Many believe that the ethical problems of donation after cardiocirculatory death (DCD) have been "worked out" and that it is unclear why DCD should be resisted. In this paper we will argue that DCD donors may not yet be dead, and therefore that organ donation during DCD may violate the dead donor rule. We first present a description of the process of DCD and the standard ethical rationale for the practice. We then present our concerns with DCD, including the following: (...) irreversibility of absent circulation has not occurred and the many attempts to claim it has have all failed; conflicts of interest at all steps in the DCD process, including the decision to withdraw life support before DCD, are simply unavoidable; potentially harmful premortem interventions to preserve organ utility are not justifiable, even with the help of the principle of double effect; claims that DCD conforms with the intent of the law and current accepted medical standards are misleading and inaccurate; and consensus statements by respected medical groups do not change these arguments due to their low quality including being plagued by conflict of interest. Moreover, some arguments in favor of DCD, while likely true, are "straw-man arguments," such as the great benefit of organ donation. The truth is that honesty and trustworthiness require that we face these problems instead of avoiding them. We believe that DCD is not ethically allowable because it abandons the dead donor rule, has unavoidable conflicts of interests, and implements premortem interventions which can hasten death. These important points have not been, but need to be fully disclosed to the public and incorporated into fully informed consent. These are tall orders, and require open public debate. Until this debate occurs, we call for a moratorium on the practice of DCD. (shrink)

Neither Johnston's nor Wright's account of response-dependence offers a complete picture of response-dependence, as they do not apply to all concepts that are intrinsically related to our mental responses. In order to (begin to) remedy this situation, a new conception of response-dependence is introduced that I call "acceptance-dependence". This account applies to concepts such as goal, constitutional, and money, the first two of which have mistakenly been taken to be response-dependent in another sense. Whereas on Johnston's and Wright's accounts response-dependent (...) concepts depend on counterfactual responses of individuals, acceptance-dependent concepts depend on the actual responses of groups of people. This implies that concepts of the latter kind are less objective than concepts of the former kind. (shrink)

The American Journal of Bioethics, Volume 12, Issue 7, Page 1-2, July 2012.

This study clearly reveals that the benefits ascribed to strategic planning typically are achieved through a variety of means. A formal process that seeks to plan in a comprehensive, linear fashion is likely to be too complicated, politically divisive, expensive and inflexible, and to ignore how decisions are made in a complex, highly decentralised university. While many approaches to planning are used, universities must ensure they provide periodically opportunities for university staff—freed from daily responsibilities—to consider strategic concerns. Accurate and relevant (...) information must be available to all who make and carry out decisions. Planning should be viewed as a learning process rather than a document producing exercise. Extensive communication among university staff and faculty is needed to ensure informed debate and substantial acceptance of decisions—otherwise they are unlikely to be implemented. Perhaps most important is not the process employed but the decision-maker's breadth of perspective and sophistication. No process will overcome lack of competent leadership. The importance of daily decision-making in various councils and committees on issues such as cost containment and budgetary priorities is underestimated in the literature on planning.Critics have doubted whether universities' structures and processes permit them, or their leaders have the resolve, to confront the emerging issues. However, in many respects, the universities' decentralised, multiple decision-making practices may suit them well. They face the same challenging societal changes as other sectors of society. Their staff include some of the most capable individuals in the United States, and in the past they have been highly adaptable during periods of profound social change.Universities do not appear to be less aware of the need to adapt, nor more constrained in adapting to new conditions, than other sectors of society. In fact, university research and scholarship will be highly important in pointing the way for the whole of society to meet this era's challenges. If pessimistic predictions about current trends turn out to be accurate, universities no doubt will adapt at least as well as other kinds of institutions. The travails of business in this environment are daily news! There will be occasional casualties among the universities, as frequently occurs during major social transitions, but institutions that have grown in importance for over 1,000 years, will doubtless emerge from this period perhaps somewhat changed but still performing their historic social functions. (shrink)

The ethics of managing obstetric patients in medical disasters poses ethical challenges that are unique in comparison to other disaster patients, because the medical needs of two patients—the pregnant patient and the fetal patient—must be considered. We provide an ethical framework for doing so. We base the framework on the justice-based prevention of exploitation of populations of patients, both obstetric and non-obstetric, in medical disasters. We use the concept of exploitation to identify a spectrum from ethically acceptable, to ethically challenging, (...) to ethically unacceptable, management of obstetric patients in medical disasters. We also address the ethics of the care of obstetric and neonatal patients when the resources of a hospital are completely overwhelmed in a large-scale medical disaster. (shrink)

Secular change in sex ratios is examined in relation to experience in the family. Two theoretical perspectives are outlined: Guttentag and Secord’s (1983) adaptation of social exchange theory, and sexual selection theory. Because of large-scale change in number of births and typical age differentials between men and women at marriage, low sex ratios at couple formation ages existed in the U.S. between 1965 and the early 1980s. The currently high sex ratios, however, will persist until the end of the century. (...) High sex ratios appear to be associated with lower divorce rates, male commitment to careers that promise economic rewards, male willingness to engage in child care, higher fertility, and higher rates of sexual violence. Sexual selection theory calls attention to intrasexual competition in the numerically larger sex. (shrink)

A modest solution to the problem(s) of rule-following is defended against Kripkensteinian scepticism about meaning. Even though parts of it generalise to other concepts, the theory as a whole applies to response-dependent concepts only. It is argued that the finiteness problem is not nearly as pressing for such concepts as it may be for some other kinds of concepts. Furthermore, the modest theory uses a notion of justification as sensitivity to countervailing conditions in order to solve the justification problem. Finally, (...) in order to solve the normativity problem, it relies on substantial specifications of normal conditions such as those that have been proposed by Crispin Wright and Mark Johnston, rather than on Philip Pettit's functionalist specification. This theory is modest in that it does not meet the demands of Kripke's sceptic in full. Arguments are provided as to why this is not needed. (shrink)

Frank A. Lewis presents a close study of book Zeta of Aristotle's Metaphysics, one of his most dense and controversial texts, commonly understood to contain his deepest thoughts on the definition of substance and related metaphysical issues. Lewis argues that Aristotle returns to the causal view of primary substance from his Posterior Analytics.

Research to improve the health of pregnant and fetal patients presents ethical challenges to clinical investigators, institutional review boards, funding agencies, and data safety and monitoring boards. The Common Rule sets out requirements that such research must satisfy but no ethical framework to guide their application. We provide such an ethical framework, based on the ethical concept of the fetus as a patient. We offer criteria for innovation and for Phase I and II and then for Phase III clinical trials (...) to improve the health of pregnant patients and of fetal patients and also criteria to responsibly manage the transition from investigation to clinical practice. Basing ethical criteria for research involving pregnant women on the ethical concept of the fetus as a patient insulates the proposed ethical framework and therefore research on pregnant women from the divisive and politicized concepts and discourses of personhood, fetal rights, and unborn child. (shrink)

In this paper, we study the lattice of r.e. subspaces of a recursively presented vector space V ∞ with regard to the various complexity-theoretic speed-up properties such as speedable, effectively speedable, levelable, and effectively levelable introduced by Blum and Marques. In particular, we study the interplay between an r.e. basis A for a subspace V of V ∞ and V with regard to these properties. We show for example that if A or V is speedable , then V is levelable (...) . We also show that if A is an r.e. subset of a recursive basis for V ∞ , then A is levelable iff V is speedable while it is not the case that A is levelable iff V is speedable. We also provide several contrasts between the lattice of r.e. subspaces and the lattice of r.e. sets with respect to these speed-up properties. For example, every maximal set is levelable but we show that there exist supermaximal spaces which are nonspeedable in all possible r.e. degrees as well as supermaximal spaces which are levelable in all r.e. degrees which contain levelable sets. (shrink)

Despite its prominence in the abortion debate and in public policy, the discourse of 'unborn patient' has not been subjected to critical scrutiny. We provide a critical analysis in three steps. First, we distinguish between the descriptive and normative meanings of 'unborn child.' There is a long history of the descriptive use of 'unborn child.' Second, we argue that the concept of an unborn child has normative content but that this content does not do the work that opponents of abortion (...) want it to do, namely, to establish the independent moral status of fetuses and their rights, the right to life in particular. Third, we argue that the normative content of 'unborn child' should be dependent moral status, not independent moral status. We conclude that the ethical concept of the fetus as a patient should replace the discourse of “unborn child” when that phrase is used normatively. (shrink)

The topic of homonymy, especially the variety of homonymy that has gone under the title, “focal meaning,” is of fundamental importance to large portions of Aristotle’s work-not to mention its central place in the ongoing controversies between Aristotle and Plato. It is quite astonishing, therefore, that the topic should have gone so long without a book-length treatment. And it is all the more gratifying that the new book on homonymy by Christopher Shields should be so comprehensive, and of such uniformly (...) high quality.’ Everyone who cares about Aristotle will be in his debt. Shields’s book falls into two parts. In the first, he is concerned to lay out the basic structure of Aristotle’s views about homonymy; in the second part, we are led through the various applications of the idea, to the analysis of friendship, for example, the homonymy of the body, the account of goodness and, not least, the homonymy of being. Shields’s book brings out well how the topic of homonymy weaves in and out of the fabric of Aristotle’s thinking in a variety of areas. I will resist the temptation to follow Shields through these various subject-matters, and instead take up essentially two topics. First, (I), the basic outline of Aristotle’s notion of homonymy, more or less independently of its different applications (here, I follow Shields’s example in the first half of his book). Thereafter, I discuss a single application: the homonymy of being (this is the subject of Shields’s last and longest chapter). Here, I will be interested (II) in how homonymy relates to the theory of the categories; and (III) in the application of homonymy to the analysis of substance in the Metaphysics. (shrink)

Physicians may justifiably limit patients' refusals of medical interventions when the refusal is based on a negative right to noninterference coupled with a request for an unreasonable alternative.

The American Journal of Bioethics, Volume 11, Issue 12, Page 59-61, December 2011.

Programmed cell death (PCD) is a process aimed at the removal of redundant, misplaced, or damaged cells and it is essential to the development and maintenance of multicellular organisms. In contrast to the relatively well‐described cell death pathway in animals, often referred to as apoptosis, mechanisms and regulation of plant PCD are still ill‐defined. Several morphological and biochemical similarities between apoptosis and plant PCD have been described, including DNA laddering, caspase‐like proteolytic activity, and cytochrome c release from mitochondria. Reactive oxygen (...) species (ROS) have emerged as important signals in the activation of plant PCD. In addition, several plant hormones may exert their respective effects on plant PCD through the regulation of ROS accumulation. The possible plant PCD regulators discussed in this review are integrated in a model that combines plant‐specific regulators with mechanisms functionally conserved between animals and plants. BioEssays 25:47–57, 2003. © 2002 Wiley Periodicals, Inc. (shrink)

ABSTARCT When people go shopping, they enter a building. But the shop cannot be identified with the building, because it would remain the same shop if it moved to another building or if it became an e-store. Daniel Korman [2019] uses these two observations to argue that establishments are immaterial objects. However, all that follows is that establishments are not buildings. I argue that establishments are organisations or corporate agents that are constituted by people. This entails that they are material (...) objects. Korman’s observations can be accommodated in terms of the further observation that corporate agents can but need not own or rent buildings. (shrink)

This book takes up the central themes of Aristotle's metaphysical theory and the various transformations they undergo prior to their full expression in the Metaphysics. Aristotle's metaphysics is bedevilled by classic puzzles involving such notions as form, predication, universal, and substance, which result from his attempt to adapt the various requirements on primary substance developed in his earlier works so that they fit the very different metaphysical picture in his later work. Professor Lewis argues that Aristotle is himself aware of (...) most if not all of these difficulties and in the Metaphysics works hard to ensure the coherence of his theory. He presents Aristotle's views as a formal theory complete with axioms, definitions, and theorems. (shrink)

**** Reprint of the Indiana U. Press edition of 1966--which is cited in BCL3. Annotation copyright by Book News, Inc., Portland, OR.