Aristotle's Politics is widely recognized as one of the classics of the history of political philosophy, and like every other such masterpiece, it is a work about which there is deep division.

Disturbances of consciousness, including fluctuations in attention and awareness, are a common and clinically important symptom in dementia with Lewy bodies. In the present study we investigate potential mechanisms of such disturbances of consciousness in a clinicopathological study evaluating specific components of the cholinergic system. [3H]Epibatidine binding to the high-affinity nicotinic receptor in the temporal cortex differentiated DLB cases with and without DOC, being 62–66% higher in those with DOC. The were no differences between DLB patients with or without DOC (...) in 125I-labeled α-bungaratoxin binding to the low-affinity nicotinic receptor, [3H]pirenzepine binding to the muscarinic M1 receptor, or in choline acetyltransferase activity. These findings provide support for the hypothesis that cholinergic activity is an important neural correlate if consciousness and suggest a mechanism of DOC in DLB involving alterations in the nicotinic receptor, composed of predominantly α4 and β2 subunits. (shrink)

Quality improvement (QI) is fundamental to maintaining high standards of health care. Significant debate exists concerning the necessity for an ethical approval system for those QI projects that push the boundaries, appearing more similar to research than QI. The authors discuss this issue identifying the core ethical issues in family medicine (FM), drawing upon the fundamental principles of medical ethics, including principles of autonomy, utility, justice and non-maleficence. Recent debate concerning the application of QI ethics boards is discussed with relevance (...) to primary care and issues such as general practitioner (GP) intentions, the impact of QI on patients and the use of confidential patient data and the impact of dissemination. The authors conclude that a system of QI ethical approval leaves many issues unresolved and potentially creates several barriers to implementing QI. To ensure ethical QI work is generated within FM it is essential for GPs to learn about and engage in more ethical reflection so that they can better judge and resolve these issues. (shrink)

What job should authorities give to review boards? We are grateful to Soren Holm, Rosamond Rhodes, Julian Savulescu and G Owen Schaefer for their thoughtful commentaries on our answer.1–4 Here we add to the discussion. Let us summarise the claims for which we argued.5 Relevant authorities can task boards with review for consistency with duly established code, thereby making code-consistent activities apt for approval and code-inconsistent activities apt for rejection. They can instead task boards with review for ethical acceptability, making (...) ethically acceptable activities apt for approval and ethically unacceptable activities apt for rejection. For every proposal a board might consider, these two different jobs establish different review bases, and their approvals and rejections also sometimes conflict. Some international and national statements require ECR, others instead require CCR, and others again seem either to require both or just to run the two together. Those responsible for these statements should make them clearer and better aligned here. For reasons of practicality, publicity and separation of powers, authorities do better to task boards with CCR and not ECR. These arguments also count against establishing any code with content that in effect collapses CCR into ECR. If our arguments withstand robust scrutiny, authorities should also remove ‘ethics’ and cognate terms from the names of these boards and their review activities and emphasise code expertise not ethics expertise in the required skill sets of boards. Our article noted that ‘ethical considerations informed the genesis of these boards and express their aspirations’. Rhodes similarly notes: ‘the authors and endorsers of research ethics codes, declarations and regulations … articulating the ethical standards for conducting human subject research’ and ‘This framework embeds the ethical parameters of human subject research into the moral missions of institutions’. Schaefer too …. (shrink)

This paper argues that a precautionary approach to scientific progress of the sort advocated by Walter Glannon with respect to life-extending therapies involves both incoherence and irresolvable paradox. This paper demonstrates the incoherence of the precautionary approach in many circumstances and argues that with respect to life-extending therapies we have at present no persuasive reasons for a moratorium on such research.

The question of if, and under what conditions transsexuals should be allowed to participate in sports in their acquired sex is becoming increasingly relevant partly because the number of transsexuals is increasing partly because many countries now provide mechanisms for achieving legal recognition as belonging to the new acquired sex. This paper develops (1) an analysis of the justification for maintaining sex segregation in some sports and (2) an account of the rights of transsexuals to be recognised in their new (...) sex. On the basis of these two analyses it critically evaluates two set of rules for the participation of transsexuals in elite sports: the UK guidelines issued in pursuance of the Gender Recognition Act 2004 and the International Olympic Committee's guidelines. It is argued that these guidelines are conflicting and that a modified set of criteria is more justifiable. (shrink)

From reason to practice in bioethics brings together original contributions from some of the world's leading scholars in the field of bioethics. With a particular focus on, and critical engagement with, the influential work of Professor John Harris, the book provides a detailed exploration of some of the most interesting and challenging philosophical and practical questions raised in bioethics.

In most Western European countries and North America, strategies to contain the spread of AIDS have emphasized civil liberties. This may be due more to the epidemiology of the disease than to moral progress.

OBJECTIVES: To study the ethical reasoning of nurses and physicians, and to assess whether or not modified focus groups are a valuable tool for this purpose. DESIGN: Discussion of cases in modified focus groups, each consisting of three physicians and three nurses. The discussion was taped and analysed by content analysis. SETTING: Five departments of internal medicine at Danish hospitals. SAMPLE: Seven discussion groups. MAIN MEASUREMENTS: Ethical content of statements, style of statements, time used by each participant. RESULTS: Danish physicians (...) and nurses do not differ in the kind of ethical reasoning they use, but physicians use more of the discussion time than nurses, they use a more assertive style of argumentation, and the solutions chosen are usually first put forward by physicians. CONCLUSION: The results and informal comparisons with similar data from long qualitative interviews indicate that groups of this kind are a useful tool for gathering data on ethical reasoning. (shrink)

Utilitarian ideas in nineteenth-centuryAmerica have been given short shrift inmodern historical and philosophicalscholarship. Collecting the relevant publishedwork together in one place is an essentialstarting point for any serious investigation of American utilitarians andtheir critics. James Crimmins and Mark Spencer have made an expertselection from scattered sources of around 60 important articles andessays. These include treatments of Bentham by his friend John Neal,editor of The Yankee, and commentaries on John Stuart Mill gatheredfrom rare American journals. There are also discussions (...) of utilitarianjurisprudence by the great American jurist Oliver Wendell Holmes, andpieces by many other writers. This collection, with its substantialeditorial introduction, will be vital reading for historians of ideas,scholars of philosophy and political thought, and any one elseinterested in the fate of utilitarianism in America. (shrink)

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Quarterly publication discussing various topics in environmental ethics, including features, discussion papers, book reviews, editorial commentaries, and other text related to environmental philosophies. Some issues also include announcements and other news related to the environmental studies community.

Talks collected from lectures given by Bennett with Gurdjieff's approval, to help people understand All and Everything: Beelzebub's Tales to His Grandson. Bennett regarded Gurdjieff's All and Everything as a work of superhuman genius.

The purpose of this study was to compare working memory (WM), executive function, academic ability and problem classroom behaviors in children aged 8 to 11 years who were either identified via routine screening as having low WM, or had been diagnosed with ADHD. Standardised assessments of WM, executive function and reading and mathematics were administered to 83 children with ADHD, 50 children with low WM and 50 typically developing children. Teachers rated problem behaviors on checklists measuring attention, hyperactivity/impulsivity, oppositional behavior, (...) and difficulties associated with executive function in the classroom. The ADHD and low WM groups had highly similar WM and executive function profiles, but were distinguished in two key respects: children with ADHD had higher levels of rated and observed impulsive behavior, and children low WM had slower response times. Possible mechanisms for these common and distinct deficits are discussed. (shrink)

The Future of Human Reproduction brings together new work, by an international group of contributors from various fields and perspectives, on ethical, social, and legal issues raised by recent advances in reproductive technology. These advances have put us in a position to choose what kindsof children and parents there should be; the aim of the essays is to illuminate how we should deal with these possibilities for choice. Topics discussed include gender and race selection, genetic engineering, fertility treatment, ovarian tissue (...) transfer, and post-menopausal pregnancy. The centralfocus of the volume is the interface between reproductive choice and public regulation. (shrink)

When children are too young to make their ownautonomous decisions, decisions have to be madefor them. In certain contexts we allow parentsand others to make these decisions, and do notinterfere unless the decision clearly violatesthe best interest of the child. In othercontexts we put a priori limits on whatkind of decisions parents can make, and/or whatkinds of considerations they have to take intoaccount. Consent to medical research currentlyfalls into the second group mentioned here. Wewant to consider and ultimately reject one (...) ofthe arguments put forward for putting medicalresearch into the second category. We willargue that some objections to children'sparticipation in research are either based onan implausibly restrictive conception of whatis in fact in the child's best interests orthat there is an implicit and false premisehidden in this argument; i.e., the premise thatour children have so deeply fallen into moralturpitude that we must assume that they wouldnot want to fulfill their moral obligations,or, that they will grow up to be morallydeficient and will then wish not to have actedwell while a child. (shrink)

OBJECTIVES: To study the ethical reasoning of nurses and physicians, and to assess whether or not modified focus groups are a valuable tool for this purpose. DESIGN: Discussion of cases in modified focus groups, each consisting of three physicians and three nurses. The discussion was taped and analysed by content analysis. SETTING: Five departments of internal medicine at Danish hospitals. SAMPLE: Seven discussion groups. MAIN MEASUREMENTS: Ethical content of statements, style of statements, time used by each participant. RESULTS: Danish physicians (...) and nurses do not differ in the kind of ethical reasoning they use, but physicians use more of the discussion time than nurses, they use a more assertive style of argumentation, and the solutions chosen are usually first put forward by physicians. CONCLUSION: The results and informal comparisons with similar data from long qualitative interviews indicate that groups of this kind are a useful tool for gathering data on ethical reasoning. (shrink)

Introduction: Raising the Issues John Bowker What ought I to do? Or not to do, as the case may be? What 'the case' is turns out to be all-important: the ...

In “A Paradox out of Context: Harris and Holm on the Precautionary Principle,” Sandin criticizes the earlier paper “Extending Human Lifespan and the Precautionary Paradox” wherein John Harris and I argued that the precautionary principle is incoherent. These criticisms offer me the possibility to briefly expand and clarify some of our previous arguments, and to show that the paradox of precaution is not dispelled by attention to context as Sandin maintains. Even when context is fully acknowledged, application of the (...) PP will still lead to paradox and paralysis. (shrink)

This paper analyses the question what other healthcare professions should learn from nursing ethics, e.g. what should medical ethics learn from nursing ethics. I first analyse and reject all strong versions of the claim that nursing ethics is unique, because nursing is a unique practice. I then move to the question of whether the link between nursing ethics and nursing theory can be a model for other areas of healthcare ethics. I provide an analysis of the possibility of creating a (...) theory of medicine and find that there cannot be a theory of medicine, and I argue briefly that this finding is also applicable to nursing. If there cannot be a theory of nursing, this entails that nursing ethics cannot be justifiably based on such a theory. In the final section, I then analyse the success of nursing ethics in resisting certain of the vices of Anglo‐American analytic ethics, in particular the reductionism and individualism that characterizes much of healthcare ethics. I conclude that other healthcare ethics could usefully learn from this aspect of nursing ethics. (shrink)

This paper focuses on the practical question of how the ideas of John Dewey can contribute to improved intercultural communication theory and practice, especially to training. The question is answered in four parts. The first part refers to the presumed superiority of sensitivity to difference as opposed to similarity in intercultural communication. The second part suggests that Dewey’s duality of potentiality and interaction can be carried over to the duality of competence and performance. The third part highlights the use (...) of the generic concepts of pattern and habit to better understand culture as a practical experience. The final part advocates a closer look at the idea and experience of rhythm as an epistemological alternative to subject vs object. The author relies on his experience as a trainer and a teacher of Intercultural Communication and proceeds down an interdisciplinary path, especially attempting to set up a dialogue with biology, systems and the arts. (shrink)

Environmental ethics has a future as long as there are moral agents on Earth with values at stake in their environment. Somewhat ironically, just when humans, with their increasing industry and development, seemed further and further from nature, having more power to manage it, just when humans were more and more rebuilding their environments with their super technologies, the natural world emerged as a focus of ethical concern. Environmental alarms started with prophets such as Aldo Leopold, Rachel Carson, John (...) Muir, and David Brower, and have, over recent decades, become daily news. (shrink)

Editors-in-Chief Søren Holm and John Harris announce exciting changes for the journalStarting with this issue, the Journal of Medical Ethics has a new editorial team. We inherit one of the best—we believe the best—journal concerned with medical ethics and bioethics in the world. Certainly it is the journal with the highest impact factor in bioethics, applied philosophy, and medical ethics. For this we have to thank not only Julian Savulescu from whom we take over but also the two previous (...) editors, Raanan Gillon and Alistair Campbell.Søren Holm and John Harris are the new Editors-in-Chief and the editorial team welcomes several new members: Richard Ashcroft and Nikola Biller-Andorno as …. (shrink)

The central concern of this article is whether early induction of labor for an anencephalic fetus can ever be morally justified, particularly by a Catholic healthcare ethics committee. By revisiting and refining arguments in articles by Drane (1992) and Bole (1992) published in this journal, a revised argument – consistent with the Catholic moral tradition – can seemingly be constructed that a Catholic healthcare ethics committee might use to justify early induction of labor in some pregnancies involving an anencephalic fetus. (...) Such a revised argument depends upon two central claims; first, that the anencephalic fetus in question is necessarily in the process of dying when early induction of labor occurs, and second, that the fetus is judged to be undergoing extraordinary or disproportionate means of preserving their life as a result of receiving ongoing maternal support of a mother’s womb. The revised argument developed in this article aims to utilize the doctrine of double effect in conjunction with these two central claims to justify early induction of labor for anencephalic fetal persons in some circumstances. Unfortunately, the revised argument – if successful – would be at odds with a stance taken in the United States Conference of Catholic Bishops (USCCB) 1996 statement “Moral Principles Concerning Infants with Anencephaly.” However, there is reason to believe the revised argument offered in this article is well aligned with other guidance from the USCCB, contained in the publication _Ethical and Religious Directives for Catholic Healthcare Services_ (2018). This article concludes by noting some important limitations of the argument and offering hope that consideration of the argument ultimately helps to strengthen the Catholic moral tradition. (shrink)

For three decades Jeremy Holmes has been a leading figure in psychodynamic psychiatry in the UK and across the world. He has played a central role in promoting the ideas of John Bowlby and in developing the clinical applications - psychiatric and psychotherapeutic - of Attachment Theory in working with adults. Drawing on both psychoanalytic and attachment ideas, Holmes has been able to encompass a truly biopsychosocialperspective. As a psychotherapist Holmes brings together psychodynamic, systemic and cognitive (...) models, alert to vital differences, but also keenly sensitive to overlaps and parallels. This volume of selected papers brings together the astonishing range of Holmes' interests and contributions. The various sections in the book cover: An extended interview - covering Holmes' career and philosophy as a psychodynamic psychiatrist 'Juvenilia' - sibling relationships, the psychology of nuclear weapons, and the psychodynamics of surgical intervention. Psychodynamic psychiatry: Integrative and Attachment-Informed A psychotherapy section inwhich he develops his model of psychotherapeutic change 'Heroes' - biographical pieces about the major influences including, John Bowlby, Michael Balint, David Malan, Jonathan Pedder and Charles Rycroft. 'Ephemera' - brief pieces covering such topics as frequency of psychodynamic sessions and fees. Attachments: Psychiatry, Psychotherapy, Psychoanalysis - The Selected Works of Jeremy Holmeswill be essential and illuminating reading for practitioners and students of psychiatry and psychotherapy in all its guises. (shrink)