The best interest standard is the threshold most frequently employed by physicians and ethics consultants in challenging a parent’s refusal to provide consent for a child’s medical care. In this article, I will argue that the best interest standard has evolved to serve two different functions, and that these functions differ sufficiently that they require separate standards. While the best interest standard is appropriate for choosing among alternative treatment options for children, making recommendations to parents, and making decisions on behalf (...) of a child when the legal decision makers are either unable to make a decision or are in dispute, a different standard is required for deciding when to seek state interference with parental decision-making authority. I will suggest that the harm principle provides a more appropriate threshold for determining when to seek state intervention than the best interest standard. (shrink)

The case of Ashley X involved a young girl with profound and permanent developmental disability who underwent growth attenuation using high-dose estrogen, a hysterectomy, and surgical removal of her breast buds. Many individuals and groups have been critical of the decisions made by Ashley's parents, physicians, and the hospital ethics committee that supported the decision. While some of the opposition has been grounded in distorted facts and misunderstandings, others have raised important concerns. The purpose of this paper is to provide (...) a brief review of the case and the issues it raised, then address 25 distinct substantive arguments that have been proposed as reasons that Ashley's treatment might be unethical. We conclude that while some important concerns have been raised, the weight of these concerns is not sufficient to consider the interventions used in Ashley's case to be contrary to her best interests, nor are they sufficient to preclude similar use of these interventions in the future for carefully selected patients who might also benefit from them. (shrink)

Robertson's earlier work, The New Renaissance projected the likely future impact of computers in changing our culture. Phase Change builds on and deepens his assessment of the role of the computer as a tool driving profound change by examining the role of computers in changing the face of the sciences and mathematics. He shows that paradigm shifts in understanding in science have generally been triggered by the availability of new tools, allowing the investigator a new way of seeing into questions (...) that had not earlier been amenable to scientific probing. (shrink)

Buddhist traditions understand emptiness in various ways, and two streams of interpretation, “self-emptiness” and “other-emptiness” , have emerged in Tibet that help bring into focus the extent to which interpretations diverge.1 In contrast to self-emptiness, other-emptiness does not refer to a phenomenon’s lack of its own essence; it refers to the ultimate reality’s lack of all that it is not. Rather than claiming the universality of self-emptiness , proponents of other-emptiness assert another way to understand emptiness with regard to the (...) ultimate . These two interpretations of emptiness—as ground and as groundless .. (shrink)

With each novel infectious disease outbreak, there is scholarly attention to healthcare providers’ obligation to assume personal risk while they care for infected patients. While most agree that healthcare providers have a duty to assume some degree of risk, the extent of this obligation remains uncertain. Furthermore, these analyses rarely examine healthcare institutions’ obligations during these outbreaks. As a result, there is little practical guidance for healthcare institutions that are forced to weigh whether or when to exclude healthcare providers from (...) providing care or allow them to opt out from providing care to protect themselves. This article uses the COVID-19 pandemic to examine the concept of risk and the professional duties of both healthcare providers and healthcare institutions, and proposes a framework that can be used to make concrete institutional policy choices. This framework should be a useful tool for any hospital, clinic, or health agency that must make these choices during the current pandemic and beyond. (shrink)

The scholarly enterprise known as the psychology of religion can be understood as the psychological study of religious practice, belief, and experience. With one foot in the stream of psychological theory and research and the other in the flow of religious experience and understanding, it seeks to illuminate the latter through use of the former. In other words, religion becomes the object of psychological analysis, that is, in some sense subordinated to psychology. This relative inequality raises significant methodological issues for (...) anyone attempting to study religion in this way. In particular, one is confronted with the prospect of becoming reductionistic, that is, of explaining what is in fact a complex phenomenon in terms too simple and uni-dimensional, distorting the object of study in the process. (shrink)

Two new notions of compactness, each classically equivalent to the standard classical one of sequential compactness, for apartness spaces are examined within Bishop-style constructive mathematics.

The minimax theorem of matrix game theory is examined from a constructive point of view. It is then shown that the existence of solutions for matrix games cannot be proved constructively, but that a 2-by-2 game with at most one solution has a constructible solution.

It is shown how, under certain circumstances and within Bishop‐style constructive mathematics, one can construct a product of two a‐frames (the structures underlying the constructive theory of apartness on frames).

God Never ChangesOr does he? God has been getting a makeover of late, a "reinvention" that has incited debate and troubled scholars and laypeople alike. Modern theological sectors as diverse as radical feminism and the new “open theism” movement are attacking the classical Christian view of God and vigorously promoting their own images of Divinity.God Under Fire refutes the claim that major attributes of the God of historic Christianity are false and outdated. This book responds to some increasingly popular alternate (...) theologies and the ways in which they cast classical Christian theism in a negative light. Featuring an impressive cast of world-class biblical scholars, philosophers, and apologists, God Under Fire begins by addressing the question, “Should the God of Historic Christianity Be Replaced?” From there, it explores issues as old as time and as new as the inquest into the “openness of God.” How, for instance, does God risk, relate, emote, and change? Does he do these things, and if so, why? These and other questions are investigated with clarity, bringing serious scholarship into popular reach.Above all, this collection of essays focuses on the nature of God as presented in the Scriptures and as Christians have believed for centuries. God Under Fire builds a solid and appealing case for the God of classical Christian theism, who in recent years—as through the centuries—has been the God under fire. (shrink)

Thirty years ago, Buchanan and Brock distinguished between guidance principles and interference principles in the setting of surrogate decision making on behalf of children and incompetent adult patients. They suggested that the best interest standard could serve as a guidance principle, but was insufficient as an interference principle. In this issue of The Journal of Clinical Ethics, Ross argues that the best interest standard can serve as neither a guidance nor interference principle for decision making on behalf of children, but (...) that her model of constrained parental autonomy can serve as both. I will argue that Buchanan and Brock were correct that a single model or standard cannot serve as both a guidance and interference principle in pediatrics and that the best interest standard is a sufficient guidance principle. The harm principle fulfills the conditions necessary for an interference principle, at least insofar as deciding when state intervention to interfere with parental decision making is justified. (shrink)

Emptiness ( śūnyatā ) is one of the most important topics in Buddhist thought and also is one of the most perplexing. Buddhists in Tibet have developed a sophisticated tradition of philosophical discourse on emptiness and ineffability. This paper discusses the meaning(s) of emptiness within three prominent traditions in Tibet: the Geluk ( dge lugs ), Jonang ( jo nang ), and Nyingma ( rnying ma ). I give a concise presentation of each tradition’s interpretation of emptiness and show how (...) each interpretation represents a distinctive aspect of its meaning. Given that Buddhist traditions (1) accept an extra-linguistic reality and (2) maintain a strong tradition of suspicion of language with the belief that language both constructs and distorts reality, this paper responds to an issue that is not so much whether or not an inexpressible reality can be expressed, but rather how it is best articulated. (shrink)

The existence of either a maximum or a minimum for a uniformly continuous mapping f of a compact interval into ${\mathbb{R}}$ is established constructively under the hypotheses that f′ is sequentially continuous and f has at most one critical point.

Two classically equivalent, but constructively inequivalent, strict convexity properties of a preference relation are discussed, and conditions given under which the stronger notion is a consequence of the weaker. The last part of the paper introduces uniformly rotund preferences, and shows that uniform rotundity implies strict convexity. The paper is written from a strictly constructive point of view, in which all proofs embody algorithms. MSC: 03F60, 90A06.

The anti-Specker property, a constructive version of sequential compactness, is used to prove constructively that a pointwise continuous, order-dense preference relation on a compact metric space is uniformly sequentially continuous. It is then shown that Ishihara's principle BD-ℕ implies that a uniformly sequentially continuous, order-dense preference relation on a separable metric space is uniformly continuous. Converses of these two theorems are also proved.

Jamgön Mipam (1846–1912) is one of the most extraordinary figures in the history of Tibet.

Clinical ethics training programs are responsible for preparing their trainees to be competent ethics consultants worthy of the trust of patients, families, surrogates, and healthcare professionals. While the American Society for Bioethics and Humanities (ASBH) offers a certification examination for healthcare ethics consultants, no tools exist for the formal evaluation of ethics trainees to assess their progress toward competency. Medical specialties accredited by the Accreditation Council for Graduate Medical Education (ACGME) use milestones to report trainees’ progress along a continuum of (...) professional development as a means of “operationalizing and implementing” medical competencies. Utilizing the Core Competencies for Healthcare Ethics Consultation and the ACGME and American Board of Pediatrics’ (ABP) Pediatric Milestones Project, we developed milestones for 17 subcompetencies in clinical ethics consultation and academic bioethics. As the field of clinical ethics becomes more standardized, such tools will be needed to promote the development of robust training programs and to certify that their graduates are competent practitioners. (shrink)

A characterisation of a type of weak-operator continuous linear functional on certain linear subsets of B, where H is a Hilbert space, is derived within Bishop-style constructive mathematics.

The nature of modern constructive mathematics, and its applications, actual and potential, to classical and quantum physics, are discussed.

The case presented here is tragic, not just in the sense of being a sad story, but in the dramatic meaning of tragedy. It presents us with a situation where there is no clear path, where moral ambiguity exists, and where no possible solution could unequivocally be declared the right or good one. Ethical deliberation can help here, but only as a way of clarifying the issues and offering reasonable solutions. It cannot show us the one right way.Baby G has (...) profound medical conditions, including respiratory failure, a chest wall deformity that will require surgery, and profound neurodevelopmental disability. Even a best case scenario portends a shortened lifespan and.. (shrink)

The main result of this paper is a weak constructive version of the uniform continuity theorem for pointwise continuous, real-valued functions on a convex subset of a normed linear space. Recursive examples are given to show that the hypotheses of this theorem are necessary. The remainder of the paper discusses conditions which ensure that a sequentially continuous function is continuous. MSC: 03F60, 26E40, 46S30.

It is argued that Hellman's arguments purporting to demonstrate that constructive mathematics cannot cope with unbounded operators on a Hilbert space are seriously flawed, and that there is no evidence that his thesis is correct.

We examine, from a constructive perspective, the relation between the complements of S, T, and S ∩ T in X, where X is either a metric space or a normed linear space. The fundamental question addressed is: If x is distinct from each element of S ∩ T, if s ϵ S, and if t ϵ T, is x distinct from s or from t? Although the classical answer to this question is trivially affirmative, constructive answers involve Markov's principle and (...) the completeness of metric spaces. (shrink)

In the 1960s, human experimentation and public funding of research increased significantly, and with the rise of the modern teaching hospital, the distinction between clinical care and experimentation became more and more blurred. Yet little in the way of meaningful government regulation existed in the United States prior to 1970. In 1966, Paul Freund, the president of the American Academy of Arts and Sciences, appointed an interdisciplinary working group to consult on the issues being raised by human experimentation. Contributions from (...) the group were published in a 1969 issue of Daedalus titled Ethical Aspects of Experimentation with Human Subjects. In the lead essay, Hans Jonas challenged then‐conventional understandings of the moral problems posed by research involving humans and argued for an alternative moral framework. To Jonas, it mattered whether the physician was trying to make the patient well rather than trying to find out how to improve the health of future patients. (shrink)