Requests by patients or their families for treatment which the patient's physician considers to be "inappropriate" are becoming more frequent than refusals of treatment which the physician considers appropriate. Such requests are often based on the patient's religious beliefs about the attributes of God (sovereignty, omnipotence), the attributes of persons (sanctity of life), or the individual's personal relationship with God (communication, commands, etc). We present four such cases and discuss some of the basic religious tenets of the three Abrahamic faith (...) traditions as they relate to such requests. We suggest that religious reasons for requesting "inappropriate" treatment are "special" and deserve serious consideration. We offer guidance to assist clinicians and clinical ethicists as they attempt to resolve these conflicts, emphasising the importance of understanding the religious beliefs of the patient/surrogate and suggesting the assistance of a religious interpreter. We suggest open discussion with patients and families of both the clinical situation and the theological basis for these requests. We also suggest that clinicians use additional religious doctrines or principles from patients' own traditions to balance the reasons behind the requests. We conclude that most persistent requests for "inappropriate" treatment should be honoured. (shrink)

Savulescu maintains that our paper, which encourages clinicians to honour requests for "inappropriate treatment" is prejudicial to his atheistic beliefs, and therefore wrong. In this paper we clarify and expand on our ideas, and respond to his assertion that medicine, ethics and atheism are objective, rational and true, while religion is irrational and false.

Governments are investing in precision medicine with the aim of improving healthcare through the use of genomic analyses and data analytics to develop tailored treatment approaches for individual patients. The success of PM is contingent upon clear public communications that engender trust and secure the social licence to collect and share large population-wide data sets because specific consent for each data re-use is impractical. Variation in the terminology used by different programmes used to describe PM may hinder clear communication and (...) threaten trust. Language is used to create common understanding and expectations regarding precision medicine between researchers, clinicians and the volunteers. There is a need to better understand public interpretations of PM-related terminology. This paper reports on a qualitative study involving 24 focus group participants in the multi-lingual context of Singapore. The study explored how Singaporeans interpret and understand the terms ‘precision medicine’ and ‘personalised medicine’, and which term they felt more aptly communicates the concept and goals of PM. Results suggest that participants were unable to readily link the terms with this area of medicine and initially displayed preferences for the more familiar term of ‘personalised’. The use of visual aids to convey key concepts resonated with participants, some of whom then indicated preferences for the term ‘precision’ as being a more accurate description of PM research. These aids helped to facilitate dialogue around the ethical and social value, as well as the risks, of PM. Implications for programme developers and policy makers are discussed. (shrink)

One of the most recent controversies to arise in the field of bioethics concerns the ethics for the Groningen Protocol: the guidelines proposed by the Groningen Academic Hospital in The Netherlands, which would permit doctors to actively euthanise terminally ill infants who are suffering. The Groningen Protocol has been met with an intense amount of criticism, some even calling it a relapse into a Hitleresque style of eugenics, where people with disabilities are killed solely because of their handicaps. The purpose (...) of this paper is threefold. First, the paper will attempt to disabuse readers of this erroneous understanding of the Groningen Protocol by showing how such a policy does not aim at making quality-of-life judgements, given that it restricts euthanasia to suffering and terminally ill infants. Second, the paper illustrates that what the Groningen Protocol proposes to do is both ethical and also the most humane alternative for these suffering and dying infants. Lastly, responses are given to some of the worries expressed by ethicists on the practice of any type of non-voluntary active euthanasia. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:THE UNITY OF THE VICES JONATHAN JACOBS Oolgate University, Hamilton, New York JOHN ZEIS Oanisius Ooilege, Buffalo, New York W:E SOMETIMES describe someone 1rus "just plain,, ' ' • • 0 " ' ' • • mean, or Just plam d1shonesit, orr JUSt pJam unw." Or we say" thaJt wrus ·a just plain ·stupid thing rto do.," G~a:liizing from tlhese and lik!e descriiptions, we can ask, are there any (...) "just plain" vices? By this I mean, are :amy vices pure, 1e.g., can rthere he Cl'lllelty hut nort injustice or in!t:Jempertance, intemperance hut no!t a £ailill'e orf pmctical wisdom, cowardice but not intemperance or injustice, and so on? Is therie perhaps a unity of the vices? Is each ;a col'l'IU!ption thrat involves the coITUpiting ctontriburtion of the othe'l'IS? If there is,a, run:iity of the vicies, then 1be:inig ra vicious individual is Il!Ort siinply 1a ma!bter o:f failing :across the dimensioill of one or rrunothe.r 1 Cihaa:iae1becisltic. ]t ms tan extensi,ve diaiilure, 1a unified (:if l[JIOrt toit.al) failure, even if it is most evident 1and preVialent in one or another •specific respecit. 'f1his iis not to isay thrut.theiie is just one vice,.any moil'!e 1than '!Jo.endorse the unity of it.he virtues is to reduce tth:em to Ollle. There.are many woes OOlld many virrbues, eaiCh respeotively h!ruving to do with dillemnt 1and variously!l'le1aibed crupacirties, motives, emotions, and tiiaiits. Yet, rut least with respect to the virtues a good caise can be mrude :that they.are unified, aind thrut ·AnisbotLe was oorrreot in concluding that practical wisdom :and viWtues of cha;riacter mum occur st quite 1 s1tably, even if '1llolt happily. In any case, we ail"e in 1 to:tal ag.rteemelllt with Geach when he 1sayis 1that ithaJt "If 1a man's ha1bit of sound moml judgme1J11t is virtiiafod anyiwhere, then :it is at risk eVierywhere; but not all dangel"s issue in disa1sit1e'f!s." 3 But 1thes1e dis1as!ters arie aV1eTted r.not because of,any moml str1ength of characil:er 1 th:ait the agent 1truly ihas bUJt heca:us1 e of a me11e inc1ilJJaition tues. 'Ilhe former may he very :firm ox srtable. Mo11eover the n:aituil'ally vi11tuous rindividual may giener1a1ly no1t he oornfused or.impeded maction by "b.ar:d easies" or nnvelty. Alt times he rmay, 1and lthien me may find his re1sourroes iinoompe1be!I1t O'I.' unoel 'l:Ja1in in 1bhreir direetives. Hut the main rpo:inlt of co111iCT'last is thait mo11al virtues 11eflieot 1a 1evel of 1agency wh1oh involves undersitanding 1and self-determin1ation engiaged 1 to t:hat undersltanding, 1a 1leviel tihJait tis 1ruhsen1t foom iinc1ination-grounded action. Na,tu11a1l vri:r1tues 1a1rie ll101t to he despised, 1 and 1aclts :thait fLorw 1f110m 1tJhem 1are not w:iithout moml Wiortlh. But, using the fangiuiage of Fr1a:nk£u:rt, mom1l virtues are oha1racter]s,tios thait refiecrt second order volitions.5 The aiotis: thait flow fil1om them •are not H11e reis:ult of ways one just hrupens to be. And the undeil'-,starnding involvred in moml vrntues makes mo'ral misdireotion 1 1es;s li1"ely. Again, mnswder suoh t.lrings rus mis1applied oomprussfon, or paiti:errce, whioh can involve u1mairness 1and imprudence. P1 errharpis it.is heoausie rbhe mo:rial V1mtueis rare unified that it is 1so hard to rbe 1good. They invo1vie a complex reperrto:We of judgmenits, d1sposi!tiorrs, and moti¥es. No one of them can he oomp1ete on its own, and wie c1an't oome to have 1 tJhem simply 1hy decis1on. One oan til.'y rbo he move coumgeous bU1t caill't ibring it rubout meriely hy init1emal eommanid. Self-imposrutiion in5 In " Freedom of the Will and 'The Concept of a Person," H. Frankfurt writes, "Someone has a desire of the second order when he wants simply to have a certain desire or when he wants a certain desire to be his will. In situations of the latter kind, I shall call his second-order desires "secondorder volitions" or " volitions of the second order." Now it is having... (shrink)

This article deals with the specific claim that prophylactic male infant circumcision should be employed to prevent HIV transmission in countries in which the prevalence of HIV is relatively low. In a recent editorial, Australian researchers sought to promote the procedure as a ‘surgical vaccine’ against HIV in their country. This raises the question whether it would be reasonable for the UK to adopt a policy of mass infant male circumcision in order to protect individuals from heterosexually acquired infection with (...) HIV. A review of the relevant data and associated commentary indicates that the actual benefits of real-world circumcision policies to prevent HIV transmission are disputed and that circumcision, at best, provides partial protection. In addition, it is uncertain whether infant circumcision confers the same benefits that the adult procedure is proposed to provide. Reasons for performing circumcisions on infants include that the procedure is easier, less complicated and cheaper. However, it is not risk free. Despite arguments to the contrary, this article contends that it is morally problematic to operate on thousands of male infants each year for little benefit to children qua children. It is also argued that the use of the term ‘surgical vaccine’ to describe the procedure is both inaccurate and misleading. (shrink)

Citation data have become an increasingly significant source of information for historians, sociologists, and other researchers studying the evolution of science. In the past few decades elaborate methodologies have been developed for the use of citation data in the study of the modern history of science. This article focuses on how citation indexes make it possible to trace the background and development of discoveries as well as to assess the credit that publishing scientists assign to particular discoverers. Kuhn's notion of (...) discovery is discussed. The priority dispute over the discovery of the AIDS virus is used as an example. (shrink)

Between 1860-1920 a number of distinguished Scottish theologians grappled with the problems of reconciling a biblical faith with current philosophical and theological trends. Alan Sell has selected eight of these: John Kennedy of Dingwall ; Robert Flint ; John Caird ; A. B. Bruce ; James Iverach ; James Orr ; D. W. Forrest ; and James Denney. The book is not only of historical interest; many of the issues confronted by these scholars are also of contemporary interest. Professor James (...) Torrance comments: 'This study is invaluable in keeping alive the authentic tradition that Scotland has produced great theologians,... but perhaps supremely in the period covered by this eminently readable book.'. (shrink)

"This title was first published in 2003.Developments in genetic science are opening up new possibilities for human beings; both the creation and the shaping of human life are now possible in the laboratory. As these techniques develop, questions are increasingly asked about how far everything that is scientifically possible should - morally, legally and socially - be pursued. Whilst much attention and policy-making has focussed on the development of regulation of technologies affecting human reproduction, regulation where plants and animals are (...) concerned is much more limited. In this book, developments in genetics are addressed in the broad sense by an international range of contributors. This includes not only issues such as eugenics and the modification of the human embryo, but also the genetic modification of plants and animals in the pursuit of commerce, agriculture and biomedical research. This book is published in association with the Society for Applied Philosophy"--Provided by publisher. (shrink)