This article addresses a common yet rarely discussed aspect of hospital care—a pro-active approach to ethical dilemmas. Potential ethical conflicts often present warning signs to clinicians, analogous to the warning lights on a car’s dashboard. Using a recent case study, a commonly encountered clinical decision—a conflict about whether to terminally extubate a critically ill patient versus whether to offer a tracheostomy— we describe a pro-active approach to ethical conflicts and outline three learning objectives: (1) the need for a robust understanding (...) of the term “futility,” (2) the need for an appreciation of the various and often conflicting interpretations of “improved/improving,” and (3) the need to understand the challenges of surrogate decision making. (shrink)

In this issue of the American Journal of Bioethics, manuscripts focus on the obligations of clinicians and researchers in pragmatic clinical trials (Garland, Morain, and Sugarman 2023; Morain and L...

As our scientific and technical abilities expand at breathtaking speeds, concern that modern genetics and bioengineering are leading us to a posthuman future is growing. Is Human Nature Obsolete? poses the overarching question of what it is to be human against the background of these current advances in biotechnology. Its perspective is philosophical and interdisciplinary rather than technical; the focus is on questions of fundamental ontological importance rather than the specifics of medical or scientific practice.The authors -- all distinguished scholars (...) in their fields -- take on questions about technology's goals and values that are often ignored or sidelined in the face of rapid scientific advances and the highly specialized nature of technical knowledge. The essays included represent a rich variety of thought, ranging from finely nuanced philosophical and theological arguments to historical studies and cultural commentaries. Several explore the historical background of today's biotechnology: Timothy Casey traces such developments as the emergence of cybernetic humanity from Cartesian dualism, and Diane Paul presents the history of "positive" versus coerced eugenics. Jean Bethke Elshtain discusses cloning as a "messianic project" to perfect the body and exclude natural diversity -- giving as an example the elimination of Down Syndrome as an acceptable human type -- while Harold Baillie calls for an examination of the metaphysical roots of personhood. Robert Proctor finds no evidence in paleontology for any "essence of humanity," and Tom Shannon argues against materialist reductionism. Addressing social concerns, Lisa Sowle Cahill finds the possibility of a political solution to the problems raised by genetic engineering in Catholic teachings on social justice, and Langdon Winner looks critically at the "scientific enthusiasts of a posthuman future." Taken as a whole, the book provides a humanistic overview of a subject too often considered only in its technological aspect. (shrink)

We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Under the Supreme Court's compelled speech cases, the context of government-mandated disclosures determines the standard of review. Pursuant to Casey, Zauderer, and Whalen, compelled disclosures in the medical context, such as speech-and-display ultrasound laws, are subject to – and survive – a form of rational basis scrutiny.

A chapter in the book, Philosophies of Place: An Intercultural Conversation, edited by Peter D. Hershock and Roger T. Ames, and published by University of Hawaii Press. In this chapter I present a phenomenological ontology of place vis-a-vis horizon and also alterity (otherness), discussing related themes in Heidegger, Kitaro Nishida, Shizuteru Ueda, Otto Bollnow, Karl Jaspers, Ed Casey, Günter Figal, Bernhard Waldenfels, and others. Wherever we are we are implaced, delimited in our being-in-the-world constituted by a horizon that implaces (...) us, not only literally but semantically and ontologically. Whether we take place in its semantic sense or as ontological, I underscore its duplicity—taking off from Ueda Shizuteru’s concept of two-fold being-in-the-world—as on the one hand demarcating a realm of determinacy, our ontological finitude or our social imaginary world, and on the other hand through its horizonal nature as pointing to an indeterminacy or exteriority that demarcates or delimits that realm, finitizing us. That latter may be characterized as an excess irreducible to semantic or ontological determination or as a nothing or a-meaning. Hence place with its horizon implies the interface of meaning and a-meaning, nomos and anomy, principles and anarché, in Nishidian terms being and the nothing (mu), in Heideggerian terms unconcealment and concealment or world and earth. Thus the horizon that constitutes place entails both finitude and openness, allowing for alterity and alteration, whereby the determinations within place are never fixed, secure, or guaranteed. In demarcating a place, the horizon always points to a yonder beyond the place, its other. In its very contact with the unassmilable or irreducible, the line of demarcation is itself thus unpredictable in its fluctuations. The place determined within the nothing or the clearing of unconcealment amidst the concealed will thus always be provisional despite any appearance or claims to the contrary. Its determination is indeterminate. (shrink)

The article sets out from an understanding of design as an aesthetic form of practical world access. This is specified to the effect that design gives the world an expression in the first place: design is a way through which the world comes to view. This assumption is to be explained in more detail by means of a phenomenologically shaped concept of topology. At the center of a phenomenological topology lies the concept of place. According to Edward Casey, the (...) nature of place should be determined on the basis of the connection between things and the livedbody, whose topological meaning will first be explained in more detail. In the second step, it is then shown that design is topological design. Design as aesthetic workmakes the world appear by referring to the two constitutive moments of place, the gathering of things and the entangled corporeality, and thus brings the world to view in a topological fashion. (shrink)

Thomas Hobbes’s innovative anthropology and novel doctrines of natural right, natural law, and positive law have been taken to inaugurate a tradition that grows into modern United States abortion jurisprudence. In this essay I argue that a careful rereading of Hobbes reveals that the characterization of Hobbes as the philosophical and jurisprudential forefather of abortion rights is false. While Hobbes never directly addressed the question of abortion, I argue that we can reconstruct his position from his philosophical texts. First, I (...) reconstruct the Hobbesian philosophical case against abortion via a rereading of his notions of family, hominization, and natural law. Second, I apply these principles along with Hobbes’s theories of equity and sovereignty to formulate a Hobbesian jurisprudential case against the Roe-Casey order of permissive abortion law. (shrink)

Interest in imagination dates back to Plato and Aristotle, but full-length works have been devoted to it only relatively recently by Sartre, McKellar, Furlong, Casey, Johnson, Warnock, Brann, and others. Despite their length and variety, however, these current theories take overly narrow views of this complex phenomenon. Their definitions of “imagination” neglect the multiplicity of its meanings and tend to focus narrowly on the power of imaging alone. But imagination in the fullest, most encompassing sense centers instead on creativity, (...) which involves both imaging and reasoning powers. Current accounts of the operations of imagination narrowly construe it in fixed, immutable terms. But it’s instead a dynamic, evolving synergy of its psychological roots and sociobiological roots. This synergy has transformed the roles of images and symbols in imagination. For example, in the shift from mytheopic to scientific imagination, literacy and formal education fostered abstract symbolic thinking, which differs from mytheopic thinking based on richly concrete associations. The result was “more than cool reason”, but experimental studies show that it’s also more than just dreamy imagery. It’s a dynamic synergy of the two that has transformed both. Current evaluations of imagination’s potentials are also narrow. They tend to focus on its role in mental life while ignoring social and political life. Also, they tend to follow romantic and existentialist customs of extolling imagination’s virtues without soberly critiquing its limitations. Again, they ignore the synergy of psychological, sociological and biological forces that shape mental and social evolution, and promote and constrain imagination in complex ways. For example, Sartre surreally asks us to choose our own nature with an imagination emancipated from institutional and instinctual strictures. Yet making intelligible choices depends on these strictures. In conclusion, current theories define imagination narrowly in terms of imaging, they describe its operations in fixed and immutable terms, and they evaluate its potentials without examining the full interplay of forces shaping it. These shortcomings are remedied by a broader perspective that defines imagination more adequately and comprehensively, and that recognizes it’s complex roots, dynamic operations, and evolving potentials. This paper is based on my 1994 work, The Roots of Imagination, which can be downloaded in full here in PhilPapers. (shrink)

First published in 1979, Irish Identity and the Literary Revival, through the works of W.B. Yeats, James Joyce, J. M. Synge, and Sean O'Casey, documents the complex spectrum of political, social and other pressures that helped fashion modern Ireland. At least three sets of cultural assumptions coexisted in Ireland during the years between 1890 and 1930, -- English, Irish and Anglo-Irish, each united by a common language but divided by considerable tensions and strain. The question of Irish identity forms (...) the central theme of the study, and illustrates how it was a major, even obsessive concern for these writers. Subsidiary and interwoven themes constantly recur. Themes such as the concepts of the peasant and the hero, political nationalism, the meaning of Ireland's history and the validity of her cultural traditions. Rather than use the literature concerned as merely endorsing evidence for a sociological or political thesis, this study allows its major themes and issues to emerge and develop from direct and close study of the work of the writers. This book will be of interest to students of literature and history. (shrink)

Books reviewed:John Barton, Joel and Obadiah: A Commentary John P. Meier, A Marginal Jew, Volume III: Companions and CompetitorsWilliam E. Arnal, Jesus and the Village Scribes: Galilean Conflicts and the Setting of QRichard A. Horsley, Hearing the Whole Story: The Politics of Plot in Mark's GospelMaurice Casey, Aramaic Sources of Mark's GospelPhilip Jenkins, Hidden Gospels: How the Search for Jesus Lost its WayChristopher M. Tuckett, Christology and the New Testament: Jesus and His Earliest FollowersMarkus Bockmuehl, The Cambridge Companion to (...) JesusShelly Matthews, First Converts: Rich Pagan Women and the Rhetoric of Mission in Early Judaism and ChristianityStephen J. Davis, The Cult of Saint Thecla: A Tradition of Women's Piety in Late AntiquityJ. Nimmo Smith, A Christian's Guide to Greek Culture. The Pseudo‐Nonnus Commentaries on Sermons 4, 5, 39 and 43 by Gregory of Nazianzus: Introduction, Translation and Notes.David Thomas, Early Moslem Polemic Against Christianity: Abu Isa al‐Warraq's ‘Against the Incarnation’Thomas O'Loughlin, Celtic Theology: Humanity, World and God in Early Irish WritingsCaroline M. Baron and Jenny Stratford, The Church and Learning in Later Medieval Society: Essays in Honour of R. B. Dobson Owen Chadwick, The Early Reformation on the Continent Benson Bobrick, The Making of the English BiblePeter Marhall and Alec Ryrie, The Beginnings of English ProtestantismRobert Tittler, The Reformation and the Towns in England. Politics and Political Culture, c. 1540–1640Peter Marshall, Beliefs and the Dead in Reformation EnglandNicholas Tyacke, Aspects of English Protestantism, c.1530–1700John Coffey, Persecution and Toleration in Protestant England, 1558–1689William Gibson, The Church of England 1688–1832: Unity and AccordWarwick Gould and Marjorie Reeves, Joachim of Fiore and the Myth of the Eternal Evangel in the Nineteenth and Twentieth CenturiesJames M. Byrne, God: Thoughts in an Age of Uncertainty Michael Palmer, The Question of God: An Introduction and SourcebookMichel René Barnes, The Power of God: ΔYNAMIΣ in Gregory of Nyssa's Trinitarian TheologyThomas Aquinas, Disputed Questions on VirtueStanley M. Hauerwas, Wilderness Wanderings: Probing Twentieth‐Century Theology and PhilosophyDavid Toole, Waiting for Godot in Sarajevo: Theological Reflections on Nihilism, Tragedy, and ApocalypseJohn Sullivan, Catholic Education: Distinctive and InclusiveGeorge Dennis O'Brien, The Idea of a Catholic UniversityGunnar Skirbekk and Nils Gilje, A History of Western ThoughtEllen Wagner, Essays on Plato's PsychologyAnthony Kenny, Aquinas on BeingJame Daly, Deals and Ideals: Two Concepts of EnlightenmentManfred Kuehn, Kant: A BiographyP. Travis Kroeker and Bruce K. Ward, Remembering the End: Dostoevsky as Prophet to ModernityStephen Mulhall, Inheritance and Originality: Wittgenstein, Heidegger, KierkegaardDavid Braybrooke, Natural Law ModernizedMaría Pía Lara, Rethinking EvilW. W. Meisner, Freud and PsychoanalysisJennifer Jackson, Truth, Trust and MedicineJeremy Sugarman and Daniel P. Sulmasy, Methods in Medical EthicsH. Tristram Engelhardt, Jr. and Mark J. Cherry, Allocating Scarce Medical Resources: Roman Catholic PerspectivesMaura A. Ryan, The Ethics and Economics of Assisted Reproduction: The Cost of LongingMichael Walsh, Dictionary of Christian Biography. (shrink)

In 1992, the United States Supreme Court, in Planned Parenthood of Southeastern Pennsylvania v. Casey, upheld the ruling in Roe v. Wade, namely that women have a right “to choose to have an abortion before viability and to obtain it without undue interference from the State.”1 However, since this ruling, some states have imposed regulations that greatly limit this right by restricting access. Texas is a recent example of this. Two proposed restrictions in House Bill 2, which will be (...) discussed in detail below, will force all but eight clinics that are located in metropolitan areas to shut down. The U.S. Supreme Court put the proposed restrictions on hold in October 2014, allowing several clinics to remain open while the restrictions are being appealed in the U.S. Court of Appeals for the Fifth Circuit. If the restrictions are passed, however, those clinics will be forced to shut down and, as a result, many women in Texas will be required to travel more than 100 miles in order to access a safe and legal abortion. Much of the focus of these restrictions has been on women and rightly so. However, I want to turn the attention to physicians. The requirements exacerbate unfair treatment of abortion providers compared with other physicians. Abortion providers face threats from the public—some of which turn into violent attacks—and they are often ostracized by their fellow medical practitioners. There are so few abortion providers to begin with and the proposed requirements limit these physicians’ opportunities to practice the branch of medicine of their choosing. Although the HB 2 requirements may not result in an unconstitutional undue burden on physicians, the challenges created by the bill limit physicians’ abilities to provide abortions. As a result of these limits, HB 2 creates an unconstitutional undue burden for women seeking abortions by creating barriers directed at abortion providers and clinic staff who are willing and able to provide abortions. The first of the two controversial HB 2 requirements is the admitting privileges requirement: “A physician performing or inducing an abortion must, on the date the abortion is performed or induced, have active admitting privileges at a hospital that is located not further than 30 miles from the location at which the abortion is performed or induced.”2 The second requirement is the ambulatory surgical center requirement: “The minimum standards for an abortion facility must be equivalent to the minimum standards adopted under [Texas Health & Safety Code] [...] for ambulatory surgical centres.”3 In order to meet these state-mandated obligations, some abortion clinics would have to spend more than $1 million in upgrades if they wish to remain open. The District Court decided that the ambulatory surgical center requirement places an unconstitutional undue burden on women, and that the two requirements together place an undue burden on women in Texas and especially in the Rio Grande Valley where the nearest clinic is a couple hundred miles away.4 Later, the U.S. Court of Appeals for the Fifth Circuit reversed the District Court’s decision and argued, “the admitting privileges requirement is constitutional on its face.”5 While the regulations are being appealed, the Supreme Court granted a stay of injunction, allowing about twelve abortion clinics to reopen until a final decision regarding the regulations is made. The District Court ruled that the purpose of the two regulations was to create a substantial obstacle for women seeking abortions in Texas. While the defendants argued that the regulations were designed to make abortions safer and reduce risk, the Court decided that this was not the case. An abortion, especially a first-term abortion, is a very safe procedure and is safer than many other routine surgical procedures. As stated in Planned Parenthood v. Casey, “Unnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on the right.”6 The undue burden in this case is imposed, not through restricting women’s access directly, but by restricting physicians’ freedom to perform abortions. The admitting privileges requirement has reduced the number of physicians who can perform abortions and the ambulatory surgical center requirement has reduced the number of clinics where abortions can be performed. The American Medical Association states, “[t]he Principles of Medical Ethics of the AMA do not prohibit a physician from performing an abortion in accordance with good medical practice and under circumstances that do not violate the law.”7 This means that physicians are not required to perform abortions, except in emergency situations, but can as long as the procedure is done safely and does not violate the law. The new Texas regulations, however, are so restrictive that few abortion providers, limited to only four urban areas, can legally perform abortions. Physicians do not have an absolute right to perform abortions as opposed to women who have an absolute right to have access to an abortion. Physicians do face many challenges that other professionals face in terms of obtaining qualifications and finding work. Abortion providers, however, face challenges that most other physicians do not. The restrictions imposed by these regulations exacerbate unfair treatment toward abortion providers and place further obstacles in their path in terms of providing the service they want and are qualified to provide. Both abortion clinics and abortion providers are being treated differently from other medical clinics and physicians. For instance, “grandfathering of existing facilities and the granting of waivers from specific requirements is prohibited for abortion providers, although other types of ambulatory surgical facilities are frequently granted waivers or are grandfathered.”8 Many abortion clinics cannot afford the necessary upgrades. Furthermore, it is extremely expensive to open a brand new clinic that complies with the ambulatory surgical center requirements. Being grandfathered in would be the only option available to abortion clinics that cannot afford the upgrade. However, unfair treatment of abortion clinics and providers is preventing those clinics from being grandfathered into the new system. As a result, many abortion clinics may be forced to close. Admitting privileges are proving difficult or impossible for physicians both to obtain and, for those who have already been granted privileges, to keep. Dr. Sherwood Lynn, an obstetrician-gynecologist who has performed abortions for decades, describes the process of obtaining admitting privileges and the difficulties abortion providers face. After sending in an application a physician must wait for the hospital to send them the required materials, “but if the address of the practice on the application is of an abortion provider or clinic, [the hospital] won’t send [them] the package of materials required. [They] simply can’t apply.”9 Dr. Lynn and several other physicians have surmised that hospitals are only withholding privileges from qualified physicians who perform abortions and that other physicians do not face this discriminatory treatment. Hospitals have also revoked privileges granted to physicians after learning that the physicians perform abortions. For instance, in Texas two doctors, “received notices [...] informing them that their admitting privileges to the University General Hospital of Dallas have been revoked, with the hospital’s CEO claiming the hospital was unaware they were providing abortion care and that the hospital believed such care would damage its reputation.”10 What is curious about this revocation is that, “federal and state laws [...] forbid hospitals from discriminating against doctors who perform abortions,” and yet hospitals are clearly doing just that.11 Dr. Pamela Richter, another abortion provider in Texas, had her temporary admitting privileges revoked with no explanation and because of this, the clinic where she performed abortions, Reproductive Services, can no longer provide abortions at all.12 As the hospital gave no reason for the revocation, it not clear Dr. Richter’s privileges were revoked because she performs abortions. Dr. Richter, however, has performed over 17,000 abortions and her privileges were revoked soon after HB 2 was introduced.13 According to the Texas Hospital Association, giving admitting privileges to doctors who do not work for the hospital is expensive and time-consuming but this does not account for the fact that hospitals are revoking previously granted privileges from physicians whom they learn are providing abortion services.14 As mentioned previously, the District Court found that the admitting privileges requirement and the ambulatory surgical center requirement do not further ensure the health and safety of women undergoing an abortion. Several physicians have testified to this fact. Dr. Lynn stated in an interview: The admitting privileges requirements are [...] absolutely unnecessary. If you have a number of patients waiting for procedures, and something happens and a patient needs to be transferred to a hospital, you’re not going to leave everyone else and go to the hospital. That makes no sense. You’re going to refer that person to a gynecologist at the hospital. There is no safety issue involved here. If a patient shows up with an emergency, every hospital is required to admit that patient. They have to by law.15 It is rare that complications will arise from an abortion performed in a clinic. Dr. Richter, for example, has performed more than 17,000 abortions and not once had to send a patient to a hospital because of complications resulting from the procedure. According to Dr. Lynn even if abortion providers were granted privileges to hospitals, it is unlikely that they will exercise them. In essence, having admitting privileges at a hospital does nothing to further ensure the safety of an already safe procedure. The only result of the admitting privileges requirement is to limit certain physicians’ ability to perform legal abortions. Not only do the HB 2 requirements fail to further ensure the health and safety of women, the HB 2 requirements may actually create more health risks to women who cannot access the eight remaining clinics. The first risk is that the remaining clinics would have an influx of patients that they may not be able to handle, forcing women to wait longer for an appointment. As stated by the District Court, “[e]ven assuming every woman in Texas who wants an abortion [...] could travel to one of the four metropolitan areas where abortions will still be available, the cumulative results of HB 2 are that, at most, eight providers would have to handle the abortion demand of the entire state.”16 Furthermore, “[t]hat the State suggests that these seven or eight providers could meet the demand of the entire state stretches credulity.”17 Abortion is a time sensitive procedure. It is safest when performed early in a pregnancy. The increase in patients to these remaining clinics, assuming all women in Texas can access them, will increase wait times and may force women to have abortions later in pregnancy. In the worst-case scenario, a woman would not see an abortion provider at all before viability. Such instances may be rare, but they are possible. In such cases, women’s access to legal abortions becomes impossible and thereby violate the ruling in Roe. Clinics may be able to avoid the aforementioned problems if they hire more physicians. However, there are two barriers to hiring more physicians. First, as mentioned previously, admitting privileges to Texas hospitals are difficult, if not impossible, for abortion providers to obtain. Second, given the negative treatment of abortion providers by anti-abortion groups, many physicians are not willing to perform abortions. The harassment abortion providers face is unique to those physicians and many physicians will not perform abortions for that reason. In an article published in the Austin Chronicle, anti- abortion activist Abby Johnson, “discusses how her group investigated appraisal district records to find the new location of where an Austin abortion physician plans to work.”18 Johnson states, “These abortionists are feeling the pressure from the pro-life movement in Texas. I think they feel like they’re on the run. And that’s how we want to keep it.”19 If the HB 2 requirements are passed and there remain at most eight abortion providers in Texas, these activists will concentrate on those clinics and, “the dangerous impact of their intimidation tactics will be exacerbated.”20 Even if the number of physicians needed to meet the demand in Texas can obtain admitting privileges and work at one of the remaining clinics, they may choose not to do such work because they are putting themselves at risk. The harm abortion providers face from such anti-abortion groups is not unique to Texas. There are stories from all over the country and from other countries where abortion is legal of physicians receiving death threats. Dr. George Tiller, an abortion provider in Kansas, was killed outside his church and had received numerous death threats prior to this. The HB 2 requirements are making it so that abortion providers either cannot provide their services any longer or will face increased threats and increased danger to themselves. Physicians are allowed to conscientiously object to providing medical interventions in certain circumstances for moral and religious reasons. However, there are limits on this right. According to the American Congress of Obstetricians and Gynecologists, “[w]hen conscientious refusals conflict with moral obligations that are central to the ethical practice of medicine, ethical care requires that the physician provide care despite reservations or that there be resources in place to allow the patient to gain access to care in the presence of conscientious refusal.”21 I would argue fear for one’s safety in the face of immediate threats is perhaps a stronger ground on which to refuse to provide care than a personal belief that abortion is immoral or against one’s religion. ACOG also states, “[p]roviders with moral or religious objections should either practice in proximity to individuals who do not share their views or ensure that referral processes are in place so that patients have access to the service that the physician does not wish to provide.”22 This responsibility has been largely disputed by the medical community but in cases of rape, incest, and health risks to women, referrals must be made without exception. However, under the requirements of HB 2, working in proximity to an abortion provider may not be possible because they are so geographically limited. Referrals are supposed to be made within reason. Some areas of Texas, such as the Rio Grande Valley, are up to 200 miles away from the nearest clinic that would remain open if HB 2 is passed. Referrals may simply not be feasible given the geographical distances and the decreasing number of available physicians. As mentioned above, there are two risks to the health and safety of women as a result of HB 2. The second of these is that if a woman cannot access one of the remaining clinics, she may seek out a more convenient but illegal and unsafe abortion, which is far more likely to result in a dangerous complication. Dr. Lynn states, “[b]ecause of the restrictions lawmakers impose, women will seek abortions illegally, and we’re going to see a rise in septic abortions.”23 Some areas of Texas might effectively revert back to a pre-Roe era where abortions were performed in unsanitary conditions by unqualified people resulting in dangerous medical complications far more often than legal abortion procedures do now. Physicians like Dr. Lynn who want to prevent this from happening generally cannot do so without facing legal sanction. Physicians have a duty to provide safe medical care and if they cannot obtain admitting privileges, they cannot exercise this duty. ACOG released a statement expressing their objections to the new requirements. They state that HB 2 is, “plainly intended to restrict the reproductive rights of women in Texas through a series of requirements that improperly regulate medical practice and interfere with the patient-physician relationship.”24 Executive Vice-President of ACOG, Hal C. Lawrence III stated: The Texas bills set a dangerous precedent of a legislature telling doctors how to practice medicine and how to care for individual patients. ACOG opposes legislative interference, and strongly believes that decisions about medical care must be based on scientific evidence and made by licensed medical professionals, not the state or federal government.25 Abortion is one of only a few areas of medicine where the legislature imposes so many regulations restricting particular physicians’ ability to practice medicine. Not only are abortions providers being regulated by the state, they are also facing clear discrimination from others within the medical community. The state is closing down clinics that do not meet the ambulatory surgical center requirements and hospitals are denying physicians admitting privileges because they perform abortions. In summary, abortion providers are being discriminated against both by the legislature and other members of the medical community. Other physicians who do not perform abortions are not denied admitting privileges on discriminatory grounds. Clinics that cannot afford upgrades to become an ambulatory surgical center are being grandfathered in, while abortion clinics are being forced to close down. Ob-Gyns who conscientiously object to performing abortions and who are not located in close proximity to at least one abortion provider cannot effectively fulfill their duty to refer patients. Lastly, given the barriers these regulations will create, there will likely be a rise in complications resulting from abortions provided under grossly unsafe conditions. Physicians, whose duty it is to provide safe and effective medical care, are being denied the right to exercise this duty. While this denial may not be unconstitutional, it is certainly unjust and discriminatory and creates obstacles that other physicians do not face. Most importantly, these obstacles are creating an undue burden for women. The HB 2 requirements do not increase the health and safety of abortions; all they do is create substantial obstacles for women. In light of these observations, the requirements seem to me to be in clear violation of Casey, in which it was decided that, “[u]nnecessary health regulations that have the purpose or effect of presenting a substantial obstacle to a woman seeking an abortion impose an undue burden on that right.”26 These regulations do just what Casey was meant to prohibit and this is accomplished through limiting physicians’ ability to practice safe abortions across the state of Texas. Therefore, the HB 2 requirements may not impose an undue burden on doctors but they do impose an undue burden on women. PDF available: Rachel Hill, "Texas HB 2," Voices in Bioethics. References: 1 Planned Parenthood of Southeastern Pennsylvania v. Casey, pg. 2. 2 Whole Women’s Health v. Lakey, pg. 2. 3 Ibid. 4 Ibid., 4. 5 Ibid., 2. 6 Planned Parenthood v. Casey, pg. 16 7 AMA Code of Medical Ethics, “Opinion 2.01 – Abortion,” American Medical Association. 8 Whole Women’s Health v. Lakey, pg. 10. 9 Dr. Sherwood Lynn, “A Texas Ob-Gyn Details the Horrific Consequences of Abortion Restrictions,” Cosmopolitan. 10 Feminist Newswire, “Texas Hospitals Revoke Admitting Privileges to Abortion Providers,” Feminist Majority Foundation Blog. 11 Ibid. 12 Ibid. 13 Ibid. 14 Glenn Hegar, “Texas Hospital Association’s Statement of Opposition to Section 2 of the Committee Substitute for Senate Bill 5,” Texas Hospital Association. 15 Dr. Lynn, “A Texas Ob-Gyn.” 16 Whole Women’s Health v. Lakey, pg. 10. 17 Ibid. 18 Mary Tuma, “Undercover Audio Reveals Anti-Abortion Tactics: Anti-abortion activists monitor and track providers, patients,” Austin Chronicle. 19 Ibid. 20 Ibid. 21 Committee on Ethics, “The Limits of Conscientious Refusal in Reproductive Medicine,” The American Congress of Obstetricians and Gynecologists. 22 Ibid. 23 Dr. Lynn, “A Texas Ob-Gyn.” 24 “Ob-Gyns Denounce Texas Abortion Legislation: Senate Bill 1 and House Bill 2 Set Dangerous Precedent,” The American Congress of Obstetricians and Gynecologists. 25 Ibid. 26 Planned Parenthood v. Casey, pg. 16. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Imperfect Men in Perfect Societies:Human Nature in UtopiaGorman BeauchampIUtopists view man as a product of his social environment. Nothing innate in the psychic make-up of man—no inherent flaw in his nature, no inheritance of original sin—prevents his being perfected, or at least radically ameliorated, once the social structure that shapes character can be properly reordered. Utopists, in short, deny that there is such a thing as "human nature"—if, as (...) John Plamenatz suggests, to say that something is human nature is just another way of saying that it cannot be changed.1 To accept the psychic constitution of man as fixed, immutable, is anathema to utopists, who agree rather with Ortega y Gasset: "Man has no nature. What he has is history."2 The social conditions that have obtained historically, that is to say, have made man what he has been—anything but utopian; but if man's history could be changed, so could his "nature." The idea of Progress, so pervasive in the West from the seventeenth century on, lends some credence to this contention. W. D. Howells's Altrurians, their creator notes, "get some sad amusement out of the fact that the capitalist world believes human nature cannot be changed, though cannibalism and slavery and polygamy have all been extirpated in the so-called Christian countries, and these things were once human nature, which is always changing...."3 Utopia is merely a means, then, of imaginatively expediting, directing, culminating the historically progressive creation of a morally exemplary race of men.The environmentalist psychology espoused by utopists springs from one of two anterior assumptions (although in the creation of many fictional idola the distinction between them is often blurred). The first [End Page 280] assumption is formulated most famously by Rousseau in the Discourse on Inequality: that "man is naturally good, and only by his institutions is he made bad."4 The second assumption is formulated most famously by Locke in the Essay Concerning Human Understanding: that the mind—and by extension the character—is a tabula rasa that takes impression from the stimuli exerted by the external world and thus is neither innately good or bad, but plastic, malleable.5 An intriguing conflation of these two theories operates, for instance, in the psyche of the monster in Mary Shelley's Frankenstein. In the long middle section of the book, where the monster's side of the story is presented sympathetically, his character develops in a text-book demonstration of Lockean psychology; yet, at the same time, this lumbering tabula rasa quivers with enough benevolence (the implausible provenance of which mystifies) to put most saints to shame. He becomes evil and destructive only after being persecuted unmercifully for his misshapen appearance.6 Indeed, the criminal career of Mary Shelley's monster rehearses the common utopian argument that society's injustice to man (or monster) is the source of his crimes. "With our present state of society," writes James Casey in A New Moral World (1885), "we manufacture criminals and then punish them for being so."7 H. G. Wells, in A Modern Utopia (1905), concurs: "Crime and bad lives are the measure of the State's failure, all crime in the end is the crime of the community."8 And both are but restating the charge of Sir Thomas More's Raphael Hytholoday, leveled several centuries earlier in the original Utopia (1519): "If you allow people to be badly brought up and their habits to be corrupted little by little from childhood and if you then punish them for crimes to which their early training has disposed them, what else is this, I ask, but first making them thieves and then punishing them for it?"9 Evil deeds, then, to reiterate the utopist's point, result not from some vicious mole in human nature, but from the malfunctioning of society itself. Utopia, by contrast, is—or theoretically ought to be—a world without crime.Rousseau's concept of the innate goodness of man and the evil of his institutions most often informs primitivist models of utopia, exotic worlds inhabited by noble savages uncorrupted by civilization. The idealized Indians of Montaigne's essay... (shrink)

Even lawyers who obey the law often seem to act unethically--interfering with the discovery of truth, subverting justice, and inflicting harm on innocent people. Standard arguments within legal ethics attempt to show why it is permissible to do something as a lawyer that it would be wrong to do as an ordinary person. But in the view of most critics these arguments fail to turn wrongs into rights. Even many lawyers think legal ethics is flawed because it does not accurately (...) describe the considerable moral value of their work. In Lawyers and Fidelity to Law, Bradley Wendel introduces a new conception of legal ethics that addresses the concerns of lawyers and their critics alike.Wendel proposes an ethics grounded on the political value of law as a collective achievement that settles intractable conflicts, allowing people who disagree profoundly to live together in a peaceful, stable society. Lawyers must be loyal and competent client representatives, Wendel argues, but these obligations must always be exercised within the law that constitutes their own roles and confers rights and duties upon their clients. Lawyers act unethically when they treat the law as an inconvenient obstacle to be worked around and when they twist and distort it to help their clients do what they are not legally entitled to do. Lawyers and Fidelity to Law challenges lawyers and their critics to reconsider the nature and value of ethical representation. (shrink)

W E Andersen; Education and the Ethical Concept of a Person or Willie, and the Redoubtable Mr. Chips, Journal of Philosophy of Education, Volume 2, Issue 1, 30.

A non-epistemological history of historical epistemology Content Type Journal Article DOI 10.1007/s11016-010-9501-5 Authors W. R. Albury, School of Humanities, University of New England, Armidale, NSW 2351, Australia Journal Metascience Online ISSN 1467-9981 Print ISSN 0815-0796.

Within this 1963 text, Professor Watson writes as a physicist seeking to understand how it is that physics goes on at an ever increasing pace to reveal new ...

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