Volume 24, Issue 7, July 2024, Page 104-106.

The call has been made for global bioethics. In an age of pandemics, international drug trials, and genetic technology, health has gone global, and bioethics must follow suit. George Annas is one among a number of thinkers to recommend that bioethics expand beyond its traditional domain of patient–physician interactions to encompass a broader range of health-related matters. Medicine, Annas argues, must “develop a global language and a global strategy that can help to improve the health of all (...) of the world's citizens.” Individual countries cannot address global health issues, and culturally specific principles are inadequate for addressing global bioethics concerns. We will need a language and moral framework grounded in a foundation of universally shared, transcultural judgments about humankind that will also recognize moral pluralism. The claim has been made that such a foundation already exists in human rights, and that human rights should, therefore, be the new lingua franca of bioethics. (shrink)

There are many good reasons for a merger between bioethics and human rights. First, though, significant philosophical groundwork must be done to clarify what a human right to health would be and—if we accept that it exists—exactly how it might influence the practical decisions we face about who gets what in very different contexts.

Two questions emerge from the target article about reciprocity as a priority principle for health resource allocation: (1) whether we owe people priority for scarce and potentially life-saving heal...

The Routledge Companion to Bioethics is a comprehensive reference guide to a wide range of contemporary concerns in bioethics. The volume orients the reader in a changing landscape shaped by globalization, health disparities, and rapidly advancing technologies. Bioethics has begun a turn toward a systematic concern with social justice, population health, and public policy. While also covering more traditional topics, this volume fully captures this recent shift and foreshadows the resulting developments in bioethics. It highlights emerging (...) issues such as climate change, transgender, and medical tourism, and re-examines enduring topics, such as autonomy, end-of-life care, and resource allocation. (shrink)

ABSTRACT Genetic enhancement is the modification of the human genome for the purpose of improving capacities or ‘adding in’ desired characteristics. Although this technology is still largely futuristic, debate over the moral issues it raises has been significant. George Annas has recently leveled a new attack against genetic enhancement, drawing on human rights as his primary weapon. I argue that Annas’ appeal to human rights ultimately falls flat, and so provides no good reason to object to genetic technology. Moreover, this (...) argument is an example of the broader problem of appealing to human rights as a panacea for ethical problems. Human rights, it is often claimed, are ‘trumps’: if it can be shown that a proposed technology violates human rights, then it must be cast aside. But human rights are neither a panacea for ethical problems nor a trump card. If they are drafted into the service of an argument, it must be shown that an actual human rights violation will occur. Annas’ argument against genetic technology fails to do just this. I shall conclude that his appeal to human rights adds little to the debate over the ethical questions raised by genetic technology. (shrink)

The circumstances of a public health emergency shape reasoning and decision-making in ways that deviate from routine circumstances, where adherence to established values, principles, and methodologies is expected. Understanding what drives these deviations is critical to assessing their ethical consequences. In this paper we describe four conditions that influence decision-making during PHEs, in particular regarding the deployment and conduct of research on experimental or novel biomedical interventions. These four conditions are politicization, urgency, uncertainty, and fear. We argue that taken together (...) these four conditions create pressure to address the most visible targets of immediate crisis events, driving emphasis on research and development of biomedical interventions. However, this emphasis raises ethical concerns regarding the extent to which attention to and investment in the underlying causes of PHEs, particularly impoverished global public health infrastructure, is diminished as a result. (shrink)

Responses to the COVID-19 pandemic have been widely criticized for being too delayed and indecisive. As a result, the precautionary principle has been endorsed, applauded, and proposed to guide future responses to global public health emergencies. Drawing from controversial issues in response to COVID-19, especially in Vietnam, this paper critically discusses some key ethical and legal issues of employing the precautionary principle in public health emergencies. Engaging with discussions concerning this principle, especially in environmental law where the precautionary principle first (...) appeared as a guiding principle with objective content(s), this paper formulates the precautionary principle as ‘in dubio pro salus’, which is about advising, justifying and demanding states to proactively prepare for scenarios arising out of any public health emergency. It distinguishes the precautionary principle into moderate and hard versions. A moderate version largely takes a holistic approach and fulfils a series of criteria specified in this paper, while a hard version either permits restrictive measures to be deployed primarily on a hypothetic basis or expresses an instrumental mentality. The hard version should be rejected because of the ethical and legal problems it raises, including risk-risk tradeoffs, internal paradoxes, unjustified causing of fear and unreasonable presupposition. Ultimately, this paper defends the moderate version. (shrink)

Reconciliation and the Technics of Healing Content Type Journal Article Pages 235-237 DOI 10.1007/s11673-011-9318-y Authors Paul A. Komesaroff, Monash Centre for Ethics in Medicine and Society, Monash University, Melbourne, Vic., Australia Elizabeth Kath, Global Cities Institute, RMIT University, Melbourne, Vic., Australia Paul James, Global Cities Institute, RMIT University, Melbourne, Vic., Australia Journal Journal of Bioethical Inquiry Online ISSN 1872-4353 Print ISSN 1176-7529 Journal Volume Volume 8 Journal Issue Volume 8, Number 3.

Background: Ethical care in maternity is fundamental to providing care that both prevents harm and does good, and yet, there is growing acknowledgement that disrespect and abuse routinely occur in this context, which indicates that current ethical frameworks are not adequate. Care ethics offers an alternative to the traditional biomedical ethical principles. Research aim: The aim of the study was to determine whether a correlation exists between midwifery-led care and care ethics as an important first step in an action research (...) project. Research design: Template analysis was chosen for this part of the action research. Template analysis is a design that tests theory against empirical data, which requires pre-set codes. Participants and context: A priori codes that represent midwifery-led care were generated by a stakeholder consultative group of nine childbearing women using nominal group technique, collected in Perth, Western Australia. The a priori codes were applied to a predesigned template with four domains of care ethics. Ethical considerations: Ethics approval was granted by the Edith Cowan University research ethics committee REMS no. 2019-00296-Buchanan. Findings: The participants generated eight a priori codes representing ethical midwifery care, such as: 1.1 Relationship with Midwife; 1.2 Woman-centred care; 2.1 Trust women’s bodies and abilities; 2.2. Protect normal physiological birth; 3.1. Information provision; 3.2. Respect autonomy; 4.1. Birth culture of fear (midwifery-led care counter-cultural) and 4.2. Recognition of rite of passage. The a priori codes were mapped to the care ethics template. The template analysis found that midwifery-led care does indeed demonstrate care ethics. Discussion: Care ethics takes into consideration what principle-based bioethics have previously overlooked: relationship, context and power. Conclusion: Midwifery-led care has been determined in this study to demonstrate care ethics, which suggest that further research is defensible with the view that it could be incorporated into the ethical codes and conduct for the midwifery profession. (shrink)

The Borg are always confident that humans will be assimilated into their collective hive and therefore that, as they say, “resistance is futile.” In Star Trek, of course, the humans always successfully resist. Elizabeth Fenton and John Arras, like the Borg, resist the idea that humans are uniquely special as well as the utility of the human rights framework for global bioethics. I believe their resistance to human rights is futile, and I explain why in this essay. (...) Let me begin with their subtitle, because we do seem to agree that popular culture is a powerful aid to understanding human actions and motivations. (shrink)

Malm and colleagues (2008) consider (and reject) five arguments putatively justifying the idea that healthcare workers (HCWs) have a duty to treat (DTT) during a pandemic. We do not have sufficient...

In the course of developing his arguments against making genetic enhancements to one's children, Habermas assumes that a clear line can be drawn between the natural and the manufactured. But given the current state of medical science, this is precisely what we can no longer take for granted.

Citing grounds of conscience, pharmacists are increasingly refusing to fill prescriptions for emergency contraception, or the "morning-after pill." Whether correctly or not, these pharmacists believe that emergency contraception either constitutes the destruction of post-conception human life, or poses a significant risk of such destruction. We argue that the liberty of conscientious refusal grounds a strong moral claim, one that cannot be defeated solely by consideration of the interests of those seeking medication. We examine, and find lacking, five arguments for requiring (...) pharmacists to fill prescriptions. However, we argue that in their professional context, pharmacists benefit from liberty restrictions on those seeking medication. What would otherwise amount to very strong claims can be defeated if they rest on some prior restriction of the liberty of others. We conclude that the issue of what policy should require pharmacists to do must be settled by way of a theory of second best. Asking "What is second best?" rather than "What is best?" offers a way to navigate the liberty restrictions that may be fixed obstacles to optimality. (shrink)

We concur with Baum and colleagues (2009) on the importance of pandemic planners taking explicit steps to employ public engagement methodologies. Thus far, as Baum and colleagues note, there have b...

In ‘Obesity, equity and choice’ (J Med Ethics2018;0:1–7. doi:10.1136/medethics-2018-104848), Timothy Wilkinson argues that preventive regulations to address obesity, such as taxes on sugary drinks, are at worst inequitable and at best fail to increase or improve equity. He concludes that we do not yet have good reasons to adopt them. I argue that equity considerations are not as problematic for preventive regulations as Wilkinson suggests.

It is clear from George Annas's response to our arguments that he has misunderstood and misrepresented our positions on several key points. We suspect that this may be due in part to significant differences between our respective agendas and points of view, so we begin this exchange with an exploration of these differences.

Gaps in funded cancer medicines between New Zealand and Australia can have significant implications for patients and their families. Pharmac, the New Zealand pharmaceutical funding agency, has been criticised for not funding enough cancer medicines, and a 2022 review identified ethical concerns about its utilitarian focus on efficiency. However, as the costs of new cancer medicines rise along with public and political pressure to fund them, questions about value for money remain critical for health systems worldwide. In this paper, we (...) compare funding for cancer medicines in New Zealand and Australia, specifically medicines for non-small cell lung cancer. We argue that the ethical imperatives on funding agencies to get value for money and provide medicines for patients with cancer underscore the importance of transparent decision-making processes, including identifying and explaining intercountry differences in funded medicines. (shrink)

Health worker shortages in many countries are reaching crisis levels, exacerbated by factors associated with the COVID-19 pandemic. In New Zealand, the medical specialists union has called for a health workforce emergency to be declared, yet at the same time, many foreign-trained healthcare workers are unable to stay in the country or unable to work. While their health systems differ, countries such as New Zealand, the USA and the UK at least partially rely on international medical graduates (IMGs) to ensure (...) access to health services, particularly in underserved communities. This paper focuses on the challenges faced by many IMGs, particularly those that constrain their capacity to live and work in the countries that rely on their skills. These challenges give rise to two ethical problems. First, they represent a failure of reciprocity towards IMGs; second, they represent a source of harm, both to IMGs themselves and to communities whose healthcare service depends on contributions made by IMGs. We argue that brain waste and disvaluing the contributions of IMGs and other foreign-trained health professionals have significant costs for maintaining a functional healthcare system, costs which must be adequately recognised and counted. (shrink)

Volume 24, Issue 12, December 2024, Page 32-34.

In this comment, we propose a short exploration of the differences among the declaration of death, the determination of death, and the concept of death, and how they relate to the ethics and practi...

Experiments with young infants provide evidence for early-developing capacities to represent physical objects and to reason about object motion. Early physical reasoning accords with 2 constraints at the center of mature physical conceptions: continuity and solidity. It fails to accord with 2 constraints that may be peripheral to mature conceptions: gravity and inertia. These experiments suggest that cognition develops concurrently with perception and action and that development leads to the enrichment of conceptions around an unchanging core. The experiments challenge claims (...) that cognition develops on a foundation of perceptual or motor experience, that initial conceptions are inappropriate to the world, and that initial conceptions are abandoned or radically.. (shrink)

As current events around the world have illustrated, epistemological issues are at the center of our political lives. It has become increasingly difficult to discern legitimate sources of evidence, misinformation spreads faster than ever, and the role of truth in politics has allegedly decayed in recent years. It is therefore no coincidence that political discourse is currently saturated with epistemic notions like ‘post-truth,’ ‘fake news,’ ‘truth decay,’ ‘echo chambers,’ and ‘alternative facts.’ This book brings together leading philosophers to explore ways (...) in which the analytic and conceptual tools of epistemology bear on political philosophy, and vice versa. It is organized around three broad themes: truth and knowledge in politics; epistemic problems for democracy; and disagreement and polarization. The authors provide new and rich insights on topics such as: propaganda, fake news, weaponized skepticism, belief polarization, political disagreement, the epistemic value of democracy, voter ignorance, irrationality in politics, political bullshit, and identity politics. (shrink)

When trust is broken, how should we determine who is at fault? Previous discus- sions of broken trust typically attribute the fault to trusters who place trust foolishly or trustees who act in an untrustworthy manner. These discussions take for granted the ability of the truster and trustee to communicate and understand the boundaries of what is being entrusted, that is, the domain of trust. However, the boundaries of entrusted domains are not always clear to either party which can result (...) in broken trust despite the best efforts of both truster and trustee. In this paper, I argue that deter- mining who to blame when trust is broken is a messy affair in which disagreements over fault regularly arise. I introduce three features of trust domains that take center stage in negotiations regarding who is at fault when trust is broken: scope, rigidity and ordering. (shrink)

Military-on-military sexual violence—the type of sexual violence that most directly disrupts operations, harms personnel, and undermines recruiting—occurs with astonishing frequency. The U.S. military has responded with a campaign to prevent and punish military-on-military sex crimes. This campaign, however, has made little progress, partly because of U.S. military law, a special realm of criminal justice dominated by legal precedents involving sexual violence and racialized images. By promulgating images and narratives of sexual exploitation, violent sexuality, and female subordination, the military justice system (...) has helped to sustain a legal culture that reifies the connection between sexual violence and authentic soldiering. (shrink)

In Rousseau's Republican Romance, Elizabeth Wingrove combines political theory and narrative analysis to argue that Rousseau's stories of sex and sexuality offer important insights into the paradoxes of democratic consent. She suggests that despite Rousseau's own protestations, "man" and "citizen" are not rival or contradictory ideals. Instead, they are deeply interdependent. Her provocative reconfiguration of republicanism introduces the concept of consensual nonconsensuality--a condition in which one wills the circumstances of one's own domination. This apparently paradoxical possibility appears at the (...) center of Rousseau's republican polity and his romantic dyad: in both instances, the expression and satisfaction of desire entail a twin experience of domination and submission.Drawing on a wide variety of Rousseau's political and literary writings, Wingrove shows how consensual nonconsensuality organizes his representations of desire and identity. She demonstrates the inseparability of republicanism and accounts of heterosexuality in an analysis that emphasizes the sentimental and somatic aspects of citizenship. In Rousseau's texts, a politics of consent coincides with a performative politics of desire and of emotion. Wingrove concludes that understanding his strategies of democratic governance requires attending to his strategies of symbolization. Further, she suggests that any understanding of political practice requires attending to bodily practices. (shrink)

This paper examines the idea that straight talk can actually pose certain dangers for democracy by asking two interrelated questions. First, does our belief in the importance of sincerity necessarily improve political deliberation? Second, does our belief cause us to under-appreciate other important communicative resources? We will see that much hinges on our answers to these questions because they deal directly with whose voices are to be considered legitimate and authoritative in our public sphere. This paper begins from a deliberative (...) democratic standpoint: democracy is a logocentric enterprise—that is, language is at the center of democratic political projects. So it is critical that we pay attention to how we evaluate political words. Otherwise, not only can we not really understand what is going on in the public sphere, but we are also more likely to make poor judgments about what sort of speech and speakers make our democracy more robust. -/- To explore these questions, this paper examines the discourse ethics that underwrite much of deliberative democratic theory (section I). It then goes on to discuss some of the dangers that the particular ethic of sincerity poses for democratic communication. The paper argues that the emphasis on sincerity: -/- 1) too easily collapses the relation between claims to truthfulness and truth claims and contributes to an undemocratic epistemology; 2) oversimplifies human psychology, ignoring the possibility of multiple and complexly related intentions; 3) denigrates “rhetorical” forms of speech; and 4) privileges a seemingly non-rhetorical mode of communication: hyper-sincerity. (shrink)

Among the "hard cases" of captive animal research is the continued use of chimpanzees in harmful experimental science. In a recent article I contend that contemporary animal welfare science and chimpanzee behavioral studies permit, if not require, a reappraisal of the moral significance of chimpanzee dissent from participation in certain experiments. In what follows, I outline my earlier argument, provide a brief survey of some central concepts in pediatric research ethics, and use these to enrich an understanding of chimpanzee dissent (...) useful for research ethics. (shrink)

RESUMEN El presente trabajo describe los cambios estratégicos del Centro de Inmunología y Productos Biológicos de la Universidad de Ciencias Médicas de Camagüey que contribuyen a la formación profesional, la investigación y los servicios científico técnicos. Recoge los resultados obtenidos desde el 2015 hasta el 2017. Los referentes teóricos permiten un acercamiento epistémico que facilita la relación con el conocimiento y la creación de concepciones para abordar los problemas de salud. El centro tiene cuatro proyectos asociados a programas y 11 (...) institucionales. Se posee 2,7 publicaciones por autor y 18 participaciones en eventos, de ellos, ocho internacionales. Se perfecciona un sistema de gestión de la calidad, nueve servicios científico-técnicos, diversos servicios a la docencia y proyectos de investigaciones. Se aprovecha el potencial que genera el proceso de auto-organización del trabajo colectivo, para un mejor funcionamiento, sinergia y sustentabilidad de la gestión de una unidad de desarrollo e innovación. ABSTRACT The present work describes the strategic changes of the Center of Immunology and Biological Products of the University of Medical Sciences of Camagüey that contributes to the professional training, the investigation and the technical-scientist services. It gathers the results obtained from 2015 to 2017. The theoretical bases allow an epistemic approach that facilitates the relation with the knowledge and the creation of conceptions to tackle the health problems. The center has four projects associated with programs and 11 institutional ones. There are possessed 2.7 publications per author and 18 participations in events, of them, eight international ones. Scientist - technical staff perfects a system of management of the quality, nine services, diverse services to the teaching and projects of investigations. One makes use of the potential that generates the auto-organization process of collective work, for a better functioning, synergy and sustainability of the management of a unit of development and innovation. (shrink)

In this article, we critically examine some of the ethical challenges and interpretive difficulties with possible future non-clinical applications of pediatric fMRI with a particular focus on applications in the classroom and the courtroom - two domains in which children come directly in contact with the state. We begin with a general overview of anticipated clinical and non-clinical applications of pediatric fMRI. This is followed by a detailed analysis of a range of ethical challenges and interpretive difficulties that trouble the (...) use of fMRI and are likely to be especially acute with non-clinical uses of the technology. We conclude that knowledge of these challenges and difficulties should influence policy decisions regarding the non-clinical uses of fMRI. Our aim is to encourage the development of future policies prescribing the responsible use of this neuroimaging technology as it develops both within and outside the clinical setting. (shrink)

Have you ever wondered what life would look like if you woke up happy every day, satisfied, feeling fulfilled and energized? This may seem impossible to most, considering all the daily news from around the world. Every spiritual discipline talks of what we call "enlightenment," but finding it continues to bewilder many seekers. Dr. Elizabeth Cantey, leader of the Jacksonville Center for Spiritual Living in Florida, has walked many paths in her search and ultimately realized that enlightenment-the feeling of (...) wholeness and peacefulness-is very hard to find if you keep looking for the solution outside of yourself. In her new book, LIVING ENLIGHTENED: The Joy of Integrating Spirit, Mind and Body she writes, "My life didn't change much in the external world of my affairs. Most would say my life is somewhat ordinary. But my inner life... wow!" Join Elizabeth and learn how to find the wholeness from within, an integration of spirit, mind and body. You'll discover that the enlightened live in the world, but are not affected by the world. Instead, they affect the world around them. The enlightened create the changes they wish to see rather than being subjected to the changes of others. What a powerful place to stand in and live from... and wake up to every day. (shrink)

In this special issue of _difference_s, leading feminist theorists acknowledge Derrida’s contribution to feminist theory, discuss the crucial place of difference in both Derridian deconstruction and feminist theory, and reflect on the ethical, professional, and epistemological implications of Derrida’s thought for the discipline of women’s studies. In bringing together major feminist critics whose work has been touched by the writings of Derrida, this issue both pays tribute to and reflects upon Derrida’s ideas. Among the essayists included, Jane Gallop considers Derrida’s (...) writings on Levinas; Judith Butler reads Derrida’s final interview in _Le Monde_ in 2004; Elizabeth Grosz signals Derrida as a rare philosopher for whom sexual difference was crucial; Gayatri Chakravorty Spivak explores the figure of the mother’s child in Derrida, focusing on the critique of reproductive heteronormativity and the question of agency in feminism; and Joan Wallach Scott argues for the importance of critique in the academy. The issue also includes an edited transcription of a vibrant discussion between feminist theorists and Derrida called “Women in the Beehive: A Seminar with Jacques Derrida,” which took place at Brown University’s Pembroke Center for Teaching and Research on Women in 1984. _Contributors_. Fran Bartkowski, Anne-Emmanuelle Berger, Susan Bernstein, Judith Butler, Pheng Cheah, Drucilla Cornell, Jane Gallop, Elizabeth Grosz, Peggy Kamuf, Christie McDonald, Joan Wallach Scott, Gayatri Chakravorty Spivak. (shrink)

ABSTRACTThis paper integrates some Buddhist moral values, attitudes and self‐cultivation techniques into a discussion of the ethics of cognitive enhancement technologies – in particular, pharmaceutical enhancements. Many Buddhists utilize meditation techniques that are both integral to their practice and are believed to enhance the cognitive and affective states of experienced practitioners. Additionally, Mahāyāna Buddhism's teaching on skillful means permits a liberal use of methods or techniques in Buddhist practice that yield insight into our selfnature or aid in alleviating or eliminating (...) dukha . These features of many, if not most, Buddhist traditions will inform much of the Buddhist assessment of pharmaceutical enhancements offered in this paper. Some Buddhist concerns about the effects and context of the use of pharmaceutical enhancements will be canvassed in the discussion. Also, the author will consider Buddhist views of the possible harms that may befall human and nonhuman research subjects, interference with a recipient's karma, the artificiality of pharmaceutical enhancements, and the possible motivations or intentions of healthy individuals pursuing pharmacological enhancement. Perhaps surprisingly, none of these concerns will adequately ground a reflective Buddhist opposition to the further development and continued use of pharmaceutical enhancements, either in principle or in practice. The author argues that Buddhists, from at least certain traditions – particularly Mahāyāna Buddhist traditions – should advocate the development or use of pharmaceutical enhancements if a consequence of their use is further insight into our self‐nature or the reduction or alleviation of dukha. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:The Patient Self-Determination ActElizabeth Leibold McCloskey (bio)What are the ethics of extending the length of life? We know that we cannot artificially end life (Thou Shalt not Kill), but how about artificially extending life? Is that always good, sometimes good?... In ethics, is keeping people alive the highest good? Should our priority be to keep people breathing?... What does basic religious ethics say about this?(John C. Danforth, letter to (...) the author, 19 August 1989)The Patient Self-Determination Act, signed into law as part of the Omnibus Budget Reconciliation Act of 1990 (OBRA '90) last November, marks the first time that Congress has passed legislation concerning the ethics of life-sustaining medical treatment. The bill was spearheaded by Senator John C. Danforth (RMO), who has a special interest in this area. An Episcopal priest, Danforth was formerly an assistant chaplain at New York's Memorial Sloan-Kettering Cancer Center and now sits as a senior member of the Senate Finance Committee, which oversees Medicare and Medicaid. Although Senator Danforth's legislative initiative was not a result of the Cruzan case, it was in his state of Missouri that the U.S. Supreme Court case involving removal of Nancy Cruzan's feeding tube arose (Cruzan v. Director of Missouri Department of Health, U.S. Supreme Court, 58 LW 4916, 26 June 1990). From his unique vantage point, he felt it was time to craft a legislative response to some of the difficult issues surrounding prolongation of life.The short answer to Senator Danforth's questions about when to artificially extend life is simple enough: people must be free to determine that for themselves. Common law and common sense dictate such a conclusion; living will and health care proxy statutes, enacted in almost every state, codify that right. The Catholic moral tradition teaches that one is not morally obligated to use extraordinary means to prolong life, a tradition shared both by the mainline Protestant and the reform and conservative Jewish community. Yet most people are unaware of their fundamental legal right to make such decisions, and as court cases from Quinlan (In re Quinlin, 137 N.J. Super. 227, 1975) to Cruzan demonstrate, few know [End Page 163] how to make arrangements for this right to be exercised if they become incapacitated.Meanwhile, health care practices are often driven by a denial of death. When Senator Danforth and Senator Daniel Patrick Moynihan (D-NY) introduced the bill on October 17, 1989, Senator Danforth said:More and more it is arguable that we play God by subjecting people to unwanted and sometimes unnecessary treatment, treatment that unnaturally prolongs the dying process. Our health care system has become obsessed with extending life, at times neglecting the caring component of medicine and trampling on the rights of patients.(Congressional Record 1989, 135:5.13566)The American Hospital Association estimates that 70 percent of deaths now occur after a determination to withhold or withdraw medical treatment. Many of those decisions are made without the benefit of an incapacitated patient's views, yet a Harvard study revealed that 95 percent of the population would like to prepare in advance for such decisions. Only 4 percent of hospitals have a systematic method of asking patients if they have an advance directive. Family members confront painful choices in the face of uncertainty about their loved one's wishes and it can be even more painful when a family knows the patient's desires but providers and the courts act otherwise because clear evidence is lacking.The Patient Self-Determination Act is rooted in the belief that people should be given information that enables them to specify the extent of medical treatment they wish to receive should they become incapacitated. The public should be educated about applicable state laws that protect the individual's right to make such choices through the use of an advance directive.The Act moves toward that goal by promoting knowledge of state laws. It requires every hospital, nursing home, home health agency, hospice, and health maintenance organization that participates in Medicaid or Medicare to routinely give all adult patients information about advance directives. Patients will also be given information on the... (shrink)

Though there is a burgeoning interest in applied Buddhist ethics, Buddhist animal research ethics remains an underdeveloped area. In this paper I will explore how some central Buddhist ethical considerations can usefully engage our use of other animals (henceforth, animals) in science. As the scientific use of animals is broad, I will narrow my focus to laboratory science. I will show that, though a Buddhist abolitionism would not be unmotivated, it is possible to reject it. While doing so, it will (...) be important to resist emphasizing elements of Buddhist thought that merely provide reasons to adopt the dominant ethical framework governing laboratory animal research ethics, known as the 3Rs. Though I will suggest how a Buddhist animal research ethics can sometimes permit the use of animals in harmful research, it will also require ethical constraints that resonate with some of the more progressive elements in ‘Western’ bioethics. (shrink)

There's no doubt that reproductive technologies can transform lives for the better. Infertile couples and single, lesbian, gay, intersex, and transgender people have the potential to form families in ways that would have been inconceivable years ago. Yet we are concerned about the widespread commercialization of certain egg‐freezing programs, the messages they propagate about motherhood, the way they blur the line between care and experimentation, and the manipulative and exaggerated marketing that stretches the truth and inspires false hope in women (...) of various ages. We argue that although reproductive technology, and egg freezing in particular, promise to improve women's care by offering more choices to achieve pregnancy and childbearing, they actually have the potential to be disempowering. First, commercial motives in the fertility industry distort women's medical deliberations, thereby restricting their autonomy; second, having the option to freeze their eggs can change the meaning of women's reproductive choices in a way that is limiting rather than liberating. (shrink)

An apparent tension persists in Peirce’s philosophy between the purpose-driven nature of inquiry, destined to achieve truth in the long run, on the one hand, and, on the other hand, the fact that inquiry depends upon musement (or the free play of ideas), which is purposeless. If there is no purpose in musement then it would appear there is no rational self-control in musement, and thus, irrationality lies at the center of Peirce’s theory of inquiry. I argue that in musement (...) the individual sets off without a purpose, thereby opening herself to noticing novelty, and that noticing is itself a form of creative thought insofar as it allows the individual to discover new wonders and anomalies. Not all creativity in inquiry aims at solving problems or formulating new hypotheses. Some creative thinking is about noticing what is already there or possibly there. Such noticing in musement is purposeless, and yet the individual retains some rational self-control within this thought process. She controls the entry into the activity, and, prior to musing, she controls the adoption of the ideals which are inevitably employed in musement. This adoption of some ideals rather than others can explain why some people notice things while others do not. (shrink)