Rawls' main aim in A Theory of Justice is to provide a viable alternative to the utilitarianism which has dominated so much modern moral philosophy. Although philosophers have long recognised the difficulties in the way of acceptance of a utilitarian account of judgments of justice, they have often responded by seeking merely to reformulate the principle of utility. Other philosophers, with a juster appreciation of the seriousness of these difficulties, have been prepared to reject utilitarianism in all its guises, (...) but they have failed “to construct a workable and systematic moral conception to oppose it”. What is needed, beyond a powerful reaffirmation of the familiar objections to utilitarian accounts of justice, is the careful elaboration of a radically non-utilitarian theory of justice. It is this need which Rawls sets out to meet in his book. (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)

Critical literatures, and public discourses, on public health policies and practices often present fixated concerns with paternalism. In this paper, rather than focus on the question of whether and why intended instances of paternalistic policy might be justified, we look to the wider, real-world socio-political contexts against which normative evaluations of public health must take place. We explain how evaluative critiques of public health policy and practice must be sensitive to the nuance and complexity of policy contexts. This includes sensitivity (...) to the ‘imperfect’ reach and application of policy, leading to collateral effects including collateral paternalism. We argue that theoretical critiques must temper their demandingness to real-world applicability, allowing for the detail of social and policy contexts, including harm reduction: apparent knock-down objections of paternalism cannot hold if they are limited to an abstract or artificially-isolated evaluation of the reach of a public health intervention. (shrink)

In ethical theory, different concepts of autonomy can be distinguished. In this article we explore how these concepts of autonomy are combined in theory in the citizenship paradigm, and how this turns out in the practice of care for people with acquired brain injury. The stories of a professional caregiver and a client with acquired brain injury show that the combination of various concepts of autonomy in practice leads to tensions between caregivers and clients. These dynamics are discussed from a (...) care ethics perspective, stressing the importance of relationships and interdependence, as well as paying attention to various, sometimes conflicting, perspectives in a deliberative dialogue. (shrink)

Classical particles of the same kind are distinguishable: they can be labeled by their positions and follow different trajectories. This distinguishability affects the number of ways W a macrostate can be realized on the micro-level, and via S=k ln W this leads to a non-extensive expression for the entropy. This result is generally considered wrong because of its inconsistency with thermodynamics. It is sometimes concluded from this inconsistency, notoriously illustrated by the Gibbs paradox, that identical particles must be treated as (...) indistinguishable after all; and even that quantum mechanics is indispensable for making sense of this. In this article we argue, by contrast, that the classical statistics of distinguishable particles and the resulting non-extensive entropy function are perfectly all-right both from a theoretical and an experimental perspective. We remove the inconsistency with thermodynamics by pointing out that the entropy concept in statistical mechanics is not completely identical to the thermodynamical one. Finally, we observe that even identical quantum particles are in some cases distinguishable; and conclude that quantum mechanics is irrelevant to the Gibbs paradox. (shrink)

The patient-doctor relationship has recently come under intense scrutiny, resulting in a re-evaluation of the basis of that relationship. The papers by Glannon and Ross, and McKay seek to identify the sources of authority in the patient-doctor relationship by evaluating it in terms of the concept of altruism. In this paper I argue that the analysis of Glannon and Ross, and of McKay is unnecessary and that the analysis offered by the latter is also flawed. I do acknowledge, however, that (...) Glannon and Ross's description of doctors' responsibilities and patients' roles has much to commend it. (shrink)

The system of clinical ethics committees (CECs) in the United Kingdom is based on goodwill. No formal requirements exist as to constitution, membership, range of expertise or the status of their recommendations. Healthcare professionals are not obliged to use CECs where they exist, nor to follow any advice received. In addition, the make-up of CECs suggests that ethics itself may be under-represented. In most cases, there is one member with a training in ethics – the rest are healthcare professionals or (...) administrators, although a lawyer is generally also included in the membership. This begs the question as whether CECs can ‘do ethics’, as well whether or not they can take seriously the requirements of due process, formal justice and human rights. Moreover, the role of the patient in this system is opaque. (shrink)

Emergencies are extreme events which threaten to cause massive disruption to society and negatively affect the physical and psychological well-being of its members. They raise important practical and theoretical questions about how we should treat each other in times of 'crisis'. The articles selected for this volume focus on the nature and significance of emergencies, demonstrate the normative implications of emergencies and provide multi-disciplinary perspectives on the ethics of emergency response.

Ausgehend von der, von Journalisten und Musikern immer wieder bemühten Metapher des 'Black CNN' wird versucht, das Potenzial der musikalischen Ausdrucksform des HipHop als Kommunikationsstruktur der Schwarzen Minderheit in den USA zu analysieren. Nach einer historisch-kulturellen Erläuterung, die sich mit der Tradition der Reflektion sozialer und politischer Aspekte in den unterschiedlichen musikalischen Äußerungen der Schwarzen Volksgruppe in den USA beschäftigt und schon ansatzweise die Bedeutung dieser Ausdrucksmöglichkeit im Kontext eines 'internal colonialsm' vor Augen führt, werden jene soziodemographischen Entwicklungen nachvollziehbar gemacht, (...) die sich als zentraler Kritikpunkt in den verbalen Artikulationen des HipHop widerspiegeln. Bestehende mediale Dysfunktionen hinsichtlich der Repräsentation von Angehörigen der Schwarzen Minderheit werden mit einem entsprechenden Fallbeispiel belegt. Vor dem theoretischem Hintergrund von 'cultural citizenship' - ein Konzept zur Bestimmung kultureller Teilhabe in der Mediengesellschaft -, werden 25 Textbeispiele, die sich auf HipHop-Veröffentlichungen von 1982 bis 2004 finden, auf ihre Übereinstimmung mit Indikatoren untersucht, die sich aus, den Medien zugeschriebenen, politischen und sozialen Funktionen ableiten lassen. Die angewandte Inhaltsanalyse lässt zahlreiche Entsprechungen erkennen, die sich zum Teil in komplexen, der Kritik- und Kontrollfunktion bzw. Integrationsfunktion der Medien zuzuordnenden Inhalten äußern. (shrink)

The universe, of which our domicile the planet Earth forms but a minuscule part, has an architecture that changes and has been changing in time. In other words, it has a history of evolution. Lack of experimental evidence denies us the knowledge of what the universe was like “at the time of its origin,” as discussed by Hubert Reeves in the preceding chapter. Neither do we know much about its geometry, simply because our observatories are concentrated, for all practical purposes, (...) vanishingly close to a single point in an immensity whose size can only be measured by the billions of years required by light to go from one extremity to another! (shrink)

The essays collected together in this volume, many of them written by leading scholars in the field, explore the commonsensical fact that our presence as..