legal matters, or even, perhaps, to recognise them when they arise. Yet, as Doyal says, “clinical life must go on and moral and legal indeterminacy within medicine cries out for practical resolution.”1 Meanwhile, the expectations of patients and their families—and, indeed, of wider society—are that decisions about patient care, resources and therapeutic regimes should be soundly based on appropriate ethicolegal, as well as scientific, principle.Recognition of these additional burdens on healthcare professionals has generated some interest in the provision of ethics consultation. In the USA this has been undertaken by a variety of tribunals and individuals. Hospital ethics committees and ethics consultants feature in many US hospitals and perform a variety of roles. In Europe, a number of countries have also established clinical ethics committees and they are becoming more common in the UK—primarily in England and Wales for the moment. Whereas, however, “[i]n North America, CECs have … become an integral part of the organisational infrastructure of hospitals ...”,1 in the United Kingdom they remain essentially ad hoc bodies, generated for a variety of reasons and with different goals, structures, membership, methods of working and functions. The initial impetus for the …. (shrink)

What difference does the philosophical revolution of Deleuze and Guattari make to our understanding the early Christianity? In honour of the fortieth anniversary of publication of A Thousand Plateaus, this article argues that the discipline of Christian origins is currently premised on a historically condemned mode of subjectivity, that of subject/object metaphysics. The philosophical processes found in A Thousand Plateaus are particularly apposite to the current dilemma of Christian origins: as a rhizome-book consisting of plateaus, machines, singularities and non-representational concepts, (...) this book models new modes of thinking that can help the discipline rejuvenate itself and accomplish new tasks which are presently beyond its reach – for Deleuzian philosophy privileges the virtual over the actual, becoming over being, machinic transformations over static structures, and semiotics over linguistics. (shrink)

The rapid rise of varieties of historicism in Germany, during the mid- to late-nineteenth century, and subsequently in England and America, resulted in a radical transformation of the principles of coherence and methods of analysis within biblical studies.1This paper will argue that the foundational ‘subject/object’ metaphysics of historicism has been subverted over the past century. For this reason, historical positivism should no longer be accorded the status of ‘normative paradigm’ and ‘gatekeeper’ over and against other interpretive approaches. This paper next (...) lays out five principles for a renewed practice of historical inquiry. It argues, first, that historical inquiry continues to serve a vital function within biblical studies in its ability to call attention to historical difference, and, thereby, to contribute to a strategy of resistance to ideology and to totalizing theories; second, that the traditional appeal to historical ‘context’ and ‘author’ in the interpretation of texts continues to be a useful practice – despite the provisional and constructed nature of both – as a way of taking into account extra-lingual reference and of avoiding presentism; third, that the substitution of new ‘grand narratives’ of Christian origins in place of the (quasi-theological) ‘historical’ narrative of traditional Christianity – under the claim of historical objectivity – should be abandoned because the very concept of ‘origins’ is the result of a literalizing of a metaphor. Such totalizing narratives always reduce history's inherent polycentricism. Fourth, I will argue that the continued use of historicism in the antiquarian attempt to reconstruct the past, disconnected from both a quest for social justice and a desire for personal self-creation, represents a form of thought that alienates scholars from themselves and from their real material contexts. Finally, and following on the previous point, this paper submits that the practice of historical analysis has an ethical dimension by virtue of the fact that the personhood of the biblical historian is indissolubly linked to other dimensions of life including the social and ethical aspects of life. These added dimensions complicate the making of choices, which is implicit within all practices of interpretation. These five principles are here suggested as points of departure for the reconceptualization of the scope and function of historical inquiry within the discipline of New Testament studies. (shrink)

There is a debate regarding the use of the white coat, a traditional symbol of the medical profession, by students. In a study evaluating final-year South African medical students' perceptions, the white coat was associated with traditional symbolic values (e.g., trust) and had practical uses (e.g., identification). The coat was generally perceived to evoke positive emotions in patients, but some recognized that it may cause anxiety or mistrust. Donning a white coat generally implied a responsibility to the profession. For a (...) few, without the coat, patients would not cooperate, resulting in some perceiving no need to be distinguished from qualified practitioners. There was thus some evidence of entitled (vs. earned) respect. In the light of the underresourced health care setting in which these students learn clinical medicine, we recommend that students be able to recognize the potential for unprofessional or unethical behavior. Students should also be able to identify role models. (shrink)

In 2005, Ethiopia changed its abortion law to curb its high maternal mortality. This has led to a considerable reduction in deaths from unsafe abortions. Abortion is now legal if the woman’s pregnancy is a result of rape or incest, if her health is endangered, if the fetus has a serious deformity, if she suffers from a physical or mental deficiency, or if she is under 18 years of age. The word of the woman, if in compliance with the law, (...) is sufficient to qualify for an abortion. In this context, where the law makes the door slightly open, health workers become important in deciding who gets access to safe services and who doesn’t, thus creating considerable ethical dilemmas. The objective of this study was to explore abortion service providers’ personal experiences and reflections, perceptions of the abortion law, and ethical and dilemmas that arise. Data collection took place from March to May 2016 in Addis Ababa, at different health clinics providing abortion services. Thirty in-depth interviews and three focus group discussions were conducted with 41 abortion service providers at governmental and non-governmental clinics. Content analysis was drawn upon in the interpretation of the findings. When working in a context where the law has slightly opened the door for abortion seeking women, the health workers describe conflicting concerns, burdensome responsibilities, and ambiguity concerning how to interpret and implement the law. They describe efforts to balance their religious faith and values against their professional obligations and concern for women’s health and well-being. This negotiation is particularly evident in the care of women who fall outside the law’s indications. They usually handle ethical dilemmas and decision-making alone without guidance. Moreover, many health workers face a stigma from fellow colleagues not performing abortions and therefore keep their job a secret from family and friends. Health workers in Ethiopia experience ethical dilemmas trying to maneuver between the abortion law, their personal values, and their genuine concern for the health of women. More research is needed to further explore this. (shrink)

An essential and neglected distinction between contract and administrative law is in how each conceives of the Crown as a juristic person. This article explores the extent of this distinction, and its implications for the rule of law and the separation of powers. It offers explanations—historical, jurisprudential and pragmatic—for why contract law conceives of the Crown as a corporation aggregate with the powers and liberties of a natural person, and why administrative law disaggregates the State into named officials.

I read Robert Card's recent paper entitled ‘Is there no alternative? Conscientious objection by medical students’ with great interest.1 That Muslim students in America are able to conscientiously object to the cross-gender consultation is somewhat startling. I have just left the Middle East, where I worked as a medical educator for five-and-a-half years , and, to the best of my knowledge, even in the conservative, gender-segregated traditional Muslim culture of the United Arab Emirates, not once did a male or female (...) student refuse to examine a patient of the opposite sex.Several issues, many of which have been described by Padela and del Pozo,2 should be taken into consideration in relation to Muslim students’ conscientious objection to the cross-gender consultation on religious grounds. Although Islam prohibits touching or physical contact by the opposite gender, unless appropriate , in some circumstances, the ‘prohibited becomes permissible’.3 Medicine is one such circumstance. Islam does not …. (shrink)

From Hippocrates to paternalism to autonomy : the new hegemony -- From autonomy to consent -- Consent, autonomy, and the law -- Autonomy at the end of life -- Autonomy and pregnancy -- Autonomy and genetic information -- Autonomy and organ transplantation -- Autonomy, consent, and the law.

Steve Biko died in detention in South Africa in 1977. Critical ethical issues are raised both by the conduct of the doctors responsible for Biko's care and by the subsequent response of the medical profession as a whole. Because those issues are relevant to all healthcare professionals everywhere, the Biko affair provides a useful case study in medical ethics. We discuss the case in this article, describing how we use it in our teaching.

This book applies philosophical hermeneutics to biblical studies. Whereas traditional studies of the Bible limit their analysis to the exploration of the texts' original historical sense, this book discusses how to move beyond these issues to a consideration of biblical texts' existential significance for the present. In response to the rejection of biblical significance in the late nineteenth century and the accompanying crisis of nihilism, B. H. McLean argues that the philosophical thought of Heidegger, Bultmann, Gadamer, Habermas, Ricoeur, Levinas, (...) Deleuze and Guattari provides an alternative to historically oriented approaches to biblical interpretation. He uses basic principles drawn from these philosophers' writings to create a framework for a new 'post-historical' mode of hermeneutic inquiry that transcends the subject-based epistemological structure of historical positivism. (shrink)

Antipathy towards the possibility that God exists is a common attitude, which has recently been clearly expressed by Thomas Nagel. This attitude is presumably irrelevant to the question whether God does exist. But it raises two other interesting philosophical issues. First, to what extent does this attitude motivate irrational belief? And secondly, how should the attitude be evaluated? This paper investigates that latter issue. Is the hope that God does not exist a morally proper hope? I simplify this question by (...) interpreting the relevant attitude as an aversion towards the Christian picture of the world coupled with a preference for the naturalist atheistic picture. And comparing the content of those two world pictures, I argue that the attitude, though partly explicable, is morally unjustifiable, for clearly recognisable reasons. Regardless, then, of further concerns about the doxastic influence of this attitude, we ought to be ashamed of our antipathy to God, which reflects badly upon us. (shrink)

PART The Origins of a Philosophy of Reality "When you have listened, not to me, but to the Law (Logos), it is wise to agree that all things are one. ...

To find more information about Rowman and Littlefield titles, please visit www.rowmanlittlefield.com.