In a large proportion of health care research based on the retrospective review of records, minimal breach of patient confidentiality appears to be inevitable. This occurs at initial identification of and access to the chart, selected on the basis of the condition under investigation, and while individual identifiability can be blocked at subsequent stages, at this point it does occur. Prospective individual consent is impractical because often neither the desirability nor the specific subject of the research is known at the (...) time of making the record, and retrospective patient tracing to obtain it is often impossible. I argue that the benefit of the research outweighs the minimal breach of confidentiality, and that in my own jurisdiction, this appears to be envisaged and accepted in Canadian law. (shrink)

The rights of the various individuals involved in decision-making in cadaver organ donation are considered, and there is discussion of the relation of human cadavers to the planetary biomass. I conclude that the rights of the potential recipient should outweigh those of the other parties concerned and that education and legislation should recognise and promote this.

The ethical issues around decision making on behalf of infants have been illuminated by two empirical research studies carried out in Scotland. In-depth interviews with 176 medical and nursing staff and with 108 parents of babies for whom there was discussion of treatment withholding/withdrawal, generated a wealth of data on both the decision making process and the management of cases. Both staff and parents believe that parents should be involved in treatment limitation decisions on behalf of their babies. However, whilst (...) many doctors and nurses consider the ultimate responsibility too great for families to carry, the majority of parents wish to be the final arbiters. We offer explanations for the differences in perception found in the two groups. The results of these empirical studies provide both aids to ethical reflection and guidance for clinicians dealing with these vulnerable families. They demonstrate the value of empirical data in the philosophical debate. (shrink)

Kant's philosophy of arithmetic / by Charles Parsons -- Visual geometry / by James Hopkins -- The proof-structure of Kant's transcendental deduction / by Dieter Henrich -- Imagination and perception / by P.F. Strawson -- Kant's categories and their schematism / by Lauchlan Chipman -- Transcendental arguments / by Barry Stroud -- Strawson on transcendental idealism / by H.E. Matthews -- Self-knowledge / by W.H. Walsh -- The age and size of the world / by Jonathan Bennett.

In the language of secular bioethics, autonomy is always accorded first place in the hierarchy of values that has come to be referred to as the “Georgetown mantra” A dictionary definition of mantra is “a verbal spell, ritualistic incantation, or mystic formula used devotionally,” and the value placed upon autonomy is largely of this nature: uncritical and uncriticised. That there should be and are limits to autonomy is obvious, but these boundaries are undefined, little discussed, and mostly unexplored. To use (...) another metaphor, our emphasis on autonomy is an index of how far the pendulum has swung in an understandable and partly justifiable reaction from, earlier paternalism; has this swing approached its proper limit, and should we be seeking a less extreme and more balanced assessment of autonomy as a bioethical value? (shrink)

It is difficult to reconcile claims about the Father's role as the progenitor of Trinitarian Persons with commitment to the equality of the persons, a problem that is especially acute for Social Trinitarians. I propose a metatheological account of the doctrine of the Trinity that facilitates the reconciliation of these two claims. On the proposed account, ‘Father’ is systematically ambiguous. Within economic contexts, those which characterize God's relation to the world, ‘Father’ refers to the First Person of the Trinity; within (...) theological contexts, which purport to describe intra-Trinitarian relations, it refers to the Trinity in toto-thus in holding that the Son and Holy Spirit proceed from the Father we affirm that the Trinity is the source and unifying principle of Trinitarian Persons. While this account is solves a nagging problem for Social Trinitarians it is theologically minimalist to the extent that it is compatible with both Social Trinitarianism and Latin Trinitarianism, and with heterodox Modalist and Tri-theist doctrines as well. Its only theological cost is incompatibility with the Filioque Clause, the doctrine that the Holy Spirit proceeds from both the Father and the Son—and arguably that may be a benefit. (shrink)

Prima facie, relative identity looks like a perfect fit for the doctrine of the Trinity since it allows us to say that the Father, Son and Holy Spirit, each of which is a Trinitarian Person, are the same God but not the same Person. Nevertheless, relative identity solutions to logic puzzles concerning the doctrine of the Trinity have not, in recent years, been much pursued. Critics worry that relative identity accounts are unintuitive, uninformative or unintelligible. I suggest that the relative (...) identity account is worth a second look and argue that it provides a coherent account of the doctrine of the Trinity. (shrink)

In its original expression as a medical value confidentiality may have been absolute; this concept has become eroded by patient consent, legal actions and change in the climate of public opinion. In particular requirements arising out of legal statutes and common law judgements have greatly modified the confidentiality of the doctor-patient relationship in societies deriving their law from English origins. Despite this, confidentiality remains a value which the physician must strive to preserve. He cannot however do this without considering its (...) effect upon possible innocent third parties. (shrink)

This book identifies the physical, emotional, and psychological adjustments many boys have been forced to navigate alone during their most vulnerable, formative years and provides adjustments that adults must make to assist them in these transitions.

One hears increasingly from philosophers that statistical inference is a technical study that is well in control by statisticians and should be left to them; and one hears, increasingly, from mathematical statisticians that all this talk about interpretations of probability is so much philosophical frosting that is utterly irrelevant to the serious business of producing mathematical statistics. "The more interpretations of probability there are, the wider the scope of applications of our purely mathematical theories." The point of this paper is (...) to present, in detail, a situation in which an individual with given degrees of belief, given evidence, and given values, will have three different and contrary courses of action recommended to him, each according to one of the three most popular interpretations of probability. (shrink)

Critics suggest that without some "objective" account of well-being we cannot explain why satisfying some preferences is, as we believe, better than satisfying others, why satisfying some preferences may leave us on net worse off or why, in a range of cases, we should reject life-adjustment in favor of life-improvement. I defend a subjective welfarist understanding of well-being against such objections by reconstructing the Amartya Sen's capability approach as a preferentist account of well-being. According to the proposed account preference satisfaction (...) alone—possible as well as actual—is of value. States of affairs contribute to well-being because and to the extent that they satisfy actual or nearby possible preferences, and are fruitful, that is, compatible with a range states that satisfy further actual or nearby possible preferences. The proposed account solves the problem of adaptive preference. Individuals whose preferences are "deformed" are satisfied with fruitless states of affairs, which constrain their options so that they are incapable of satisfying a wide range of nearby possible preferences—preferences they "could easily have had." Recognizing the value of capabilities as well as actual attainments allows us to explain why individuals who satisfy "deformed" or perverse preferences may not on net benefit from doing so. More fundamentally, it explains why some states are, as Sen suggests, bad, awful or gruesome while others are good, excellent or superb without appeal to any objective account of value. (shrink)