In the face of the moral pluralism that results from the death of God and the abandonment of a God's eye perspective in secular philosophy, bioethics arose in a context that renders it essentially incapable of giving answers to substantive moral questions, such as concerning the permissibility of abortion, human embryonic stem cell research, euthanasia, etc. Indeed, it is only when bioethics understands its own limitations and those of secular moral philosophy in general can it better appreciate those tasks that (...) it can actually usefully perform in both the clinical and academic setting. It is the task of this paper to understand and reevaluate bioethics by understanding these limits. Academic bioethicists can analyze ideas, concepts, and claims necessary to understanding the moral questions raised in health care, assessing the arguments related to these issues, and provide an understanding of the different moral perspectives on bioethical issues. In the clinical setting, bioethicists can provide legal advice, serve as experts on IRBs, mediating disputes, facilitating decision-making and risk management, and clarifying normative issues. However, understanding this is only possible when one understands the history, genesis, and foundations of bioethics and its inability to provide a resolution to postmodern moral pluralism. (shrink)

H. Tristram Engelhardt, Jr.; Medicine, Philosophy, and Theology: Christian Bioethics Reconsidered, Christian bioethics: Non-Ecumenical Studies in Medical Morali.

Humans are neophile, curious, and explorative animals with impressive capabilities for creative problem-solving. I discuss some of the ultimate roots behind human creativity while reviewing two books on creativity and problem-solving. To E. O. Wilson, the driv­ing force behind creativity is our instinctive love of novelty, and creativity’s ultimate goal is “self-understanding.” I elaborate on and question this assumption. The theories of inclu­sive fitness and group selection are discussed, with Wilson in favor of the latter. Finally, the theory of gene-culture (...) coevolution is introduced as fundamental to the unity of science and the humanities and to closing the gap between these two cultures. Eagleman and Brandt’s volume is more of an entertaining history of design and human inventiveness than a study in creativity as such. We hear about the three main operations of creative process: bending, blending, and breaking, and these operations are the primary means by which all ideas evolve, according to the authors. (shrink)

Byzantine Empire; economic and social conditions; history.

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)

Although the responsibility for health debate has intensified in several ways between Norman Daniels’ 1985 Just healthcare and Just health: meeting health needs fairly of 2008, comparatively little space is dedicated to the issue in Just health, and Daniels notes repeatedly that his account “says nothing about personal responsibility for health”. Daniels considers health responsibility mainly in a particular luck-egalitarian version which he rejects because of its potentially unfeasible, penalising and inhumane character. But I show that he nonetheless acknowledges and (...) endorses explicitly other dimensions of health responsibility. I develop a wider, more nuanced and less punitive concept of health responsibility, which expands Daniels’ brief consideration and is compatible with the overall approach set out in Just health. In its application to preventative medicine and health promotion in particular, the concept is suited to support and complement the notion that “health is special”, which is central in Just health. The concept of health responsibility as co-responsibility specifies the subjects and objects of health responsibilities. It permits the attribution of responsibility without blame and disconnects the question of assigning responsibility from decisions about entitlement to treatment or different status in prioritisation decisions. This approach secures conceptual plausibility and clarity of the concept of health responsibility, is of use in policy making, and can help reduce political tensions. (shrink)

Bonuses, as incentives or rewards for health -related behavior, feature prominently in German social health insurance. Their goal is centered around promoting personal responsibility, but reducing overall health -care expenditure and enabling competition between sickness funds also play a role. The central position of personal responsibility in German health -care policy is described, and a framework is offered for an analysis of the ethical issues raised by policies seeking to promote responsibility. The framework entails seven tests relating to: solidarity; equality (...) and equity; intrusiveness; attributability and opportunity of choice; evidence, rationale, and feasibility; affected third parties; and coherence. It is contended that a focus on tests, in particular from within contractualism, is the most appropriate way of addressing the question of health responsibility in pluralistic societies. However, taken by themselves, the tests also allow an identification of the key ethical issues by particular policies, which are illustrated by applying the framework to particular bonus polices. (shrink)

Eudemian ethics -- Nicomachean ethics -- Magna moralia -- Virtues and vices.

The European Union welfare standardsfor intensively kept pigs have steadilyincreased over the past few years and areproposed to continue in the future. It isimportant that the cost implications of thesechanges in welfare standards are assessed. Theaim of this study was to determine theprofitability of rearing pigs in a range ofhousing systems with different standards forpig welfare. Models were constructed tocalculate the cost of pig rearing (6–95 kg) in afully-slatted system (fulfilling minimum EUspace requirements, Directive 91630/EEC); apartly-slatted system; a high-welfare,straw-based system (...) (complying with the UK-basedRoyal Society for the Prevention of Cruelty toAnimals, Freedom Food standards) and afree-range system. The models were also used toassess the consequences of potential increasesin space allowance, and to estimate the cost ofrearing pigs under organic standards.The cost of rearing pigs ranged from92.0 p/kg carcass weight (cw) and 94.6 p/kgcw forthe partly-slatted and fully-slatted systems,to 98.8 p/kgcw and 99.3 p/kgcw for the FreedomFood and free-range systems respectively. Whenspace allowance was increased by 60% to levelsin a recent proposal to revise pig welfareDirective (91/630/EEC), the rearing costs wereunchanged for the free-range system but rose by4.6 p/kgcw for the fully-slatted system. Rearingcosts under organic standards were 31% higherthan in the free-range system. These resultssuggest that improved pig welfare can beachieved with a modest increase in cost. (shrink)

The traditional Christian focus concerning dying is on repentance, not dignity. The goal of a traditional Christian death is not a pleasing, final chapter to life, but union with God: holiness. The pursuit of holiness requires putting on Christ and accepting His cross. In contrast, post-traditional Christian and secular concerns with self-determination, control, dignity, and self-esteem make physician-assisted suicide and voluntary active euthanasia plausible moral choices. Such is not the case within the context of the traditional Christian experience of God, (...) which throughout its 2000 years has sternly condemned suicide and assisted suicide. The wrongness of such actions cannot adequately be appreciated outside the experience of that Christian life. Traditional Christian appreciations of death involve an epistemology and metaphysics of values in discordance with those of secular morality. This difference in the appreciation of the meaning of dying and death, as well as in the appreciation of the moral significance of suicide, discloses a new battle in the culture wars separating traditional Christian morality from that of the surrounding society. (shrink)

Transformations of the Confucian Way. John H. Berthrong. Westview, Boulder, Colorado, and Oxford 1998. xiv, 250 pp. Cloth £53.95, pbk £15.95. ISBN 0-8133-28055/2804-7.

The Travail of Nature shows that the theological tradition in the West is neither ecologically bankrupt, as some of its popular and scholarly critics have maintained, nor replete with immediately accessible, albeit long-forgotten, ecological riches hidden everywhere in its deeper vaults, as some contemporary Christians, who are profoundly troubled by the environmental crisis and other related concerns, might wistfully hope to find. This is why it is appropriate to speak of the ambiguous ecological promises of Christian theology.

Ṣadr al-Dīn Shīrāzī, Muḥammad ibn Ibrāhīm, -1641--Criticism and interpretation. ; Islamic philosophy.

Being a Christian involves metaphysical, epistemological, and social commitments that set Christians at variance with the dominant secular culture. Because Christianity is not syncretical, but proclaims the unique truth of its revelation, Christians will inevitably be placed in some degree of conflict with secular health care institutions. Because being Christian involves a life of holiness, not merely living justly or morally, Christians will also be in conflict with the ethos of many contemporary Christian health care institutions which have abandoned a (...) commitment to Christian spirituality. In this regard, managed care raises the special question of how Christian institutions can act morally under financial constraints and maintain their character while under the control of secular managers. This question itself raises the further question as to why health care institutions need even pose this query when there are Christian physicians and nurses who could work for less, or Christian men and women who could become sisters and brothers and work for nothing. Contemporary challenges to Christians to maintain their integrity in a post-Christian world have much of their force because Christians have failed to maintain traditional Christian spirituality. In the face of that failure, Christian physicians and nurses will find themselves in greater conflict with health care institutions, because few will any longer understand the requirements of traditional Christianity. In its place, they will have put a generic spirituality, a value-neutral understanding of the role of the health professional, and an anonymous commitment to social justice. (shrink)

Of all the moral concerns regarding privacy in its various meanings, this essay selects only one: the right to be left alone by others, in particular, by government. Because moral controversies in pluralist societies tend to be interminable, and surely controversies regarding privacy are no exception, I approach the right to privacy in terms of the centrality of persons. When there are foundational disputes about which content-full moral view should govern, it is not possible to resolve such controversies without begging (...) the question or conceding at the outset crucial moral premises. This observation is not to affirm a moral skepticism or relativism. At worst, it involves an epistemic skepticism, a skepticism about the possibility of resolving controversies by sound rational argument without begging the question or engaging in an infinite regress. (shrink)

This paper provides a critique of Bostrom’s concern with existential risks, a critique which relies on Adorno and Horkheimer’s interpretation of the Enlightenment. Their interpretation is used to elicit the inner contradictions of transhumanist thought and to show the invalid premises on which it is based. By first outlining Bostrom’s position this paper argues that transhumanism reverts to myth in its attempt to surpass the human condition. Bostrom’s argument is based on three pillars, Maxipok, Parfitian population ethics and a universal (...) notion of general human values. By attempting to transcend the human condition, to achieve post-humanity, transhumanism reverts to myth. Thus, the aim of this paper is to provide a critical examination of transhumanism which elicits its tacit contradictions. It will also be argued that transhumanism’s focus on a universal, all-encompassing, notion of humanity neglects any concern with actual lived lives. This absence is problematic because it clearly shows that there is a discrepancy, between transhumanism’s claimed concern for all of humanity and the practical implications of proposing a universal notion of humanity. This paper will conclude, that transhumanism’s lack of concern with actual lives is due to its universal and totalising gestures. Gestures which allow for universal claims such as general values or Earth-originating intelligent life. (shrink)