Assent to medical research or treatment may be an intuitively attractive way to address the area between incapacity and capacity that might otherwise be subject to a best interests assessment. Assent has become a widely disseminated concept in law, research, and clinical ethics, but little conceptual work on assent has so far occurred. An exploration of use of assent in treatment and research in children and people with dementia suggests that at least five claims are made on behalf of assent. (...) Since at least some of these may lead to tensions with others, assent requires firmer conceptual underpinning. Whether assent remains primarily a local approach to research in children in the United States, where it appears to fit with legal background conditions, or develops its promise to overturn the dominant, binary, approach to (in)capacity will depend on the strength of future philosophical work to improve the theoretical foundations to assent. (shrink)

The experience of being famous was investigated through interviews with 15 well-known American celebrities. The interviews detail the existential parameters of being famous in contemporary culture. Research participants were celebrities in various societal categories: government, law, business, publishing, sports, music, film, television news and entertainment. Phenomenological analysis was used to examine textural and structural relationship-to-world themes of fame and celebrity. The study found that in relation to self, being famous leads to loss of privacy, entitization, demanding expectations, gratification of ego (...) needs, and symbolic immortality. In relation to other, or world, being famous leads to wealth, access, temptations, and concerns about family impact. Areas of psychological concern for celebrity mental health include character-splitting, mistrust, isolation, and an unwillingness to give up fame. Being-in-the-world of celebrity is a process involving four temporal phases: love/hate, addiction, acceptance, and adaptation. Findings are presented in the form of a Composite Textural Description and two Individual Structural Descriptions. (shrink)

Abstract‘Dogwhistles’ and microtargeted political advertisements are objects of widespread moral and political concern. With a few notable exceptions in the case of dogwhistles (and none in the case of microtargeting) moral criticism of these speech act types generally focuses on problematiccontent—that a dogwhistle is, for instance, racist, or a microtargeted advertisement misleading. I argue that these practices areadditionallymorally wrongful on content-neutral grounds—regardless of their content. My argument proceeds from a deliberative conception of democracy according to which only a vote which (...) follows from anadequate deliberative processconfers democratic legitimacy on its results. I claim that both dogwhistles and microtargeting threaten to prevent adequate democratic deliberation from taking place, and therefore that these practices are anti-democratic and, additionally, morally impermissible. I then discuss potential objections and how my argument relates to existing work. (shrink)

_Beyond Solidarity_ is an impassioned argument for a sharable morality in a world increasingly fractured along lines of difference. Giles Gunn asks how human solidarity can be reconceived when its expressions have become increasingly exceptionalist and outmoded, and when the pressures of globalization divide as much as they unify. He finds the terms for answering these questions in a more inclusive, cosmopolitan pragmatism—one willing to explore fundamental values without recourse to absolutist arguments. Drawing on the work of William and (...) Henry James, John Dewey, Primo Levi, Richard Rorty, and many others, as well as postcolonial writing, Jewish literature of the Holocaust, and the cultural and religious experience of African Americans in slavery, Gunn points pragmatism in a transnational direction and shows how it can better account for the consequences of diversity. _Beyond Solidarity_, then, is a study of the difference that difference makes in a globalized world. (shrink)

Background Best interests is a ubiquitous principle in medical policy and practice, informing the treatment of both children and adults. Yet theory underlying the concept of best interests is unclear and rarely articulated. This paper examines bioethical literature for theoretical accounts of best interests to gain a better sense of the meanings and underlying philosophy that structure understandings. Methods A scoping review of was undertaken. Following a literature search, 57 sources were selected and analysed using the thematic method. Results Three (...) themes emerged. The first placed best interests within the structure of wider theory, noting relationships with consequentialism, deontology, prudential value theory, rights and political philosophy. The second mapped a typology of processes of decision-making, among which best interests was ambiguously positioned. It further indicated factors that informed best interests decision-making, primarily preferences, dignity and quality of life. The final theme considered best interests from a relational perspective. Conclusions Characterisation of best interests as strictly paternalist and consequentialist is questionable: while accounts often suggested a consequentialist basis for best interests, arguments appeared philosophically weak. Deontological accounts, found in law and Kantianism, and theories of political liberalism influenced accounts of best interests, with accounts often associating best interests with negative patient preferences (i.e. individual refusals). There was much more emphasis on negative interests than positive interests. Besides preference, factors like dignity and quality of life were held to inform best interests decisions, but generally were weakly defined. To the extent that preferences were unable to inform decision making, decisions were either made by proxy authority or by an intersubjective process of diffuse authority. Differing approaches reflect bifurcations in liberal philosophy between new liberalism and neo-liberalism. Although neither account of authority appears dominant, bias to negative interests suggests that bioethical debate tends to reflect the widespread ascendancy of neo-liberalism. This attitude was underscored by the way relational accounts converged on private familial authority. The visible connections to theory suggest that best interests is underpinned by socio-political trends that may set up frictions with practice. How practice negotiates these frictions remains a key question. (shrink)

The ideas of mindfulness and no-self are intimately connected in Buddhist philosophy. This is because, in Buddhist Philosophy, the practice of mindfulness leads to the realization that there is no self. In contemporary mindfulness in psychology, the no-self theory has not played such a basic role. An outline of Buddhist philosophy is given showing how the ‘root delusion’ of having a self lies at the base of human suffering and how mindfulness, when appropriately deployed, enables one to free oneself from (...) this delusion and thus achieve psychological well-being. This is not to say that mindfulness based interventions do not help to alleviate suffering. Nor is it to say that people working in these areas should not use mindfulness in their own way. It is only to say that by ignoring the no-self experience, teachers and practioners are falling short of achieving what mindfulness was originally employed to achieve. (shrink)

A growing number of bioethics papers endorse the harm threshold when judging whether to override parental decisions. Among other claims, these papers argue that the harm threshold is easily understood by lay and professional audiences and correctly conforms to societal expectations of parents in regard to their children. English law contains a harm threshold which mediates the use of the best interests test in cases where a child may be removed from her parents. Using Diekema9s seminal paper as an example, (...) this paper explores the proposed workings of the harm threshold. I use examples from the practical use of the harm threshold in English law to argue that the harm threshold is an inadequate answer to the indeterminacy of the best interests test. I detail two criticisms: First, the harm standard has evaluative overtones and judges are loath to employ it where parental behaviour is misguided but they wish to treat parents sympathetically. Thus, by focusing only on ‘substandard’ parenting, harm is problematic where the parental attempts to benefit their child are misguided or wrong, such as in disputes about withdrawal of medical treatment. Second, when harm is used in genuine dilemmas, court judgments offer different answers to similar cases. This level of indeterminacy suggests that, in practice, the operation of the harm threshold would be indistinguishable from best interests. Since indeterminacy appears to be the greatest problem in elucidating what is best, bioethicists should concentrate on discovering the values that inform best interests. (shrink)

Attempts to conduct systematic reviews of ethical arguments in bioethics are fundamentally misguided. All areas of enquiry need thorough and informative literature reviews, and efforts to bring transparency and systematic methods to bioethics are to be welcomed. Nevertheless, the raw materials of bioethical articles are not suited to methods of systematic review. The eclecticism of philosophy may lead to suspicion of philosophical methods in bioethics. Because bioethics aims to influence medical and scientific practice it is tempting to adopt scientific language (...) and methods. One manifestation is the increasing innovation in, and use of, systematic reviews of ethical arguments in bioethics. Yet bioethics, as a broadly philosophical area of enquiry, is unsuited to systematic review. Bioethical arguments are evaluative, so notions of quality and bias are inapplicable. Bioethical argument is conceptual rather than numerical, and the classification of concepts is itself a process of argument that cannot aspire to neutrality. Any ‘systematic review’ of ethical arguments in bioethics thus falls short of that name. Furthermore, labels matter. Although the bioethics research community may find that adopting the language and the outward methods of clinical science offers apparent prospects of credibility, policy influence and funding, we argue that such misdirection carries risks and is unlikely to pay dividends in the long term. Bioethical sources are amenable to the review methods of the social sciences, and it is on these methods that specific methods of bioethics literature review should be built. (shrink)

As everybody knows, advances in medicine and medical technology have brought enormous benefits to, and created vexing choices for, us all – choices that can, and occasionally do, test the very limits of thinking itself. As everyone also knows, we live in the age of consultants, i.e., of professional experts who are ready, willing, and able to give us advice on any and every conceivable question. One such consultant is the medical ethics consultant, or the medical ethicist who consults.Medical ethics (...) consultants involve themselves in just about every aspect of health care decision making. They help legislators and judges determine law, hospitals formulate policies, medical schools develop curricula, etc. In addition to educating physicians, nurses, and lawyers, amongst others, including medical, nursing, and law students, they participate in clinical decision making at the bedside. (shrink)

Given how long bioethics has been around, how long bioethicists have devoted themselves to tackling ethical issues, how much work has gone into professionalizing the practice of clinical ethics consultation, how often bioethicists have either testified as experts in court proceedings or attached their names to amicus curiae briefs, and how ubiquitously they are present throughout the clinical, research, administrative, and other dimensions of health care, one would have thought that a convergence of opinion would exist on what it is (...) that the clinical ethics consultant's expertise consists of—if only for reasons of professional solidarity and reputation management. And yet, as a recent series of articles written by... (shrink)

v. 1. Kierkegaard. Nietzsche. Husserl. Heidegger.--v. 2. Scheler. Buber. Jaspers. Sartre.

Volume 20, Issue 3, March 2020, Page 29-31.

The value of conscience in healthcare ethics is widely debated. While some sources present it as an unquestionably positive attribute, others question both the veracity of its decisions and the effect of conscientious objection on patient access to health care. This paper argues that the right to object conscientiously should be broadened, subject to certain previsos, as there are many benefits to healthcare practice in the development of the consciences of practitioners. While effects such as the preservation of moral integrity (...) are widely considered to benefit practitioners, this paper draws on the work of Hannah Arendt to offer several original arguments in defence of conscience that may more directly benefit patients, namely that a pang of conscience may be useful in rapidly unfolding situations in which there is no time to reflect satisfactorily upon activities and that, given the hierarchical nature of healthcare institutions, a right to defy authority on the basis of conscience may benefit junior staff who lack the institutional power to challenge the orders of superiors. (shrink)

1. Prolegomena -- 2. [Without special title] -- 3. Opera theologica.

The use of lay members on research ethics committees has for some time been felt to be an example of good practice in ethical review processes. In this paper, written by a lay member, the author considers what the recruitment process for lay members might be and argues how this process should largely be shaped by what role the lay member is recruited to undertake. In considering the advantages and disadvantages of lay members, the author shows that defining the role (...) of a lay member is not straightforward but is necessary to the good working of a research ethics committee. (shrink)

In Canada, as in many other countries, there exists an organ procurement/donation crisis. This paper reviews some of the most common kidney procurement and allocation programmes, analyses them in terms of public and private administration, and argues that privately administered living donor models are an inequitable stopgap measure, the good intentions of which are misplaced and opportunistic. Focusing on how to improve the publicly administered equitable cadaveric donation programme, and at the same time offering one possible explanation for its current (...) failure, it is suggested that the simple moral principle of “give and you shall receive”, already considered by some, be extended further. This would allow for those who are willing to sign up to be a public cadaveric donor be given a priority for receiving an organ donation should they ever require it. It is argued that this priority may provide the motivation to give that is so far lacking in Canada. This model is called the Public Cadaveric Organ Donation Program. (shrink)

In a recent article, Steinkamp, Gordijn, and ten Have discussed a new way of thinking about the ethics consultant's ethical expertise. After critiquing their model of ethical expertise, along with the notion that discourse can and will enable ethicists to consult without over-reaching, this essay suggests that the debate about ethical expertise is intractable because it constitutes a 'tragic choice'.

First published in 1889. This re-issues the second, revised edition of 1926. Chuang Tzu was to Lao Tzu, the author of Tao Tê Ching, as Hui-neng, the sixth Patriarch of Zen Buddhism, was to Bodhidharma, and in some respects St.Paul to Jesus; he expanded the original teaching into a system and was thus the founder of Tao-ism. Whereas Lao Tzu was a contemporary of Confucius in the sixth century B.C, Chuang Tzu lived over two hundred years later. He was one (...) of the greatest minds produced by China; philosopher, metaphysician, moralist and poet. It is impossible to understand the spiritual depth of the Tao Tê Ching without the aid of Chuang Tzu. (shrink)

New methods to analyse social media data provide a powerful way to know publics and capture what they say and do. At the same time, access to these methods is uneven, with corporations and governments tending to have best access to relevant data and analytics tools. Critics raise a number of concerns about the implications dominant uses of data mining and analytics may have for the public: they result in less privacy, more surveillance and social discrimination, and they provide new (...) ways of controlling how publics come to be represented and so understood. In this paper, we consider if a different relationship between the public and data mining might be established, one in which publics might be said to have greater agency and reflexivity vis-à-vis data power. Drawing on growing calls for alternative data regimes and practices, we argue that to enable this different relationship, data mining and analytics need to be democratised in three ways: they should be subject to greater public supervision and regulation, available and accessible to all, and used to create not simply known but reflexive, active and knowing publics. We therefore imagine conditions in which data mining is not just used as a way to know publics, but can become a means for publics to know themselves. (shrink)

In the western healthcare, shared decision making has become the orthodox approach to making healthcare choices as a way of promoting patient autonomy. Despite the fact that the autonomy paradigm is poorly suited to paediatric decision making, such an approach is enshrined in English common law. When reaching moral decisions, for instance when it is unclear whether treatment or non-treatment will serve a child’s best interests, shared decision making is particularly questionable because agreement does not ensure moral validity. With reference (...) to current common law and focusing on intensive care practice, this paper investigates what claims shared decision making may have to legitimacy in a paediatric intensive care setting. Drawing on key texts, I suggest these identify advantages to parents and clinicians but not to the child who is the subject of the decision. Without evidence that shared decision making increases the quality of the decision that is being made, it appears that a focus on the shared nature of a decision does not cohere with the principle that the best interests of the child should remain paramount. In the face of significant pressures toward the displacement of the child’s interests in a shared decision, advantages of a shared decision to decisional quality require elucidation. Although a number of arguments of this nature may have potential, should no such advantages be demonstrable we have cause to revise our commitment to either shared decision making or the paramountcy of the child in these circumstances. (shrink)

From the days of discovery, when America was for Europeans more dream than reality, to our own days of disillusionment and faltering hope, poets, philosophers, historians, novelists, and theologians have drawn on religious themes and images to express the meaning of their encounter with America. Here, in more than one hundred selections, is the record of their quest for a New World metaphysics -- a spiritual vision or ultimate idea of order expressive of the American experience.

In lieu of an abstract, here is a brief excerpt of the content:The Journal of Aesthetic Education 38.2 (2004) 116-120 [Access article in PDF] Art History in the Age of Bellori: Scholarship and Cultural Politics in Seventeenth-Century Rome, edited by Janis Bell and Thomas Willette. Cambridge: Cambridge Universtiy Press, 2002, 396 pp. Giovan Pietro Bellori is a name familiar to all who have studied seventeenth-century Italian art. His magisterial book, The Lives of the Modern Painters, Sculptors, and Architects (Le vite (...) de' pittori, scultori, ed architetti moderni), published in Rome in 1672, continued in the grand tradition of artists' biographies established by Giorgio Vasari in the sixteenth century, while at the same time espousing a classical theory of artistic creation that has often been seen as the foundation of academic classicism, popular well into the nineteenth century. He is, in other words, an immensely significant figure, as a source of information on artists' lives, and, more importantly, as a cogent, early spokesperson for one of the dominant aesthetic modes of Western European culture.Given this importance, the relative dearth of publications dedicated toBellori, especially in the Anglo-American world, is surprising. PerhapsBellori's famously negative assessment of Caravaggio, or his complete avoidance of two of the most successful Italian artists of the seventeenth century, Pietro da Cortona and Gian Lorenzo Bernini, account for the scarcity ofscholarly treatments, or maybe his supposed insistence that all great art should be grounded in rules is to blame. The reasons are hard to pin down, but the volume of essays under consideration here goes some significant way towards rectifying the situation. Stemming from a 1996 conference organized by the Association for Textual Scholarship in Art History and held at the American Academy in Rome, the volume is divided into two roughly equal sections, one on "Bellori and the Republic of Letters in Seventeenth-Century Rome," and the other on "Bellori's Lives: History, Criticism, Theory." It comprises twelve essays, including a long and very useful introduction by Janis Bell, one of the editors of the book. The overall goal of the collection is to treat Bellori's activity as a whole, rather than focus single-mindedly on the Lives. After all, as Bell points out, the preponderance of Bellori's publishing was not dedicated to aesthetic theory, or even artists' biographies, but to antiquarian studies. In this, the present volume is very different from the other major new work on Bellori, a two-volume cataloguepublished in 2000 to accompany anexhibition held at the Palazzo delle Esposizioni in Rome, L'idea del Bello: viaggio per Roma nel Seicento con Giovan Pietro Bellori. The exhibition did acknowledge Bellori's antiquarian interests, but was aimed principally at something else: making visible his aesthetic theory. Unfortunately, the authors of Art History in the Age of Belloriwere not able to take into account fully [End Page 116] the conclusions of this important study,although it should be noted that several authors are represented in both publications.The first group of essays in the book, six in number, treats a wide range of themes, with the intention of crafting a context, both literary and political, for understanding Bellori's achievement. Giovanna Perini's essay, the first of section one, describes Bellori's career trajectory, and, more significantly, how this path had an impact on his life as a scholar. Bellori did not come from the wealthiest stratum of society. On the contrary, he was of relatively modest means, which meant that he had to rely on employment income. One implication of being economically beholden to his employers was that his writing had to conform to their political agendas. The Vite, for instance, are famous for lionizing the French artist Nicolas Poussin, of obvious appeal to his Francophile patrons. Diego Velázquez, however, was not included in the Vite, perhaps because he was Spanish and would thus have appealed to the opposing political faction in Rome at the time, which was linked to Spain. At the same time, Perini convincingly argues that Bellori's own voice was not drowned out in the process... (shrink)

Desire is a central concept in Aristotle's ethical and psychological works, but he does not provide us with a systematic treatment of the notion itself. This book reconstructs the account of desire latent in his various scattered remarks on the subject and analyses its role in his moral psychology. Topics include: the range of states that Aristotle counts as desires ; objects of desire and the relation between desires and envisaging prospects; desire and the good; Aristotle's three species of desire: (...) epithumia, thumos and boulêsis ; Aristotle's division of desires into rational and non-rational; Aristotle and some current views on desire; and the role of desire in Aristotle's moral psychology. The book will be of relevance to anyone interested in Aristotle's ethics or psychology. (shrink)

This commentary asks whether ongoing efforts to accredit, certify, and credential hospital ethics consultants are nothing other than an illegal restraint on trade masquerading as an effort to protect the public from harm.

What is it about having a body that might dispose us to think it a plausible candidate for the basis of personal identity? The answer seems plain: the body is a physical object which, as long as it exists, is spatio-temporally continuous throughout the different moments of its existence. In consequence, myself of today can be said to be the same person as myself of twelve years ago so far as my body of today is spatio-temporally continuous with my body (...) of twelve years ago. Exponents of this view are not, of course, denying that over time a person's body will or may undergo various changes; rather they are claiming that so long as these changes occur within a body which maintains a spatio-temporal continuity, then the identity of the person whose body it is will be ensured. (shrink)

We develop and test a trickle-down model of how authentic leadership at the department level flows down the organizational hierarchy to encourage team leader authentic leadership and consequently, promotes team and individual-level supervisor-directed helping behavior. Analyses of multi-level and multi-source data collected from a total of 487 employees comprising 122 teams, 47 departments, and 4 different working areas of a major public sector organization in Taiwan show that team leaders’ authentic leadership mediates the relationship between departmental authentic leadership and individual-level (...) leader–member exchange. We also found that intra-team trust completely mediates the influence of team authentic leadership on both team helping behavior and individual-level supervisor-directed helping behavior. Finally, the results reveal that self-concordance mediates the influence of team authentic leadership on individual-level supervisor helping behavior as well as the influence of individual-level LMX on individual-level supervisor-directed helping behavior. Theoretical and practical implications of these findings are discussed. (shrink)