Religions often operate as comprehensive worldviews, attempting to answer the deepest existential questions that human beings can ask: Who am I? Where do I come from? Where am I going after I die? How should I live? Often ethical systems are embedded and justified within these broader narratives. Inevitably, the clinical ethics consultant will encounter and engage with religiously based ethical systems. In this issue, the authors reflect seriously and deeply on the implications of such engagement.

Burnout among health professionals is at epidemic proportions. In response, many health institutions have emphasised the importance of self-care, relying particularly on the idea that doctors who are burned out provide worse care for their patients. Although not made explicit, this suggests that doctors might have a responsibility to their patients (and perhaps others) to practice self-care. This chapter explores the potential grounds for such an obligation. We suggest that while there is potential for a limited obligation of self-care, institutional (...) emphasis on this risks instrumentalising doctors' well-being, minimising institutional responsibilities and workers' rights, and being excessively demanding for individuals. (shrink)

Entscheidungen der Therapiebegrenzung und in der Betreuung am Lebensende sind häufig komplex und von ethischen Problemen begleitet. Im Mittelpunkt der Untersuchung steht die entscheidende Frage, wie hilfreich existierende „Ethik-Richtlinien“, die eine ethische Orientierung bei solchen Entscheidungen geben sollen, in der klinischen Praxis tatsächlich sind. Die Frage, welchen Nutzen „Ethik-Richtlinien“ bei der Entscheidungsfindung haben oder haben können, wird hier exemplarisch an einem klinischen Fallbeispiel aus einer Ethik-Kooperationsstudie in der Intensivmedizin analysiert. Vergleichend werden hierzu „Ethik-Richtlinien“ aus Deutschland, der Schweiz und aus Großbritannien (...) herangezogen, die Gegenstand eines internationalen Projekts zur Analyse von Richtlinien waren. Die Möglichkeiten und Grenzen einer ethischen Orientierung an „Ethik-Richtlinien“ bei Entscheidungsproblemen der Therapiebegrenzung und in der Betreuung am Lebensende werden anhand der Fallstudie diskutiert und illustriert. Abschließend werden Schlussfolgerungen für die Entwicklung ethischer Richtlinien für die klinische Praxis formuliert. (shrink)

Abstract It is common practice to regard participants in assisted and collaborative reproduction (gamete donors, embryologists, fertility doctors, etc.) as simply providing a desired biological product or medical service. These agents are not procreators in the ordinary sense, nor do they stand in any kind of meaningful parental relation to the resulting offspring. This paper challenges the common view by defending a principle of procreative responsibility and then demonstrating that this standard applies as much to those who provide reproductive assistance (...) in the form of medical services or gametes, as it does to coital reproducers or intending parents. Drawing on vocabulary from the common law tradition, I suggest that it may be helpful to refer to the various participants in assisted and collaborative reproduction (ACR) as accessories to procreation. Referring to the participants in ACR as accessories to procreation highlights the fact that these agents are not just providing medical services or products. They are participating in a supply chain designed to bring about new persons. I conclude by arguing that regulative standards in the fertility industry should be structured such that they permit, facilitate, and encourage agents to satisfy the requirements of procreative responsibility. Content Type Journal Article Pages 1-16 DOI 10.1007/s10677-011-9330-7 Authors Melissa Seymour Fahmy, Department of Philosophy, University of Georgia, 107 Peabody Hall, Athens, GA 30602, USA Journal Ethical Theory and Moral Practice Online ISSN 1572-8447 Print ISSN 1386-2820. (shrink)

Relativism in psychology unravels the truth-claims and oppressive\npractices of the discipline, but simply relativizing psychological knowledge\nhas not been sufficient to comprehend and combat the discipline\nas part of the ‘psy-complex’. For that, a balanced review of the contribution\nand problems of relativism needs to work dialectically, and so\nthis article reviews four problematic rhetorical balancing strategies in\nrelativism before turning to the contribution of critical realism. Critical\nrealism exposes positivist psychology’s pretensions to model itself\non what it imagines the natural sciences to be, and it grounds (...) discursive\naccounts of mentation in social practices. The problem is that those\nsympathetic to mainstream psychology are also appealing to ‘realism’\nto warrant it as a science and to discredit critical research that situates\npsychological phenomena. Our use of critical realism calls for an\naccount of how psychological facts are socially constructed within\npresent social arrangements and for an analysis of the underlying historical\nconditions that gave rise to the ‘psy-complex’. Only by understanding\nhow the discipline of psychology reproduces notions of\nindividuality and human nature, a critical realist endeavour, will it be\npossible to transform it, and to socially construct it as something different. (shrink)

The European Biomedical Ethics Practitioner Education Project (EBEPE), funded by the BIOMED programme of the European Commission, is a five-nation partnership to produce open learning materials for healthcare ethics education. Papers and case studies from a series of twelve conferences throughout the European Union, reflecting the ‘burning issues’ in the participants' healthcare systems, have been collected by a team based at Imperial College, London, where they are now being edited into a series of seven activity-based workbooks for individual or group (...) study. These draft workbooks are now being read by a network of critical readers across Europe, whose comments will be incorporated into the final versions of the workbooks. The result will be the first European-wide and Europe-centred resource for teaching students, practitioners, and members of ethics committees. Topics covered include: • Resource allocation and rationing • The rights of children and young people • Long-term care of the elderly • Mental health and mental illness • Autonomy and patient choice • Decisions at the end of life • A study guide to using the workbooks The collaborative nature of the project has highlighted differentiated national approaches in medical ethics. Against the British and Dutch rights-orientated approach have emerged two other alternative models: the Nordic preference for administrative resolution of entitlement disputes, and the southern European emphasis on deontological codes. A genuinely European reconstruction of autonomy and rights, using hermeneutic, feminist and narrative approaches to counterbalance individualistic models, is emerging across the workbooks. The programme has also uncovered national differences in how ethics should be taught, with the workbooks' style being an experiential approach. Thus the EBEPE project is developing new models in both substantive and pedagogic senses, about both what should be taught and how it should be presented. (shrink)

IntroductionDeep brain stimulation (DBS) is increasingly used to treat the symptoms of various neurologic and psychiatric conditions. People can undergo the procedure during reproductive years but the safety of DBS in pregnancy remains relatively unknown given the paucity of published cases. We thus conducted a review of the literature to determine the state of current knowledge about DBS in pregnancy and to determine how eligibility criteria are approached in clinical trials with respect to pregnancy and the potential for pregnancy.MethodsA literature (...) review was conducted in EMBASE to identify articles involving DBS and pregnancy. Two reviewers independently analyzed the articles to confirm inclusion. Data extracted for analysis included conditions treated, complications at all stages of pregnancy, neonatal/pediatric outcomes, and DBS target. A second search was then conducted using www.clinicaltrials.gov. The same two reviewers then assessed whether each trial excluded pregnant individuals, lactating individuals, or persons of childbearing age planning to conceive. Also assessed was whether contraception had to be deemed adequate prior to enrollment.ResultsThe literature search returned 681 articles. Following independent analysis and agreement of two reviewers, 8 pregnancy related DBS articles were included for analysis. These articles described 27 subjects, 29 pregnancies (2 with subsequent pregnancies), and 31 infants (2 twin pregnancies). There was 1 preterm birth at 35 weeks, and 3 patients who experienced discomfort from the DBS battery (i.e., impulse generator) placement site. All 27 patients had a DBS device implanted before they became pregnant, which remained in use throughout their pregnancy. There was exclusion of pregnant individuals from 68% of 135 interventional trials involving DBS. Approximately 44% of these trials excluded persons of childbearing age not on “adequate contraception” or wishing to conceive in the coming years. Finally, 22% excluded breastfeeding persons.ConclusionThe data from 29 pregnancies receiving DBS treatment during pregnancy was not associated with unexpected pregnancy or post-partum complication patterns. Many clinical trials have excluded pregnant individuals. Documentation of outcomes in larger numbers of pregnancies will help clarify the safety profile and will help guide study designs that will safely include pregnant patients. (shrink)

The use of video for research purposes is something that has attracted ethical attention and debate. While the usefulness of video as a mechanism to collect data is widely agreed, the ethical sensitivity and impact of recording equipment is more contentious. In some clinical settings the presence of a camera has a dual role, as a portal to a reflecting team and as a recording device to obtain research data. Using data from one such setting, family therapy sessions, this article (...) shows how the role played by recording equipment is negotiated in the course of talk and other activities that constitute sessions. Analysis reveals that members of the therapy interaction orient in different ways and for different purposes to the value of recordings. The article concludes that there are layers of benefit to be derived from recording of clinical interactions, including for members themselves, and this has wider implications for the ways in which qualitative research designs in health sciences are evaluated. (shrink)

Excerpt from Talks on Wrote This In The discussion of the doctrine of Concentration presented in this book is the outcome of work done in the Cook County Normal School. In 1883 I resigned my position as one of the Supervisors of the Boston schools in order to come into closer range and con tact with children's minds. The work done in Quincy was a slight beginning of something far better. About the Publisher Forgotten Books publishes hundreds of thousands of (...) rare and classic books. Find more at www.forgottenbooks.com This book is a reproduction of an important historical work. Forgotten Books uses state-of-the-art technology to digitally reconstruct the work, preserving the original format whilst repairing imperfections present in the aged copy. In rare cases, an imperfection in the original, such as a blemish or missing page, may be replicated in our edition. We do, however, repair the vast majority of imperfections successfully; any imperfections that remain are intentionally left to preserve the state of such historical works. (shrink)

At the International Legal Ethics Conference IV held at Stanford Law School between 15 and 17 July 2010, one of the two opening plenary sessions consisted of a panel who debated the proposition that legal ethics should be mandatory in legal education. The panel included leading legal ethics academics from jurisdictions around the world—both those where legal ethics is a compulsory part of the law degree and those where it is not. It comprised Professors Andrew Boon, Brent Cotter, Christine (...) class='Hi'>Parker, Stephen L Pepper and Richard Wu, and was organised and chaired by Professor Kim Economides. This is an edited version of the panel's discussion. It provides a useful summary of the state of legal ethics teaching in the jurisdictions represented as well as a marshalling of the arguments for and against legal ethics as a required course in the university law degree. (shrink)

Along with technological progress, vocational education and training (VET) is consistently changing. Workforce disruption has serious consequences for workers and international economies, often requiring adults to transition into different occupations or to upskill to maintain employment. We review recent literature covering VET trends, theoretical considerations for the 21st century, and present an approach to workforce training to help workers not only learn necessary skills but also become adaptable to constant change. We suggest a functional contextualist approach to mastery learning achieves (...) this aim. Specifically, we offer suggestions for pedagogy that not only develop skills but also encourage higher order thinking. Within a novice to expert continuum, we suggest deliberate practice, mental simulation, and reflective meaning making as methods to achieve efficiency and transfer—learning outcomes relevant to a changing workforce. This approach recognizes that learning is context bound and should promote broader human capabilities that support both employability and the continuing development of life literacies. (shrink)

Explaining the complex history of art to an individual or group can be extremely difficult. Explaining how to approach works of art from the vast history of the subject can be nearly impossible. An entire industry of books aimed at surveying art from a Western or global view is employed each semester at colleges and universities. Straightforward and condensed survey books such as Gardner's Art Through the Ages or museum guidebooks such as The Art Institute of Chicago: The Essential Guide1 (...) are directed at providing at least a workable knowledge of art in general or the art to be encountered in a museum's collection. However, it is rare to find a book that attempts to explain how to approach works of art in any .. (shrink)

The Australian Health Ethics Committee’s National Statement on Ethical Conduct in Research Involving Humans (1999) expanded the health and medical focus of preceding statements by including all disciplines of research. The Statement purports to promote a uniformly high ethical standard for this expanded range of research, and is endorsed by, inter alia, the Australian Academy of the Humanities, the Australian Academy of Science, and the Academy of Social Sciences in Australia.High ethical standards should apply to all research involving humans. However, (...) uniformity in the review processes of disparate research endeavours is not a necessary condition for uniformly high ethical standards. Bringing the ethical review of all research under a model which has developed within the context of health and medical research ethics for over thirty years may be inappropriate and at times incoherent. The language, methods, nature and products of research in areas such as the Humanities are often very different from those of health, medical and other sciences.The Behavioural and Social Sciences Ethics Review Committee at The University of Queensland (UQ) had, since the mid-1980s, considered that the guidelines of the time did, in fact, cover all aspects of human experimentation. We describe the ways in which this position was implemented, how issues raised by the new wording in the National Statement have been recently managed by UQ’s research ethics committees, and point to outstanding questions. (shrink)

First published in 2006. Routledge is an imprint of Taylor & Francis, an informa company.

Mr. Williams argues that subjectivism or epistemological dualism is just as compatible with knowledge of objective things themselves as his own Objectivism is, that it is false that "if we experienced only...'subjective' impressions and ideas, we should never know anything of the rest of the world, not even that it exists". He maintains this on the ground that "subjective or objective... the datum is an existent and can't help being evidence about existents". It is indeed true that the datum, being (...) an existent, can't help being evidence for other existents if we know that there are other existents. But this is just what we could not know if subjectivism or epistemological dualism were true, if we knew only subjective existents. For while such subjective existents might be evidence of objective existents if there were any, we could not know that there were any and hence could not know that our subjective existents were evidence of them. (shrink)

The materials consist of a co-authored, peer-reviewed book, a co-authored, peer-reviewed book chapter, 30 single authored peer-reviewed journal papers, and 15 co-authored peer-reviewed journal papers, of which I was the lead author on 8 papers. There are 32 papers from Australasian journals, at least two of which are also regarded as international. 22 papers are published in international journals. The co-authored book was favourably described in his foreword by Justice Michael Kirby of the High Court of Australia. The refereed chapter (...) is contained in an issue of the Australian Legal Monographs series. The papers constitute a body of work in Australasian and international contexts in a field which is relatively new to academic achievement, broadly understood as philosophy of medicine, medical ethics and health law. The journals in which the papers are published include two of the most highly regarded bioethics journals in the world, Australia’s leading medical journal, the two leading world medical education journals, Australia’s leading journal for health and medical law, and the Torts Law Journal, an Australian journal which is recognized as one of the world’s leading journals in the field of tort law. (shrink)

Society and social structures play an important role in the formation and evaluation of concepts and practices in clinical ethics. This is evident in the ways the authors in this issue explore a wide range of arguments and concepts in clinical ethics including moral distress and conscience based practice, phenomenological interview techniques and gender dysphoria, continuous deep sedation (CDS) at the end of life, the notion of patient expertise, ethically permissible medical billing practices, the notion of selfhood and patient centered (...) care in dementia patients, and the definition of minimal risk as used in research regulations. (shrink)

Zusammenfassung Obwohl in letzter Zeit manche Gelehrte die Existenz des Mederreiches, das nach Herodot dem Perserreich voraufgegangen sein soll, zu leugnen versuchen, weisen die Medismen im Altpersischen darauf hin, daß die Meder eine Reichsideologie sowie Reichsinstitutionen entwickelt hatten, welche die Perser von ihnen übernahmen. Dies legt nahe, daß es ein Mederreich tatsächlich gegeben hat. Des weiteren bezeugen die vorderasiatischen Quellen ganz unabhängig von Herodot einen mächtigen medischen ‚Staat‘; Jer. 51,28 weist diesem ‚Staat‘ sogar Reichsbeamte zu. Des weiteren zeigt eine eingehende (...) Besprechung des medischen Logos bei Herodot, daß diese Partie so stark iranisch geprägt ist, daß man sie keinesfalls als Erfindung Herodots abtun kann: statt dessen ist vielmehr von iranischem Quellenmaterial zu reden, welches die Existenz eines Mederreiches von sich aus bezeugt. (shrink)

In the second book of his Epitoma rei militaris Vegetius sets himself the task of describing the organization of the antiqua legio of the Roman Army, the units into which it was divided, its officers, the arms of its soldiers, and its tactical employment on the field of battle. Interspersed in this account are frequent references to changes that had been subsequently effected and were in operation in the author's lifetime. But although these annotations destroy the synthesis of the book, (...) and the transition from past to present is not always clearly indicated, the disentanglement of Vegetius' own additions from the material provided by his source or sources is not the chief difficulty that confronts the modern historian. For with few exceptions in chapters 4–14 Vegetius describes the antiqua legio in the imperfect, the legion of his own time in the present indicative, with the not infrequent addition of the word ‘nunc’ or ‘hodie.’ The great problem is to discover whether in his account of the antiqua legio the author is referring to any one period of Roman History, and, if so, whether its limits can be exactly defined. Many solutions have been attempted. Some scholars have thought that the period is earlier than Hadrian; the more generally accepted theory is that the antiqua legio can be identified with the legion as it was constituted in the reign of Diocletian. Recently two German historians have subjected the evidence to fresh consideration, and, while one of them agrees with the majority in selecting the age of Diocletian for his answer to the problem, the other believes that he can date the period to which Vegetius is referring to the late second century A.D. (shrink)

This paper clarifies certain issues raised by Wendell Stephenson ( The Journal of Medicine and Philosophy 18: 375–388, 1993) about research programs and animal care practices at the Oregon Regional Primate Research Center. It also responds to Stephenson's critique of the National Institute of Health's Guide for the Care and Use of Laboratory Animals . It identifies utilitarianism as the ethical theory underlying Stephenson's critique. Arguing that such an ethical theory is unworkable in addressing concerns about biomedical research and the (...) use of animals, the paper defends the Guide's reliance on a wider tradition of ethical theories. Keywords: animal well-being, biomedical research, in-vitro fertilization, NIH, Stephenson, utilitarianism CiteULike Connotea Del.icio.us What's this? (shrink)

This article’s subject is the theory and practice of ‘regional survey’, the method of social and environmental study associated with Scottish thinker Patrick Geddes (1854–1932). Despite being overlooked or dismissed in most accounts of early 20th-century social science, regional survey had a wide influence on the development of the nascent disciplines of anthropology, sociology, and human geography. Emerging from late 19th-century field biology, the regional survey came to typify a methodological moment in the natural and social sciences that favoured the (...) holistic analysis of geographically delimited areas. By the interwar period, the kinds of projects that went under its name can clearly be seen as forerunners of the post-Second World War tradition of community studies. Additionally, in its self-presentation as a civic, participatory exercise, the regional survey can be read as a form of popular autoethnography that contrasts with other, more familiar social-scientific ventures in the first half of the 20th century, and defies the dichotomy between ‘gentlemanly’ and ‘technical’ modes of social science. As a result, this article argues, the regional survey provides an alternative point of departure for thinking about the origins and development of the modern social sciences in Britain. (shrink)