The surviving sources on the Stoic theory of division reveal that the Stoics, particularly Chrysippus, believed that bodies, places and times were such that all of their parts themselves had proper parts. That is, bodies, places and times were composed of gunk. This realisation helps solve some long-standing puzzles about the Stoic theory of mixture and the Stoic attitude to the present.

We often think about the alternatives to a decision that has been made. Thinking in this way is known as counterfactual thinking, that is, thinking about what could have been had an alternative dec...

One of the most important questions in the debate over the morality of euthanasia and assisted suicide is whether an important distinction between killing patients and allowing them to die exists. The U.S. Supreme Court, in rejecting challenges to the constitutionality of laws prohibiting physician-assisted suicide, explicitly invoked this distinction, but did not explicate or defend it. The Second Circuit of the U.S. Court of Appeals had previously asserted, also without argument, that no meaningful distinction exists between killing and allowing (...) to die. That court had reasoned that if this were so, it would be discriminatory to allow persons on life support to end their lives by removing such treatment, while those who are not connected to life support would be denied similar access to death. (shrink)

We thank Nielsen Busch and Mjaaland for their article on the dead donor rule (Nielsen Busch and Mjaaland 2023). We would like to take this opportunity to go beyond the dead donor rule in order to r...

Pellegrino was there at the beginning of the field. In the 1950s and 60s, before there was a Kennedy Institute of Ethics or a Hastings Center; before the word ‘bioethics’ itself was coined, Pellegrino was writing articles such as "Ethical Considerations in the Practice of Medicine and Nursing," published in 1964. He was among those who started the Society for Health and Human Values—a precursor organization to the American Society for Bioethics and Humanities. He was the founding editor of the (...) Journal of Medicine and Philosophy at a time when the notion that there was a relationship between philosophy and medicine was foreign to both physicians and philosophers. The authors of the articles published in the very .. (shrink)

The literature on conscience in medicine has paid little attention to what is meant by the word ‘conscience.’ This article distinguishes between retrospective and prospective conscience, distinguishes synderesis from conscience, and argues against intuitionist views of conscience. Conscience is defined as having two interrelated parts: (1) a commitment to morality itself; to acting and choosing morally according to the best of one’s ability, and (2) the activity of judging that an act one has done or about which one is deliberating (...) would violate that commitment. Tolerance is defined as mutual respect for conscience. A set of boundary conditions for justifiable respect for conscientious objection in medicine is proposed. (shrink)

Media coverage and statements by various Catholic spokespersons regarding the case of Terri Schiavo has generated enormous and deeply unfortunate confusion regarding Church teaching about the use of life-sustaining treatments. Two weeks ago, for example, I received a letter from the superior of a community of Missionary Sisters of Charity, who operate a hospice here in the United States The Missionary Sisters of Charity are the community founded by Mother Theresa, the 20th Century saint whose primary ministry was to rescue (...) dying Untouch-ables from the streets of Calcutta and bring them into her convent where they were washed, sheltered, fed if they were able to eat, prayed for, and cherished. In other words, the sisters gave these poor souls the gift of a death with dignity. The order Mother Theresa founded has continued this ministry, running hospices in the United States and elsewhere for the homeless, the destitute, those dying of AIDS and poverty and drug addiction, and all those dying alone and otherwise unwanted. (shrink)

Increasingly, physicians are being asked to provide technical services that many believe are morally wrong or inconsistent with their beliefs about the meaning and purposes of medicine. This controversy has sparked persistent debate over whether practitioners should be permitted to decline participation in a variety of legal practices, most notably physician-assisted suicide and abortion. These debates have become heavily politicized, and some of the key words and phrases are being used without a clear understanding of their meaning. In this essay, (...) I endeavor, firstly, to clarify the meaning of some of these terms: conscience, conscientious action, professional judgment, conscientious objection, conscience clauses, civil disobedience, and tolerance. I argue that use of the term conscientious objection to describe these refusals by health care professionals is mistaken and confusing. Secondly, relying on a proper understanding of the moral and technical character of medical judgment, the optimal deference that the state and markets ought to have toward professions, and general principles of Lockean tolerance for a diversity of practices and persons in a flourishing, pluralistic, democratic society, I offer a defense of tolerance with respect to the deeply held convictions of physicians and other health care professionals who hold minority views on contested but legal medical practices. (shrink)

Pellegrino has argued that end-of-life decisions should be based upon the physician's assessment of the effectiveness of the treatment and the patient's assessment of its benefits and burdens. This would seem to imply that conditions for medical futility could be met either if there were a judgment of ineffectiveness, or if the patient were in a state in which he or she were incapable of a subjective judgment of the benefits and burdens of the treatment. I argue that a theory (...) of futility according to Pellegrino would deny that latter but would permit some cases of the former. I call this the circumspect view. I show that Pellegrino would adopt the circumspect view because he would see the medical futility debate in the context of a system of medical ethics based firmly upon a philosophy of medicine. The circumspect view is challenged by those who would deny that one can distinguish objective from subjective medical judgments. I defend the circumspect view on the basis of a previously neglected aspect of the philosophy of medicine -- an examination of varieties of medical judgment. I then offer some practical applications of this theory in clinical practice. (shrink)

Abstract:Arguments against physicians’ claims of a right to refuse to provide tests or treatments to patients based on conscientious objection often depend on two premises that are rarely made explicit. The first is that the protection of religious liberty (broadly construed) should be limited to freedom of worship, assembly, and belief. The second is that because professions are licensed by the state, any citizen who practices a licensed profession is required to provide all the goods and services determined by the (...) profession to fall within the scope of practice of that professional specialty and permitted by the state, regardless of any personal religious, philosophical, or moral objection. In this article, I argue that these premises ought to be rejected, and therefore the arguments that depend on them ought also to be rejected. The first premise is incompatible with Locke’s conception of tolerance, which recognizes that fundamental, self-identifying beliefs affect public as well as private acts and deserve a broad measure of tolerance. The second premise unduly (and unrealistically) narrows the discretionary space of professional practice to an extent that undermines the contributions professions ought to be permitted to make to the common good. Tolerance for conscientious objection in the public sphere of professional practice should not be unlimited, however, and the article proposes several commonsense, Lockean limits to tolerance for physician claims of conscientious objection. (shrink)

This article explores the relationship between Karl Rahner’s well-known supralapsarian approach to the doctrine of the incarnation and the theme of social salvation. It examines his distinctive supralapsarian approach to the Incarnation of the Word and the implications that Christological emphasis has for understanding not just individual salvation, but corporate or social salvation, including the whole of creation—human and nonhuman alike. First, we situate Rahner’s supralapsarianism within the broader tradition of this Christological approach. Second, we highlight the cosmic significance of (...) Rahner’s supralapsarian argument for the divine ratio for the Incarnation through the lens of “deep incarnation” theology. Finally, we argue that Rahner’s supralapsarian Christology gestures toward a form of “social salvation” understood in a more cosmic and capacious sense. (shrink)

The playful re-working of the idiomatic expression ‘the apple of my eye’ to the ‘eye/I of my Apple’ provides the answer to the question on technology, emphasising its importance for societies, specifically the South African society, and embodied personhood, and at the same time its determinative contextual character. The answer to the question on technology firstly takes as the vantage point a few personal comments by the author in relation to the question at hand. Secondly, brief remarks on technology and (...) approaches to the question are made before the focus on ethics is explicated and motivated. Lastly, a deep concern is identified and is poignantly described as the probable wicked technologisation of the African soul. (shrink)

The German systematic theologian Friedrich Schleiermacher has shaped Western Christian theological thinking in many ways. One such influential way has been his formulation and exposition of religious experience, and specifically the concept of the ‘feeling of absolute dependence’. From a brief account of his understanding of the ‘feeling of absolute independence’, a few critical remarks are made from the broader context of contemporary hermeneutical discourses, focusing on the constitutive role of affectivity and narrative identity in religious experiences of embodied personhood. (...) It is argued that these two themes in revisiting Schleiermacher’s understanding of the ‘feeling of absolute dependence’ can contribute to a more comprehensive understanding of religious experience. (shrink)

The original position contractarian model of ethical reasoning put forth by John Rawls has been examined as a basis for an environmental ethic on three previous occasions in this journal and in Peter Wenz’s Environmental Justice. In this article, I critically examine each of these treatments, analyzing the proposals offered and identifying their shortcomings. I find a total of seven different proposals in this literature for modifying Rawls’ theory to augment its adequacy or as a ground environmental ethics. The diverse (...) difficulties that arise in attempting to apply Rawls suggest the conclusion that Rawlsian ethics may not be a suitable foundation for an adequate long-term environmental ethics. (shrink)

In recent years, dozens of human rights non-governmental organizations (NGOs) across the globe have begun to advocate for economic and social rights, which represents a significant expansion of the human rights movement. This article investigates a central strategy that NGOs have pursued to realize these rights: legalization. Legalization involves specifying rights as valid legal rules and enforcing them through judicial or quasi-judicial processes. After documenting some of the progress made toward legalization, the article analyzes five unique challenges involved in legalizing (...) economic and social rights. It is important to identify these challenges because they must be overcome if the human rights movement wishes to refute the notion that economic and social rights are inherently non-justiciable (and therefore, to some, invalid as rights). These challenges also point to the possibility that legalization is not the only, or even the best, strategic pathway to realize economic and social rights effectively. (shrink)

Wrestling and arguing with God: between insider and outsider African perspectives -- Introduction to Richard Kearney's intellectual autobiography: where do you come from, Richard Kearney? -- Where I speak from: a short intellectual autobiography -- Phenomenology in South Africa: an indirect encounter with Richard Kearney -- Transcendence and anatheism -- Response to Richard Kearney's Anatheism: Anatheism and holy folly -- Kearney between poles: is too much lost in the middle? -- Strangers, Gods and Africa: in dialogue with Richard Kearney on (...) Otherness -- Approaching the threshold: hospitality as a pedagogical wager in the work of Richard Kearney -- God-talk, the biblical prophets and Richard Kearney -- 'Strange' theology: engaging with Richard Kearney -- Trinitarian theology and Richard Kearney's anatheism: an engagement -- After God but behind the Cross: the procession as a way to re-encounter God in a culture beyond classical liturgy -- Touch gives rise to thought: Paul Ricoeur and Pumla Gobodo-Madikizela on mutual recognition and carnal hermeneutics -- Towards hospitality between enemies -- Across oceans: a conversation on otherness, hospitality and welcoming a strange God. (shrink)

One major argument against prohibiting euthanasia and physician-assisted suicide (PAS) is that there is no rational basis for distinguishing between killing and allowing to die: if we permit patients to die by forgoing life-sustaining treatments, then we also ought to permit euthanasia and PAS. In this paper, the author argues, contra this claim, that it is in fact coherent to differentiate between killing and allowing to die. To develop this argument, the author provides an analysis of Saint Augustine’s distinction between (...) martyrdom and suicide, highlighting the relevance of intention in the assessment of an agent’s actions. As a general matter of ethics, the intentions of agents, not just the outcomes of their actions, matter enormously for drawing distinctions between what is permissible and what is impermissible. Constructing an Augustinian account of this distinction between killing and allowing to die, the author argues that it is coherent to hold that assisted suicide is wrong, while also accepting that it is permissible to withhold or withdraw life-sustaining treatments. (shrink)

Shortly after the Presidential Commission for the Study of Bioethical Issues was constituted in 2010 and days before the commission members were to join a conference call to discuss possible topics for their deliberation, Craig Venter held a press conference announcing that his lab had created a synthetic chromosome for a species of mycoplasma and had inserted this genetic material into organisms of another species of mycoplasma (the genes of which had been deactivated), transforming the host species into the donor (...) species. While not overtly claiming to have “created life in the test tube,” Venter's publicity seemed cleverly designed to provoke the media into reporting his discovery in just that way. The resulting uproar caused President Obama to give his new bioethics commission the assignment of investigating the ethics of the emerging field of synthetic biology. The commission went right to work. It formed working groups to deliberate about parts of the report, feeding ideas and language to the staff members who would do the actual writing, and then present the working group suggestions to the commission as a whole for public deliberation at open meetings. One of those working groups was charged with coming up with ethical principles that would guide the analysis. Having served as a member of that working group, I report here on the process by which these principles emerged and reflect upon the suitability of that process for the work of public bioethics commissions. (shrink)

While 3/11 has altered energy policies around the world, insufficient attention has focused on reactions from local nuclear power plant host communities and their neighbors throughout Japan. Using site visits to such towns, interviews with relevant actors, and secondary and tertiary literature, this article investigates the community crisis management strategies of two types of cities, towns, and villages: those which have nuclear plants directly in their backyards and neighboring cities further away (within a 30 mile radius). Responses to the disaster (...) have varied with distance to nuclear facilities but in a way contrary to the standard theories based on the concept of the . Officials in communities directly proximal to nuclear power plants by and large remain supportive of Japan's nuclear power program, while those in cities and towns at a distance (along with much of the general public) have displayed strong opposition to the pre 3/11 status quo. Using qualitative data, this article underscores how national energy and crisis response policies rest strongly on the political economy, experiences of, and decisions made at the subnational level. (shrink)

Psychiatric and neurological disorders have historically provided key insights into the structure-function rela- tionships that subserve human social cognition and behavior, informing the concept of the ‘social brain’. In this review, we take stock of the current status of this concept, retaining a focus on disorders that impact social behavior. We discuss how the social brain, social cognition, and social behavior are interdependent, and emphasize the important role of development and com- pensation. We suggest that the social brain, and its (...) dysfunction and recovery, must be understood not in terms of specific structures, but rather in terms of their interaction in large-scale networks. (shrink)

Prestigious University is a large, private educational institution with a medical school, a university hospital, a law school, and graduate and undergraduate colleges all on a single campus. In the face of the Covid‐19 pandemic, students were told during spring break to return to campus only briefly to retrieve their belongings. Classes then went online. On March 23, 2020, the faculty, students, and staff were emailed the following by the university's director of infection control and public health: We have become (...) aware that a Prestigious University staff member has tested positive for the virus that causes Covid‐19. The individual, who was last on campus on March 16, is now in isolation at their permanent residence and is doing well clinically. The university has already identified those members of our community who may have been in close contact with this individual, and we are working to notify them. Further, this individual's local health department has a protocol for identifying people who have been in direct contact with anyone testing positive for Covid‐19 (such as this Prestigious University staff member) so that they can self‐quarantine and watch for COVID‐19 symptoms for a period of 14 days from their last contact with the infected individual.A professor in the Philosophy Department has asked the ethicists at the medical school whether such contact tracing suffices. “Don't the members of the community deserve to know who this is? Isn't there a mandate to identify this person in order to maximize public health benefits and slow the spread of this deadly virus?”. (shrink)

My article, “Whole-brain death and integration: Realigning the ontological concept with clinical diagnostic tests”.