This study interrogates the conventional understanding of and practice within mediated climate change communication as a forum where transformative ideas on sustainability practices are shape...

Climate change confronts humanity with a challenge it has never faced before. It combines issues of global justice and intergenerational justice on an unprecedented scale. In particular, it stands to adversely affect the global poor. So far, the global community has failed to reduce emissions to levels that are necessary to avoid unacceptable risks for the future. Nor are the burdens of emission reductions and of coping with climate impacts fairly shared. The shortcomings of both political and individual climate action (...) thus seem like a paradigmatic case for non-ideal theory. Non-ideal theory can be understood as a form of political theorising that compares different responses to (i) failures of agents to comply with the demands of justice and (ii) unfavourable circumstances. Insofar as non-ideal theory also aims to be action-guiding, it asks normative theorists for a more thorough engagement with the empirical context so as to arrive at practical recommendations for the ‘here and now’. This volume examines the normative issues that become relevant when the non-ideal circumstances of the climate context are fully taken into account. It is comprised of three parts: The first collects chapters that reflect on general issues in responding to the shortcomings of current climate action. Chapters in the second part propose more specific practical reforms. The third part examines how moral values ought to be brought into the scientific, political, and public debates under the non-ideal circumstances of this world. (shrink)

Once common, therapeutic privilege—the practice whereby a physician withholds diagnostic or prognostic information from a patient intending to protect the patient—is now generally seen as unethical. However, instances of therapeutic privilege are common in some areas of clinical psychiatry. We describe therapeutic privilege in the context of borderline personality disorder, discuss the implications of diagnostic non-disclosure on integrated care and offer recommendations to promote diagnostic disclosure for this patient population. There are no data in this work.

Parents who are facing decisions about life-sustaining treatment for their seriously ill or dying child are supported by their child's doctors and nurses. They also frequently seek other information sources to help them deal with the medical and ethical questions that arise. This might include written or web-based information. As part of a project involving the development of such a resource to support parents facing difficult decisions, some ethical questions emerged. Should this information be presented in a strictly neutral fashion? (...) Is it problematic if narratives, arguments or perspectives appear to favour stopping over continuing life-sustaining treatment? Similar questions might arise with written materials about decisions for adults, or for other ethically contentious decisions. This paper explores the meaning of ‘balance’ in information provision, focusing particularly on written information about life-sustaining treatment for children. We contrast the norm of non-directiveness in genetic counselling with the shared decision-making model often endorsed in end-of-life care. We review evidence that parents do not find neutrality from medical professionals helpful in discussions. We argue that balance in written information must be understood in the light of the aim of the document, the most common situation in which it will be used, and any existing biases. We conclude with four important strategies for ensuring that non-neutral information is nevertheless ethically appropriate. (shrink)

Dominic McIver Lopes’ Four Arts of Photography and Diarmuid Costello’s On Photography: A Philosophical Inquiry examine the state of the art in analytic philosophy of photography and present a new approach to the study of the medium. As opposed to the orthodox and prevalent view, which emphasizes its epistemic capacities, the new theory reconsiders the nature of photography, and redirects focus towards the aesthetic potential of the medium. This symposium comprises two papers that critically examine central questions addressed in (...) the two books, with responses by the two authors in defence of their respective positions. (shrink)

A distinction attributed to Gregory Palamas involves claiming that God’s essence and energies/activities are distinct, yet equally ‘uncreated.’ Traditionally, this Palamite distinction was attacked by some Latin theologians as compromising divine simplicity. A classical view holds that no properties really inhere in God, because God enters into no composition of any kind, including composition of substance and accident. God’s energies/activities seem like properties inhering in God or otherwise composing some kind of part of God. I will argue that, contrary to (...) appearances, the Palamite distinction is a consequence of commitment to a classical view of divine simplicity. (shrink)

Dominic McIver Lopes’ Four Arts of Photography and Diarmuid Costello’s On Photography: A Philosophical Inquiry examine the state of the art in analytic philosophy of photography and present a new approach to the study of the medium. As opposed to the orthodox and prevalent view, which emphasizes its epistemic capacities, the new theory reconsiders the nature of photography, and redirects focus towards the aesthetic potential of the medium. This symposium comprises two papers that critically examine central questions addressed in (...) the two books, with responses by the two authors in defence of their respective positions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:IntroductionSpatial, Environmental, and Ecocritical Approaches to Holocaust MemoryEmily-Rose Baker (bio), Michael Holden (bio), Diane Otosaka (bio), Sue Vice (bio), and Dominic Williams (bio)The successful implementation of genocide during the Holocaust depended on the spatial organisation of mass murder. From the concentrated ghettos and camps delimited by walls and barbed wire to the open fields and camouflaged forests where victims were shot en masse, Anne Kelly Knowles et al. (...) argue, specific locations, patterns of migration, deportation and evacuation, and other spatial elements such as scale, were all central to the Nazi regime's creation of a "comprehensive geography of oppression."1 This is hardly surprising given the biopolitical logics and colonial fantasies underpinning Lebensraum ('living space'), the territorial concept guiding the genocidal aims of the Third Reich, which designated zones of life as well as the inverse on the European continent. The Holocaust was also experienced spatially by its victims, who were forced to navigate new (and at times familiar) sites and landscapes as those of genocide, and whose testimonies in the aftermath of the event conjured these very places in detail.In recent years, the spaces of the Holocaust have been variously revisited, reconstructed, and reimagined within Holocaust studies scholarship. As a broader part of the 'spatial turn' in the humanities, Holocaust scholars have increasingly employed spatial perspectives of the event to deepen our understanding of the environments in which the Holocaust took place and the transformation of these spaces over time—particularly in the fields of history and social science.2 While drawing on diverse modes of spatialisation from interdisciplinary perspectives, contributions from these fields have tended to privilege methods we might describe as variously 'forensic,' including mapping, model-making, and investigations of material traces of the past.3 This work has resulted in many significant insights, not only into the [End Page 1] contexts and structures of Nazi genocide and the perpetrator imaginings of space, but also the experiences of victims and survivors.4Another significant body of work has attended to space and culture within Holocaust contexts. From early on in the postwar period, particular locations and buildings became identified with the Holocaust, such as the notorious entrance guard house at Auschwitz-Birkenau, which appears on countless book covers as well as within films and artworks. Engaging with spatial insights and methodologies from the perspective of cultural and memory studies, scholars have attested to the production and mnemonic significance of these and less well-known sites, as well as the symbolic spatial worlds and experiences to which they give rise. These include Paul Jaskot and Gavriel Rosenfeld, who have turned respectively to Holocaust and post-Holocaust architectures as commonly overlooked sites of history and memory. Drawing attention to the construction of Holocaust space, Jaskot shows how reading architecture 'as process' rather than static structures laden with symbolic meaning reveals unique histories of forced labor in which "the goals of the SS intersected with victims' experience."5 Rosenfeld demonstrates the ways in which spaces built in response to Nazi genocide after 1945 have been variously "imbued with Jewish significance" by their users and creators, resulting in the rise to prominence of Jewish-identified architects.6 Along similar lines, Michael Meng's work has explored the ways in which Jews and gentiles interact with ruined synagogues, cemeteries and Jewish districts as important remnants of pre-war Jewish life in the post-war period in German and Polish cities.7Studies such as those noted above have tended to focus on cities and public buildings, as well as state and civic policy. But as the spatial histories and geographies of the Holocaust have helped to show, extermination often took place in rural settings (mostly located in Central and Eastern Europe), such as the killing fields where Jews were shot en masse; the forests where victims hid and were hunted by Germans and local collaborators; or the open spaces of the dissolving Reich through which former concentration camp inmates were forced to march during the final year of the war—sites in which, owing to less contained spatial dynamics, violence played out differently.8These kinds of sites, which are sparsely documented and often simply thought of... (shrink)

Much has been made of how Darwinian thinking destroyed proofs for the existence of God from ‘design’ in the universe. I challenge that prevailing view by looking closely at classical ‘teleological’ arguments for the existence of God. One version championed by Aristotle and Thomas Aquinas stems from how chance is not a sufficient kind of ultimate explanation of the universe. In the course of constructing this argument, I argue that the classical understanding of teleology is no less necessary in modern (...) Darwinian biology than it was in Aristotle's time. In fact, modern biology strengthens the claims that teleological arguments make by vindicating many of their key features. As a consequence, I show how Aristotle and Aquinas' teleological argument for an intelligent First Cause remains valid. (shrink)

W. Matthews Grant has argued that it is possible to reconcile a strong theory of God’s causal sovereignty with libertarian freedom by denying that God causes the acts of free creatures by means of some factor intrinsic to Himself. Grant argues that the accounts on which God causes those actions of His creatures in virtue of His decrees cannot be libertarian. I will argue that two classical theories of grace, despite holding that God causes creaturely acts in virtue of a (...) divine decree or intention, remain libertarian in just the same sense Grant’s account is. I controversially propose that this is true even of Banezian theories of grace, on which God causes free actions directly. Instead, I suggest that we can characterize what it is for a theory to be theological determinist according to a distinction proposed by Eleonore Stump. (shrink)

Psychedelic researchers and therapists must contend with the fact that psychedelics are highly scrutinized to a degree that does appear to be problematically exceptional. That said, we believe ther...

Volume 24, Issue 8, August 2024, Page 103-106.

The parables of Jesus are an ethically appropriate genre for his claims about the kingdom of God. But our fascination with gospel parables by Jesus may be extended to gospel parables about Jesus. Especially in parables about Jesus, questions of historical accuracy may lead one to avoid questions about parabolic challenge.

Vast research has sought to better understand the origins and development of rape myth beliefs given the problematic influence of such misconceptions throughout global societies and criminal justice pathways. The current research aims to build on this body of literature by examining the contribution that psychopathic personality traits (affective responsiveness, cognitive responsiveness, interpersonal manipulation, egocentricity) and emotional intelligence may have upon rape myth beliefs. Furthermore, this study will investigate the extent to which sociodemographic characteristics (age, gender, ethnicity, education), and prior (...) experience of sexual victimisation, contribute to variance in rape myth acceptance scores. In total 251 participants (M Age = 31.66) completed an online, self-report questionnaire which included contemporary measures of psychopathy and rape myth acceptance, never previously tested in combination. Results of a hierarchical multiple regression analysis indicate that egocentricity, age, and gender were significantly associated with rape myth beliefs. Emotional intelligence, as well as affective and interpersonal traits of psychopathy, were not directly related with rape mythology. Findings are interpreted alongside previous research, where we suggest there is an urgent need for larger, nationally representative samples, systematically recruited from the general population to help clarify uncertainty in existing literature emerging from small-scale opportunistic datasets. (shrink)

Why should we obey the rules that constitute a code of conduct? If a rule is justified by conclusive moral reasons, then those reasons are sufficient, from a rational point of view (rather than, sa...

Chris Armstrong argues that attempts at justifying special claims over natural resources generally take one of two forms: arguments from improvement and arguments from attachment. We argue that Armstrong fails to establish that the distinction between natural resources and improved resources has no normative significance. He succeeds only in showing that ‘improvers’ are not necessarily entitled to the full exchange value of the improvement. It can still be argued that the value of natural and improved resources should be distributed on (...) different grounds, but that the value of improvements should be conceived differently. (shrink)

[David Charles] Aristotle, it appears, sometimes identifies well-being with one activity, sometimes with several, including ethical virtue. I argue that this appearance is misleading. In the Nicomachean Ethics, intellectual contemplation is the central case of human well-being, but is not identical with it. Ethically virtuous activity is included in human well-being because it is an analogue of intellectual contemplation. This structure allows Aristotle to hold that while ethically virtuous activity is valuable in its own right, the best life available for (...) humans is centred around, but not wholly constituted by, intellectual contemplation. /// [Dominic Scott] In Nicomachean Ethics X 7-8, Aristotle distinguishes two kinds of eudaimonia, primary and secondary. The first corresponds to contemplation, the second to activity in accordance with moral virtue and practical reason. My task in this paper is to elucidate this distinction. Like Charles, I interpret it as one between paradigm and derivative cases; unlike him, I explain it in terms of similarity, not analogy. Furthermore, once the underlying nature of the distinction is understood, we can reconcile the claim that paradigm eudaimonia consists just in contemplation with a passage in the first book requiring eudaimonia to involve all intrinsic goods. (shrink)

Dominic Scott compares the Republic and Nicomachean Ethics from a methodological perspective. He argues that Plato and Aristotle distinguish similar levels of argument in the defence of justice, and that they both follow the same approach: Plato because he thinks it will suffice, Aristotle because he thinks there is no need to go beyond it.

In cognitive science, creative ideas are defined as original and feasible solutions in response to problems. A common proposal is that creative ideas are generated across dedicated cognitive pathways. Only after creative ideas have emerged, they can be enacted to solve the problem. We present an alternative viewpoint, based upon the dynamic systems approach to perception and action, that creative solutions emerge in the act rather than before. Creative actions, thus, are as much a product of individual constraints as they (...) are of the task and environment constraints. Accordingly, we understand creative motor actions as functional movement patterns that are new to the individual and/or group and adapted to satisfy the constraints on the motor problem at hand. We argue that creative motor actions are promoted by practice interventions that promote exploration by manipulating constraints. Exploration enhances variability of functional movement patterns in terms of either coordination or control solutions. At both levels, creative motor actions can emerge from finding new and degenerate adaptive motor solutions. Generally speaking, we anticipate that in most cases, when exposed to variation in constraints, people are not looking for creative motor actions, but discover them while doing an effort to satisfy constraints. For future research, this paper achieves two important aspects: it delineates how adaptive (movement) variability is at the heart of (motor) creativity, and it sets out methodologies toward stimulating adaptive variability. (shrink)

Who should decide how a machine will decide what to do when it is driving a car, performing a medical procedure, or, more generally, when it is facing any kind of morally laden decision? More and more, machines are making complex decisions with a considerable level of autonomy. We should be much more preoccupied by this problem than we currently are. After a series of preliminary remarks, this paper will go over four possible answers to the question raised above. First, (...) we may claim that it is the maker of a machine that gets to decide how it will behave in morally laden scenarios. Second, we may claim that the users of a machine should decide. Third, that decision may have to be made collectively or, fourth, by other machines built for this special purpose. The paper argues that each of these approaches suffers from its own shortcomings, and it concludes by showing, among other things, which approaches should be emphasized for different types of machines, situations, and/or morally laden decisions. (shrink)

Certain representations are bound in special ways to our sensory capacities; consider, for instance, pictures, sound recordings, and the various forms of mental sensory imagery. What do these representations have in common, and what makes them different from representations of other kinds? Dominic Gregory employs novel ideas on perceptual states and sensory perspectives to explain the special nature of the contents of distinctively sensory representations. The book contains extensive discussions of e.g. perceptual imagination, pictorial representation, and memories.

The COVID-19 coronavirus pandemic raises a host of challenging ethical questions at every level of society. However, some of the most acute questions relate to decision making in intensive care. The problem is that a small but significant proportion of patients develop severe viral pneumonitis and respiratory failure. It now seems likely that the number of critically ill patients will overwhelm the capacity of intensive care units (ICUs) within many health systems, including the National Health Service in the UK. The (...) experience of Northern Italy—a couple of weeks ahead of the UK, suggests that it will simply not be possible to provide mechanical ventilation to every patient who might need it. When the crunch comes, the unpalatable question facing clinicians is which patient to save. There are some obvious strategies to avoid or reduce the problem—through measures to increase intensive care capacity, and via society-level interventions to reduce the spread of the virus. These are vitally important, but unfortunately they are unlikely to prevent the problem of demand outstripping supply from occurring. What, then, should clinicians do? How should they allocate the scarce resource of intensive care—particularly over the coming weeks as the crisis escalates? There are different values at stake in triage decisions, but at a basic level the key values are those of benefit and …. (shrink)

Provides an account of what it is for works of academic philosophy to be beautiful in their content or in their mode of expression.

What you see can shape how you feel, and the route from seeing to feeling sometimes involves empathy – as you might empathize with a woman you see grieving the death of her child. But empathy also comes from what you see in pictures. Bellini's Pieta? is one among many paintings, drawings, prints, and photographs that evoke empathy – and are designed to do so. Going further, it seems that episodes of empathy triggered by pictures can help build up a (...) person's capacity for empathic response. Indeed, they do so by fortifying the link between seeing and empathy in a distinctive way. To establish this thesis, we need a broad conception of empathic response and also the right conception of what we see in pictures. (shrink)

Given its brevity, Plato's Meno covers an astonishingly wide array of topics: politics, education, virtue, definition, philosophical method, mathematics, the nature and acquisition of knowledge and immortality. Its treatment of these, though profound, is tantalisingly short, leaving the reader with many unresolved questions. This book confronts the dialogue's many enigmas and attempts to solve them in a way that is both lucid and sympathetic to Plato's philosophy. Reading the dialogue as a whole, it explains how different arguments are related to (...) one another and how the interplay between characters is connected to the philosophical content of the work. In a new departure, this book's exploration focuses primarily on the content and coherence of the dialogue in its own right and not merely in the context of other dialogues, making it required reading for all students of Plato, be they from the world of classics or philosophy. (shrink)

Volume 19, Issue 10, October 2019, Page 61-63.

On 24 July 2017, the long-running, deeply tragic and emotionally fraught case of Charlie Gard reached its sad conclusion. Following further medical assessment of the infant, Charlie’s parents and doctors finally reached agreement that continuing medical treatment was not in Charlie’s best interests. Life support was subsequently withdrawn and Charlie died on 28 July 2017.Box 1 ### Case summary and timeline21–23 Charlie Gard was born at full term, apparently healthy, in August 2016. At a few weeks of age his parents (...) noticed early signs of muscle weakness. At 2 months of age, he was admitted to Great Ormond Street Hospital with poor feeding, failure to thrive and respiratory failure. He was admitted to intensive care, where investigations led to the diagnosis of a rare severe mitochondrial disorder – infantile onset encephalomyopathic mitochondrial DNA depletion syndrome. The specific genetic form of MDDS in Charlie Gard had previously been reported in approximately 15 infants, with typical clinical features including early onset, rapid progression and death in infancy.24 By that point, Charlie was paralysed and unable to breathe without respiratory support. He was found to have congenital deafness, and his heart, liver and kidneys were affected by the disorder. Doctors felt that Charlie’s prognosis was extremely poor. In early 2017, Charlie’s parents identified an experimental treatment, previously used in a different form of MDDS, which they hoped might benefit Charlie. In mouse models of a myopathic form of MDDS, early supplementation with deoxypryrimidine nucleosides apparently bypasses the genetic defect and leads to a reduction in the biochemical defect and in the severity of the clinical phenotype.25 26 Doctors at GOSH initially planned to use nucleoside treatment in Charlie, but in January he developed evidence of electrical seizures, and clinicians became convinced that treatment, both continued intensive care and the requested …. (shrink)

The representation of color by pictures raises worthwhile questions for philosophers and psychologists. Moreover, philosophers and psychologists interested in answering these questions will benefit by paying attention to each other's work. Failure to recognize the potential for interdisciplinary cooperation can be attributed to tacit acceptance of the resemblance theory of pictorial color. I argue that this theory is inadequate, so philosophers of art have work to do devising an alternative. At the same time, if the resemblance theory is false, then (...) color depiction has interesting implications for color science. Empirical researchers must rethink the widespread assumption that color recognition requires color constancy. I suggest that a neuropsychological account of color recognition will be instrumental to completing the philosophical task, but by the same token scientists might do well not to proceed without casting an eye to the work of philosophers of art. (shrink)

Limiting dangerous climate change is now widely believed to require negative emissions, a prospect some believe to be unjust and unacceptably risky. While NETs are not risk-free, I argue tha...

Empirical research on aesthetic response poses two challenges to philosophy. The more familiar challenge is that scientific explanations of aesthetic responses debunk what we take to be our reasons for those responses. One reaction to this challenge is an accommodation strategy that seeks to reconcile the scientific findings with an improved understanding of our normative reasons. This paper presents a more fundamental challenge: a well-established body of research in social psychology indicates that we routinely confabulate the reasons we give for (...) our aesthetic response. This challenges the accommodation strategy and suggests that philosophy should adopt a more radical naturalism about aesthetic response. (shrink)

This article proposes a Social Determinants of Health framework as a counter to the prominence of bio-determinist tropes in understandings of the relationship between concussion and later life neurodegenerative conditions in athletic populations. It is argued that debates about concussion (or repetitive head impacts) causing CTE have been particularly influenced by broader social trends towards neuro-essentialism. This paradigm reduces complex social behaviour to brain matter and continues to dominate the field despite the recent diversification of evidence from autopsy-based studies of (...) neuropathology to epidemiological studies comparing recorded causes of death among former elite athletes. In contrast, this article explores the ‘causes of causes’ of neurodegenerative conditions. It outlines the ways in which the distinct dynamics of: a) employment, b) education, income and wealth, c) health systems and services, and d) social environment and public safety relate to the specific occupational conditions of elite sport and likely negatively shape health outcomes of athletic populations. The article concludes by arguing that to more effectively address these particular health harms we must move beyond narrow, mono-causal models and evoke a cultural change that extends beyond making rule changes and adjusting psychological attitudes and behavioural norms, to redress the social structural parameters of elite sports participation. The continuation of narrower, neuro-centric and reductionist paradigms obscures the causes of the causes of neurodegenerative decline and limits the scope for change. (shrink)

Precautionary Principles are often said to be appropriate for decision-making in contexts of uncertainty such as climate policy. Contexts of uncertainty are contrasted to contexts of risk depending on whether we have probabilities or not. Against this view, I argue that the risk-uncertainty distinction is practically irrelevant. I start by noting that the history of the distinction between risk and uncertainty is more varied than is sometimes assumed. In order to examine the distinction, I unpack the idea of having probabilities, (...) in particular by distinguishing three interpretations of probability: objective, epistemic, and subjective probability. I then claim that if we are concerned with whether we have probabilities at all—regardless of how low their epistemic credentials are—then we almost always have probabilities for policy-making. The reason is that subjective and epistemic probability are the relevant interpretations of probability and we almost always have subjective and epistemic probabilities. In contrast, if we are only concerned with probabilities that have sufficiently high epistemic credentials, then we obviously do not always have probabilities. Climate policy, for example, would then be a case of decision-making under uncertainty. But, so I argue, we should not dismiss probabilities with low epistemic credentials. Rather, when they are the best available probabilities our decision principles should make use of them. And, since they are almost always available, the risk-uncertainty distinction remains irrelevant. (shrink)

In the case of Re M, summarised in the paper by Julian Sheather, Justice Baker faced the difficult task of weighing up objectively whether or not it was in Mâs best interests to withdraw artificial feeding and to let her die.1 The judge concluded that M was ârecognisably aliveâ, and that the advantages of continued life outweighed the disadvantages. He compared her minimally conscious state favourably to that of a persistent vegetative state .2 It was clear that artificial feeding would (...) have been withdrawn if she had been in a PVS , but because she was in fact minimally conscious, the judge decided that treatment must continue. But does it make sense to treat MCS differently from PVS in this way? Is it better to be minimally conscious than unconscious? Similar questions have been raised before.3 In 2006, scientists reported results of sophisticated neuroimaging studies which suggested that some patients in persistent vegetative state , long thought to be unaware, had evidence of minimal consciousness.4 The question then was on the moral significance of this level of consciousness, and whether the presence of such evidence meant that treatment such as artificial nutrition must be continued.5 ,6There are several potential reasons why the presence of minimal consciousness might warrant continuing life-sustaining treatment. The first is that patients in minimally conscious state might have a better prognosis than those who are in PVS. There are relatively few studies …. (shrink)

Dominic LaRochelle | : Les religions ne constituent pas des monolithes immuables et inchangés dans le temps. Elles évoluent au fil de l’histoire humaine, changent au gré des transformations culturelles et sociales des communautés dans lesquelles elles s’implantent, négocient avec les instances séculières et religieuses leur pertinence et leur droit d’exister ; bref, elles innovent constamment pour s’assurer une place dans un monde lui aussi en constant changement. Cet article propose deux outils pour analyser les innovations au sein des (...) traditions religieuses : les théories de la réception, inspirées des travaux de Hans Robert Jauss, et l’invention des traditions, inspirée du célèbre ouvrage d’Eric J. Hobsbawm et Terence O. Ranger. L’intérêt de l’utilisation de ces outils en histoire est qu’ils permettent, entre autres choses, de dépasser les oppositions classiques tradition/modernité et authenticité/innovation en analysant les religions du point de vue des ruptures et des transformations à l’intérieur de celles-ci. Ces outils seront appliqués à un cas particulier, celui de la réception et de la réinvention du taoïsme dans les sociétés occidentales au XXe siècle. Cette tradition religieuse chinoise vieille de plusieurs siècles a en effet été réinventée en Occident et transformée en une tradition spirituelle universelle répondant aux attentes des Occidentaux en matière de spiritualité contemporaine. | : Religions are not immutable monoliths that remain unchanged over time. They evolve over the course of human history ; changing according to the cultural and social transformations of the communities in which they are established and negotiating with secular and religious authorities for their relevance and right to exist. In short, they continually innovate to secure a place in a constantly changing world. This article proposes two tools to analyze innovations within religious traditions : reception theories, inspired by the works of Hans Robert Jauss, and the invention of tradition, inspired by the celebrated work of Eric J. Hobsbawm and Terence O. Ranger. The interest of using these tools in a historical approach is that they allow us, among other things, to overcome the traditional oppositions of tradition vs. modernity and authenticity vs. innovation by analyzing religions from a rupture and transformation point of view. These tools will be applied to a particular case, namely the reception and reinvention of Taoism in Western societies in the twentieth Century. This centuries-old Chinese religious tradition has been reinvented in the West and transformed into a universal spiritual tradition that meets the expectations of Westerners for contemporary spirituality. (shrink)

In the case that triggered this round-table discussion there are three separate factors that contribute to moral uncertainty.1 First, the infant, baby T, is extremely premature with suspected brain injury and potentially poor prognosis. Second, the gestational mother is critically unwell herself and her outlook is guarded. Third, as linked commentaries make clear, the legal status of the intended parents is complex and ambiguous.2 3 Any of these factors on their own would be enough to generate ethical complexity and distress (...) in the neonatal intensive care unit. The combination of the three is likely to be highly stressful for all concerned.4 Commentaries on the case emphasise the complex legal questions and the potential need to involve the court. One resource that is not mentioned is the potential value of clinical ethics input in such a case. This is complementary to the need for legal advice. Its aim would be to help think through the specifically ethical, rather than legal questions. There are several things that I would aim to clarify if chairing a clinical ethics discussion on the case. First, it may be useful to draw on the concept of the …. (shrink)

Clinical guidelines summarise available evidence on medical treatment, and provide recommendations about the most effective and cost-effective options for patients with a given condition. However, sometimes patients do not desire the best available treatment. Should doctors in a publicly-funded healthcare system ever provide sub-optimal medical treatment? On one view, it would be wrong to do so, since this would violate the ethical principle of beneficence, and predictably lead to harm for patients. It would also, potentially, be a misuse of finite (...) health resources. In this paper, we argue in favour of permitting sub-optimal choices on the basis of value pluralism, uncertainty, patient autonomy and responsibility. There are diverse views about how to evaluate treatment options, and patients’ right to self-determination and taking responsibility for their own lives should be respected. We introduce the concept of cost-equivalence, as a way of defining the boundaries of permissible pluralism in publicly-funded healthcare systems. As well as providing the most effective, available treatment for a given condition, publicly-funded healthcare systems should provide reasonable suboptimal medical treatments that are equivalent in cost to the optimal treatment. We identify four forms of cost-equivalence, and assess the implications of CE for decision-making. We evaluate and reject counterarguments to CE. Finally, we assess the relevance of CE for other treatment decisions including requests for potentially superior treatment. (shrink)

Care of the critically ill newborn includes support for the birth mother/parents with regular updates around the clinical condition of the baby, and involvement in discussions around complex decision-making issues. Discussions around continuation or discontinuation of life-sustaining are challenging even in the most straightforward of cases, but what happens when the birth mother is critically unwell? Such cases can lead to uncertainty around who should assume the parental role for these difficult discussions. In this round table discussion, we explore the (...) ethical, moral and legal uncertainties raised by coincident severe maternal and neonatal illness in the context of surrogacy. (shrink)

Ethical discussions about medical treatment for seriously ill babies or children often focus on the ‘value of life’ or on ‘quality of life’ and what that might mean. In this paper, I look at the other side of the coin—on the value of death, and on the quality of dying. In particular, I examine whether there is such a thing as a good way to die, for an infant or an adult, and what that means for medical care. To do (...) that, I call on philosophy and on personal experience. However, I will also make reference to art, poetry and music. That is partly because the topic of mortality has long been reflected on by artists as well as philosophers and ethicists. It is also because, as we will see, there may be some useful parallels to draw. (shrink)

In early 2020, a number of countries developed and published intensive care triage guidelines for the pandemic. Several of those guidelines, especially in the UK, encouraged the explicit assessment...

In this paper, we explore three separate questions that are relevant to assessing the prudential value of life in infants with severe life-limiting illness. First, what is the value or disvalue of a short life? Is it in the interests of a child to save her life if she will nevertheless die in infancy or very early childhood? Second, how does profound cognitive impairment affect the balance of positives and negatives in a child’s future life? Third, if the life of (...) a child with life-limiting illness is prolonged, how much suffering will she experience and can any of it be alleviated? Is there a risk that negative experiences for such a child will remain despite the provision of palliative care? We argue that both the subjective and objective components of well-being for children could be greatly reduced if they are anticipated to have a short life that is affected by profound cognitive impairment. This does not mean that their overall well-being will be negative, but rather that there may be a higher risk of negative overall well-being if they are expected to experience pain, discomfort, or distress. Furthermore, we point to some of the practical limitations of therapies aimed at relieving suffering, such that there is a risk that suffering will go partially or completely unrelieved. Taken together, these considerations imply that some life-prolonging treatments are not in the best interests of infants with severe life-limiting illness. (shrink)

Mental illness affects every aspect of life and society, from relationships between individuals and within families, to small communities and entire polities. People with serious mental illness die decades before those without. Mentally ill people suffer daily as they struggle to function in societies that are unforgiving and uninterested in their pain. Those with serious mental illness may be incarcerated because of their sickness, they may be passed over or fired from jobs, subjected to ridicule and mockery, given little treatment (...) or safe shelter, and violently victimized. As a result, persons with mental illness are some of the most vulnerable people in our society. And while the world is focused on the COVID-19... (shrink)