This book is the result of a three-year study undertaken by a multidisciplinary working party of the Institute of Medical Ethic (UK). The group was chaired by a moral theologian, and its members included biological and ethological scientists, toxicologists, physicians, veterinary surgeons, an expert in alternatives to animal use, officers of animal welfare organizations, a Home Office Inspector, philosophers, and a lawyer. Coming from these different backgrounds, and holding a diversity of moral views, the members produced the agreed report as (...) a result of detailed and rigorous discussions. The book sets out facts about animal experiments and about animal abilities to experience pain, distress and anxiety. There is a detailed examination of the moral claims related to the benefits likely to accrue from animal research, and of strategies for weighing these benefits against the harm caused to animals, in order to decide whether particular research projects ought or ought not to proceed. This leads to consideration of the statutory and non-statutory controls which safeguard standards in such research. The final section explores a variety of philosophical arguments about the use of animals in research, and offers a philosophical justification for the Working Party's more practical conclusions. Written in clear, nontechnical language, this book is accessible to lay people as well as to scientists. It is the first such document to emerge from a meeting of people with such widely differing views on this highly controversial subject, and represents a major contribution towards informing and raising the quality of contemporary debate. The book is unique in drawing together material and ideas never before found in one volume. It will interest a broad spectrum of readers, from ethicists and animal rights advocates to scientific researchers and laboratory administrators, along with general readers concerned about this compelling issue. (shrink)

Jane Grant's book explores the need to redefine the social compact in twenty-first century America. It proposes a new compact that would honor the expansion of civil, political, and social rights in America, and would integrate these rights within a new civic procedural ethos, clarifying our obligations to each other, future generations, other nations, and other species.

I begin my comments with a first-person narrative. I know Octavio, Erotildes, and Nuria from the time I worked at the Institute of Psychiatry and was very close to the field of mental health. They are people whose work I admire and appreciate. I comment on this text from the point of view of someone who has never worked directly in mental health assistance and whose knowledge about severe mental illness therapy has occurred mostly from a third-person perspective. My comments (...) are based on parallels with situations and experiences that I have been studying lately.First of all, I want to say that I fully agree with the authors’ argument that “experiences and narratives about illness, treatment, and recovery are... (shrink)

Eduard Pernkopf’s Atlas of Topographical and Applied Human Anatomy is a four-volume anatomical atlas published between 1937 and 1963, and it is generally believed to be the most comprehensive, detailed, and accurate anatomy textbook ever created. However, a 1997 investigation into “Pernkopf’s Atlas,” raised troubling questions regarding the author’s connection to the Nazi regime and the still unresolved issue of whether its illustrations relied on Jewish or other political prisoners, including those executed in Nazi concentration camps. Following this investigation, the (...) book was removed from both anatomy classrooms and library bookshelves. A debate has ensued over the book’s continued use, and justification for its use has focused on two issues: there is no definitive proof the book includes illustrations of concentration camp prisoners or Jewish individuals in particular, and there is no contemporary equivalent to this text. However, both points fail to address the central importance of the book, not simply as part of anatomy instruction, but also as a comprehensive historical narrative with important ethical implications. Having encountered a first edition copy, these authors were given a unique opportunity to engage with the text through the respective humanities lenses of history, ethics, and narrative. In doing so, an instructive and profound irony has surfaced: Nazis, including Pernkopf, viewed specific groups of people as less than human, giving rise to unthinkable atrocities perpetuated against them. However, these same individuals became the sources for the creation of the Atlas, which served as the model for primary instruction on the human form for more than half of the twentieth century. In this article, we recount the difficult and somewhat opaque provenance of this book, engage the ethical questions surrounding both its creation and its use, and ultimately propose a pedagogical methodology for its continued use in medical education. (shrink)

After retirement, older people often find themselves far from their children and grandchildren, and many spend their last years isolated and alone. As traditional concepts of family and social institutions fragment, social networks weaken, leading to an epidemic of loneliness, and substance abuse and suicide in developed countries. In fact, life expectancy in the US has dropped for the past few years, in large part due to a dramatic increase in suicide and drug overdose. None of these social problems is (...) likely to be solved by metformin. They point to a crisis of identity and meaning, an existential crisis. In this context, one might wonder if we are already seeing the effects of tinkering with our lifespan. There are many more conclusions one could draw about the implications of longevity, many of which have been elegantly described in Beyond Therapy: Biotechnology and the Pursuit of Happiness, published by the President’s Council on Bioethics, which I used as a reference for this talk. I hope I have been successful in providing a 10,000-foot view of the questions of efforts to extend human longevity and its implications that will provoke thought and discussion. I would like to end these reflections by turning back to my favorite transhumans. The reason we love superheroes is not for their superior strength or intelligence, but their characters. They use their powers to protect and serve humanity rather than dominate or annihilate it. It is not their gadgetry that makes them great, but how they use it to save the vulnerable. Even as a small child I knew that if everyone acted the way they did, the world would be a better place. The moral of every story was that the “enhancement” humanity needed would not come as the fruit of technology, but of virtue. (shrink)

The recently revised Common Rule requires that donors of biospecimens for research be informed if their specimens might be used for commercial profit. The Common Rule, however, does not apply to sharing or selling de-identified biospecimens that are “leftover” from clinical uses. As a result, many medical researchers remain uncertain of their legal and ethical obligations when a commercial entity expresses interest in these specimens.

Events in 2020 have sparked a reimagination of how both individuals and institutions should consider race, power, health, and marginalization in society. In a response to these developments, we exa...

Backround Education in ethics and professionalism should reflect the realities medical students encounter in the hospital and clinic. Method We performed content analyses on Case Observation and Assessments (COAs) written by third-year medical students about ethical and professional issues encountered during their internal medicine and paediatrics clinical clerkships. Results A cohort of 141 third-year medical students wrote 272 COAs. Content analyses identified 35 subcategories of ethical and professional issues within 7 major domains: decisions regarding treatment (31.4%), communication (21.4%), professional duties (...) (18.4%), justice (9.8%), student-specific issues (5.4%), quality of care (3.8%), and miscellaneous (9.8%). Conclusions Students encountered a wide variety of ethical and professional issues that can be used to guide pre-clinical and clinical education. Comparison of our findings with results from similar studies suggests that the wording of an assignment (specifying “ethical” issues, “professional” issues, or both) may influence the kinds of issues students identify in their experience-based clinical narratives. (shrink)

Numerous researchers have investigated accounting students’ levels of moral reasoning, ethical choice and judgment employing the Defining Issues Test and using its P score as an indicator of moral reasoning. Not surprisingly, a number of DIT studies report conflicting results. Moreover, despite widespread use of the DIT, there is concern that it may not adequately measure all facets of ethical judgment :1–26, 2010). Thus, we endeavor to provide insight not only into the contradictory results but also about the applicability of (...) the DIT for studying accounting students. To do so, we collect published and unpublished DIT studies employing accounting students as subjects and use meta-analysis to aggregate findings across these studies to quantify their results, examining commonly employed variables. We show significant relationships between P scores and some variables but not others. Further, our findings demonstrate that the DIT provides added insights when exploring questions of ethical choice, and ethics instruction, particularly when the instruction is embedded in an accounting course. Finally, we find that the level of DIT P scores reported in the studies relates to whether the study was published. We discuss the implications of our findings for future research. (shrink)

A paradigm for peace discovered in the cosmopolitan neighborhoods of poor urban immigrants.

Higginbotham argues that conditionals embedded under quantifiers constitute a counterexample to the thesis that natural language is semantically compositional. More recently, Higginbotham and von Fintel and Iatridou have suggested that compositionality can be upheld, but only if we assume the validity of the principle of Conditional Excluded Middle. I argue that these authors’ proposals deliver unsatisfactory results for conditionals that, at least intuitively, do not appear to obey Conditional Excluded Middle. Further, there is no natural way to extend their accounts (...) to conditionals containing ‘unless’. I propose instead an account that takes both ‘if’ and ‘unless’ statements to restrict the quantifiers in whose scope they occur, while also contributing a covert modal element to the semantics. In providing this account, I also offer a semantics for unquantified statements containing ‘unless’. (shrink)

This essay argues that pre-health humanities programs should focus on intensive research practice for baccalaureate students and provides three guiding principles for implementing it. Although the interdisciplinary nature of health humanities permits baccalaureate students to use research methods from the natural sciences, social sciences, and humanities, pre-health humanities coursework tends to force students to adopt only one of many disciplinary identities. Alternatively, an intensive research approach invites students to critically select and combine methods from multiple disciplines to ask and answer (...) questions about health problems more innovatively. Using the authors’ experiences with implementing health humanities baccalaureate research initiatives at The University of North Carolina at Chapel Hill, the authors contend that pre-health humanities programs should teach and study multiple disciplinary research methods and their values; examine how health humanities research might transfer across disciplines; and focus on mentoring opportunities for funding, presenting, and publishing research. These recommendations have the potential to create unprecedented research experiences for baccalaureate students as they prepare to enter careers within and beyond the allied health professions. (shrink)

An individual’s right to refuse life-sustaining treatment is a fundamental expression of patient autonomy; however, supporting this right poses ethical dilemmas for healthcare providers when the patient has attempted suicide. Emergency physicians encounter patients who have attempted suicide and are likely among the first medical providers to face the dilemma of honoring the patient’s DNR or intervening to reverse the effects of potentially fatal actions. We illustrate this issue by introducing a case example in which the DNR of a terminally (...) ill woman was not honored because the cause of her cardiac arrest was suicide. We argue that although a terminal diagnosis should change the way health care providers respond to a suicide attempt, many of the theoretical underpinnings for how one should treat suicide attempts—especially the criterion of external reasonability, that is the action to withhold or withdraw life-sustaining measures is reasonable independent of the precipitating event—are common to all situations :3–12, 2013). The presumption that patients who attempt suicide lack capacity due to acute mental illness is flawed because it fails to account for a competent individual’s reasonable preference to not be forced to live in an unbearable, terminal condition. In states without legislation allowing physician aid in dying, patients and providers must grapple with these limitations on a case-by-case basis. In cases where the patient has a limited life expectancy and there is not concern for psychiatric illness as the primary cause of the suicidal action, we argue that the negative right to refuse life-sustaining treatment should prevail. (shrink)

This article offers a critical reflection on the mutually resonant recent works of Clayton Crockett and Jeffrey Robbins, both of whom expose “radical theology” as insufficiently political, “political theology” as insufficiently radical, and “radical politics” as insufficiently attuned to theology. In light of these shortcomings, they offer a radical political theology as a “necessary supplement” to the project of radical democracy—which is to say a politics of, by, and for “the multitude.” This article tracks the shifting and occasionally conflicting contours (...) of this radically democratic theology. (shrink)

Implantable cardioverter defibrillators (ICDs) reduce mortality in selected patients at risk for life-threatening heart arrhythmias, and their use is increasingly common. However, these devices also confer risk for delivery of unexpected painful shocks during the dying process, thus reducing the quality of palliative care at the end of life. This scenario can be avoided by ICD deactivation in appropriate circumstances but patients will remain unaware of this option if not informed about it. It is not known how often end-of-life implications (...) are discussed with patients prior to ICD implantation, when focus is primarily on the short-term potential complications of the device placement procedure itself. We conducted a retrospective chart review to determine how often end-of-life implications were discussed with patients as part of the informed consent process. We evaluated consent forms and related other chart documentation for 91 patients (ranging from age 60 to 89 years) undergoing first-time ICD placement at a mid-western academic medical center from 2006-2008. Only one chart documented any discussion of end-of-life implications, in a case where the issue was raised by a patient who noted that quality of life was their main focus. Consent was provided by a health care surrogate in only four of the 91 cases. In conclusion, patients giving consent for ICD implantation may be uninformed about the device's potential future impact on end-of-life care, the dying process, and the option for device deactivation. Truly informed consent requires that both short- and long-term potential implications be reviewed with patients. (shrink)

Since its founding in 1943, Medievalia et Humanistica has won worldwide recognition as the first scholarly publication in America to devote itself entirely to medieval and Renaissance studies. Since 1970, a new series, sponsored by the Modern Language Association of America and edited by an international board of distinguished scholars and critics, has published interdisciplinary articles. In yearly hardbound volumes, the new series publishes significant scholarship, criticism, and reviews treating all facets of medieval and Renaissance culture: history, art, literature, music, (...) science, law, economics, and philosophy. (shrink)

"Understanding Feminism" provides an accessible guide to one of the most important and contested movements in progressive modern thought. Presenting feminism as a dynamic, multi-faceted and adaptive movement that has evolved in response to the changing practical and theoretical problems faced by women, the authors take a problem-oriented approach that maps the complex strands of feminist thinking in relation to women's struggles for equal recognition and rights, and freedom from oppressive constraints of sex, self-expression and autonomy. Each chapter focuses on (...) a different cluster of concerns, demonstrating key moves in second-wave feminist thought, as well as some of the diversity in response-strategies that encompass both socio-economic and cultural-symbolic concerns. This approach not only shows how central feminist insights, theories and strategies emerge and re-emerge across different contexts, but makes clear that far from being 'over', feminism remains a vital response to the diverse issues that women find pressing and socially important. (shrink)

Environment and Philosophyprovides an accessible introduction to the radical challenges that environmentalism poses to concepts that have become almost second nature in the modern world. These include: * the ideas of science and objectivity * the conventional placement of the human being within the environment * the individualism of convential Modern thought Written in an accessible way for those without a background in philosophy, this text examines ways of thinking about ourselves, nature and our relationship with nature. It offers an (...) introduction to the phenomenological perspective on environmental issues, and also to the questions of what natural beauty is. (shrink)

For many citizens, public services are the most direct and tangible output of the democratic process, and yet in the past thirty years policymakers have privatized a broad swath of these services. This article asks whether privatization of state services changes citizens’ willingness to use the ballot box to hold governments to account for service performance. It argues that citizens can hold governments to account for privatization, but only if they have genuine political alternatives. Where quality falls with privatization and (...) citizens can vote for an anti-privatization party, what we call a clear signal, privatization can mobilize citizens to sanction incumbents. By contrast, where quality falls but there are few anti-privatization alternatives, a mixed signal, privatization reduces sanctioning behavior. To test this theory, the article draws on a panel difference-in-differences analysis of disability reform from the United Kingdom, leveraging a geographically varied introduction of private provision across two political contexts. (shrink)

Men and women have always bargained for sex. In Hard Bargains, philosopher-lawyer Linda Hirshman and legal historian Jane Larson provide the first complete analysis of power in heterosexual relationships, combining an eye-opening legal history of sexual regulation with thought-provoking predictions of what the future might bring. Hirshman and Larson tell a riveting tale that spans the centuries--from early accounts of adulterers hanging from the gibbet, to the impact of the Kinsey Reports and Hugh Hefner's playboy philosophy, to the 1960s (...) judge who argued in favor of sex with eleven-year-olds. The book examines the factors that have shaped our notions of sex, from Catholic teaching to the theories of Sigmund Freud, and it explores the Supreme Court decisions of the last few decades that revolutionized the politics of sex. And Hard Bargains not only provides a deep understanding of historical and current disputes, it also offers striking predictions of what sexual bargaining will look like in the future--rape laws replaced by laws of sexual autonomy, adultery subjected to breach of contract action, fornicators responsible for each other's rent, prostitution considered an unfair labor practice. These are a few of the surprising--and surprisingly workable--solutions the authors foresee in the 21st century. Hard Bargains takes a forthright and level-headed look at all aspects of one of the biggest controversies in contemporary American society--heterosexual sex--and delivers a radically new perspective on the sexual lives of women and men. (shrink)