"End-Of-Law week drinkS @ ACT Magistrates Court: Friday 20 May 2005." Ethos: Official Publication of the Law Society of the Australian Capital Territory, (198), pp. 24.

Modern medicine provides unprecedented opportunities in diagnostics and treatment. However, in some situations at the end of a patient’s life, many physicians refrain from using all possible measures to prolong life. We studied the incidence of different types of treatment withheld or withdrawn in 6 European countries and analyzed the main background characteristics.

Even in the Netherlands, where the practice of physician-assisted death (PAD) has been legalized for over 20 years, there is no such thing as a ‘right to die’. Especially patients with extraordinary requests, such as a wish for PAD based on psychiatric suffering, advanced dementia, or (a limited number of) multiple geriatric syndromes, encounter barriers in access to PAD. In this paper, we discuss whether these barriers can be justified in the context of the Dutch situation where PAD is legally (...) permitted for those who suffer unbearably and hopelessly as a result of medical conditions. Furthermore, we explore whether there are options to address some of the barriers or their consequences, both within the Dutch legal framework or by adjusting the legal framework, and whether these options are feasible. We conclude that although there are insufficient arguments to overrule the doctor’s freedom of conscience in the Netherlands, there are ways to address some of the barriers, mainly by offering support to doctors that would be willing to support a request. Moreover, we believe it is morally required to reduce or mitigate where possible the negative consequences of the barriers for patients, such as the long waiting time for those who suffer from psychiatric disorders, because it is unlikely the adjustments suggested to the system will ensure reasonable access for these patient groups. (shrink)

Why is it that most fictions present one and only one ending, rather than multiple ones? Fictions presenting multiple endings are possible, because a few exist; but they are very rare, and this calls for an explanation. We argue that such an explanation is likely to shed light on our engagement with fictions, for fictions having one and only one ending seem to be ubiquitous. After dismissing the most obvious explanations for this phenomenon, we compare the scarcity of multiple (...) endings in traditional kinds of fiction to their profusion in the case of interactive fictions. This contrast poses a challenge to accounts of our engagement with fictions in terms of games of make-believe. We conclude that solving this puzzle is likely to improve our philosophical understanding of fictions. (shrink)

If the Anthropocene represents a new epoch of thought, it also represents a new form of materiality and historicity for the human as strata and stratigrapher of the geologic record. This collision of human and inhuman histories in the strata is a new formation of subjectivity within a geologic horizon that redefines temporal, material, and spatial orders of the human. I argue that the Anthropocene contains within it a form of Anthropogenesis – a new origin story and ontics for man (...) – that radically rewrites material modes of differentiation and concepts of life, from predominantly biopolitical notions of life toward an understanding of life’s geophysical origination. Here, I use the term Anthropogenesis to suggest that two things explicitly happen in the nomination of the Anthropocene: 1) the production of a mythic Anthropos as geologic world-maker/destroyer of worlds, and 2) a material, evolutionary narrative that re-imagines human origins and endings within a geologic rather than an exclusively biological context. In contrast to the homogeneous geomorphizing of the Anthropocene, I suggest that socializing the strata needs a more nuanced notion of ‘geologic life’ that challenges the construction of the Anthropocene as an undifferentiated social stratification. (shrink)

Assessing psychophysiological responses of emotion regulation is a cost-efficient way to quantify emotion regulation and to complement subjective report that may be biased. Previous studies have revealed inconsistent results complicating a sound interpretation of these findings. In the present study, we summarized the existing literature through a systematic search of articles. Meta-analyses were used to evaluate effect sizes of instructed downregulation strategies on common autonomic (electrodermal, respiratory, cardiovascular, and pupillometric) and electromyographic (corrugator activity, emotion-modulated startle) measures. Moderator analyses were conducted, (...) with moderators including study design, emotion induction, control instruction and trial duration. We identified k = 78 studies each contributing multiple sub-samples and performed 23 meta-analyses for combinations of emotion regulation strategy and psychophysiological measure. Overall, results showed that effects of reappraisal and suppression on autonomic measures were highly inconsistent across studies with rather small mean effect sizes. Electromyography (startle and corrugator activity) showed medium effect sizes that were consistent across studies. Our findings highlight the diversity as well as the low level of standardization and comparability of research in this area. Significant moderation of effects by study design, trial duration, and control condition emphasizes the need for better standardization of methods. In addition, the small mean effect sizes resulting from our analyses on autonomic measures should be interpreted with caution. Findings corroborate the importance of multi-channel approaches. (shrink)

"Make your own Bible. Select and collect all the words and sentences that in all your readings have been to you like the blast of a trumpet." -Ralph Waldo Emerson We have all come across a sentence in a book or a line of poetry that seems to jump off the page as if it has been patiently waiting for you to discover it in this precise instant. At times, the lyrics of a song or words spoken in a play (...) can feel as if God is speaking directly to you, guiding you on your quest for truth and authenticity in this weird and wonderful life. (shrink)

Allyne L. Smith, Jr.; Personhood: Beginnings and Endings, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 6, Issue 1, 1 January 2000, Pa.

Studying national and local contexts is essential for understanding the ending of epidemics and related policy responses. This article examines HIV/AIDS in the 1980s and 1990s and swine flu in 2009-2010 in the UK as comparative “tracer epidemics” to understand the multiplicity of endings from the perspective of the contemporary history of policy. Such endings can include: the political ending, changes in definition away from epidemic, the medical end, different endings for different “risk groups,” local endings, (...) and media endings. This multiplicity of endings throws light on the nature of political and institutional structures and their change over time. (shrink)

_Explores the philosophical, literary, and psychoanalytic significance of film endings._ Editing has been called the language of cinema, and thus a film’s ending can be considered the final punctuation mark of this language, framing everything that came before and offering the key to both our interpretation and our enjoyment of a film. In _Cinematic Cuts_, scholars explore the philosophical, literary, and psychoanalytic significance of film endings, analyzing how film endings engage our fantasies of cheating death, finding true (...) love, or determining the meaning of life. They examine how endings offer various forms of enjoyment for the spectator, from the momentary fulfillment of desire in the happy ending to the pleasurable torment of an indeterminate ending. The contributors also consider how film endings open onto larger questions relating to endings in our time. They suggest how a film ending’s hidden counternarrative can be read as a political act, how our interpretation of a film ending parallels the end of a psychoanalytical session, how film endings reveal our anxieties and fears, and how cinema itself might end with the increasing intervention of digital technologies that reorient the spectator’s sense of temporality and closure. Films by Akira Kurosawa, Lars von Trier, Joon-Hwan Jang, Claire Denis, Christopher Nolan, Jane Campion, John Huston, and Spike Jonze, among others, are discussed. (shrink)

In the relational literature, the subject of termination - the ending of an analysis - has received scant attention, and traditional Freudian or ego-psychological criteria are not always enough to assess the readiness to terminate therapy in the coconstructed, intersubjective analytic relationship. _Good Enough Endings _seeks to remedy this gap, bringing together contributions from contemporary relational thinkers, while at the same time engaging with ideas from other psychoanalytic perspectives. Topics given consideration include: Can there be a relational criteria or (...) paradigm for termination, and what would it include? How do treatment goals of the analyst and/or that of the patient affect the decision to terminate? How do recent developments in attachment theory and research influence the preparation to end analysis? What occurs for the patient after termination, and how do we assess the need for follow-up? Integrating elements of existing psychoanalytic theory with the fruits of the relational turn, _Good Enough Endings _expands and expounds upon the relational considerations in ending analysis, providing a resource for reflection and insight into the final - and perhaps most difficult - aspect of psychoanalytic treatment. (shrink)

This article is a longitudinal analysis of the relation between gendered labour divisions and new data processing technologies at the Dutch Central Bureau of Statistics. Following social-constructivist and evolutionary economic approaches, the authors hold that the relation between technology and work organization is a two-way process. This means that technology does not only affect the relations between men and women at work, but that these relations also influence technological choices. The proportional numbers of men and women on the labour market (...) and changing conceptions of which work is deemed appropriate for women have been important factors in the strongly varying extent to which women participated in office work. They have also been important factors in determining the course of technological development. Shortages of women on the labour market have even determined search heuristics for new technological solutions in specific directions. (shrink)

Pandemic-related restrictions can be especially tragic for people whose lives are ending; it seems that the needs and desires of people who are dying should be given extra consideration. Given an additivist view of well-being, however, the last weeks of a person's life can only matter so much relative to the rest of the life they had. This article reflects on the end of my mother's life during the Covid-19 pandemic in order to make the case that the additive view (...) of well-being is part of a broader trend of dehumanizing emergency ethics. (shrink)

At age twenty-nine, while a graduate student in computer science at the University of Pennsylvania, Mark Albertson was diagnosed with lymphosarcoma. He died four months later, leaving a wife and two young daughters—Robin, three years old, and Kim, three months. Sandra Albertson, a Quaker, writes about their family’s experience with death and renewal.The following is reprinted from Sandra Albertson, Endings and Beginnings : chs. 9, 10.

This work examines the relationship between the endings chosen for musical works based on the biblical story of Jephtah's daughter and broader currents of European thought. Because the biblical story leaves the fate of Jephtah's daughter unclear, commentators have offered two interpretations: Jephtah's daughter is either sacrificed or consecrated to God. The examination of these two interpretations in the various commentaries and artistic works throughout the ages suggest a possible correlation between a given artist's religious affiliation and the type (...) of ending he composed for the story. Although Catholics would appear more likely to choose consecration as promoting the ideal of women's celibacy, no such correlation is seen in practice. Rather, the determining factor in the choice of the musical ending of the story is the dominant artistic convention of the time. This finding is in line with Curt Sachs's cultural theory of a universal pendulum of styles in Western civilization. Thus, the specific choice of the ending of the story of Jephtah's daughter in various artistic media may serve as a paradigm for broader trends of European thought. (shrink)

The end of the world is a seemingly interminable topic; at least, of course, until it happens. Environmental catastrophe and planetary apocalypse are subjects of enduring fascination and, as ethnographic studies show, human cultures have approached them in very different ways. Indeed, in the face of the growing perception of the dire effects of global warming, some of these visions have been given a new lease on life. Information and analyses concerning the human causes and the catastrophic consequences of the (...) planetary crisis have been accumulating at an ever-increasing rate, mobilising popular opinion as well as academic reflection. In this book, philosopher Deborah Danowski and anthropologist Eduardo Viveiros de Castro offer a bold overview and interpretation of these current discourses on the end of the world, reading them as thought experiments on the decline of the West's anthropological adventure; that is, as attempts, though not necessarily intentional ones, at inventing a mythology that is adequate to the present. This work has important implications for the future development of ecological practices and it will appeal to a broad audience interested in contemporary anthropology, philosophy, and environmentalism. (shrink)

Intentions matter. They have some kind of normative impact on our agency. Something goes wrong when an agent intends some end and fails to carry out the means she believes to be necessary for it, and something goes right when, intending the end, she adopts the means she thinks are required. This has even been claimed to be one of the only uncontroversial truths in ethical theory. But not only is there widespread disagreement about why this is so, there is (...) widespread disagreement about in what sense it is so. In this paper I explore an underdeveloped answer to the question of in what sense it is so, and argue that resolving an apparent difficulty with this view leads to an attractive picture about why it is so. (shrink)

"The End of the Search" is the real and uplifting interpretation of The Book of Revelations. A discussion of the last books of the Bible (The Acts of the Apostles, The Letters of Paul, The Rest of the Letters and The Book of Revelations), it leaves the readers with a tremendous sense of hope instead of thoughts of destruction and doom.

The ends of medicine are sometimes construed simply as promotion of health, treatment and prevention of disease, and alleviation of pain. Practitioners might agree that this simple formulation captures much of what medical practice is about. But while the ends of medicine may seem simple or even obvious, the essays in this issue demonstrate the wide variety of philosophical questions and issues associated with the ends of medicine. They raise questions about how to characterize terms like “health” and “disease”; whether (...) medicine’s goals should be extended to include enhancement beyond normal human function; and whether the ends of medicine are binding on those involved in health care outside of professional medicine, such as pharmaceutical companies. They also give philosophical attention to patient experiences, and so raise questions about whether current practices achieve the ends of medicine from the perspective of the patient. Together these essays demonstrate the important role played by a conception of medicine’s ends in a wide variety of issues and problems in the philosophy and ethics of medicine. (shrink)

In a widely noted book, Henry Greely has suggested that “the end of sex” is on the horizon. By this he means that sexual activity for pleasure will be increasingly disconnected from the process by which children are conceived—a result of the growing availability of what he terms Easy PGD. This essay explores the possibility that this sense of an “end” of sex fails to attend adequately to another sense of “end”—namely, the telos that connects human sexual activity to the (...) birth of children. Articulating a Christian understanding of procreation, the essay notes that Easy PGD may invite us to miss the human significance of the connection between the love-giving and life-giving aspects of sexual activity. (shrink)

In The Life of a Style, Jonathan Gilmore claims that such narrative developments inhere in the history of art itself.By exploring such topics as the discovery ...

Background: End-of-life decision-making for terminally ill neonates raises important legal and ethical issues. In Greece, no recent data on nurses’ attitudes and involvement in end-of-life decisions are available. Research question/aim: To investigate neonatal nurses’ attitudes and involvement in end-of-life decisions and the relation to their socio-demographic and work-related background data. Research design: A survey was carried out in 28 neonatal intensive care units between September 2018 and January 2019. A structured questionnaire was distributed by post. Participants and research context: The (...) questionnaire was answered anonymously by 312 nurses (response rate, 71.1%) and returned to the investigators. Ethical considerations: The study was approved by the Bioethics and Research Committee of Aretaieio Hospital in accordance with the Helsinki Declaration. Findings: Nurses more often reported involvement in various end-of-life decisions, such as continuation of treatment without adding further therapeutic interventions for terminally ill neonates, while less reported were mechanical ventilation withdrawal and drug administration to end life. Nurses with a high attitude score, reflecting a more quality-of-life approach, were more likely to be involved in setting limits to intensive care. α low score was consistent with life preservation. Nurses’ religiousness ( p = 0.097), parenthood ( p = 0.093), involvement in daily practice ( p = 0.03), and position on the existing legal framework ( p < 0.002) influenced their attitude score. Discussion: The likelihood of nurses to support interventions in neonates with poor prognosis in neonatal intensive care units was related to their attitudes. After adjusting for potential confounders, the most important predictors for nurses’ attitudes were parenthood, involvement in daily practice, and position supporting current legislation reform. Conclusion: Variability in involvement in end-of-life decisions among nurses exists on a national level. (shrink)

End of Days (translated from the recently published Hebrew book, Atchalta) is both a meditation on Jewish morality in the age of Israeli Jewish power, and a cri du coeur by an Orthodox Israeli Jew, a former combat officer in the IDF, for Israelis to look into the Jewish religious ethical tradition for an alternative to the secular and religious Zionism that sanctifies power, statehood, and sovereignty. Appealing to a wealth of Jewish sources from the Bible to the present, including (...) medieval Jewish ethical literature, rabbinic sources, Jewish law, and contemporary Israeli thought, the book presents an argument against the Israeli's occupation of the Palestinian people and the suppression of their rights from the perspective of a modern Israeli religious Jew. (shrink)