The church and other community organisations have a legitimate role to play in influencing public policy. However, intervention by the church and other religious bodies in recent litigation in Australia and the United Kingdom raises questions about the appropriateness of such bodies being permitted to intervene directly in the court process as amici curiae. We argue that there are dangers in such bodies insinuating their doctrine under the guise of legal argument in civil proceedings, but find it difficult to enunciate (...) a principled distinction between doctrine and legal argument. We advise that judges should exercise caution in dealing with amicus submissions. (shrink)

Dr Boyle is right in drawing attention to the apparent inconsistency between laws that allow a fetus in utero to be aborted at the mother’s will but give the law’s full protection to a newborn infant, perhaps of the same gestation as the aborted fetus. It makes no difference how disabled the infant is, or how poor the prognosis. The reason for the inconsistency is that the two stages of the infant’s development—before birth and after birth—are governed by different legal (...) principles.While a fetus is in utero, the applicable laws are the criminal law of abortion and the civil law of battery, which here focuses on the mother’s direction alone. As Dr Boyle says, the law on abortion in the UK—and also in Australia—enables an abortion to be lawfully performed if continuing the pregnancy would present a real risk to the mother’s life, or her physical and mental health; and, additionally, in some jurisdictions like the UK, for serious fetal abnormality: see Abortion Act 1967 ,1 which includes risks to “existing children” as well as to the mother.2 Recent changes to the criminal law in the Australian Capital Territory and Western Australia have gone further and abortion is now lawful in those jurisdictions, simply on the informed request of the mother.3In jurisdictions that do not have a specific provision allowing abortion on the grounds of fetal abnormality, doctors have inferred that having a child with a serious abnormality would constitute a threat to the mother’s life or health, again focussing on the mother. The concept of harm to the mother’s health has been interpreted by the courts to include harm during pregnancy and delivery and also after the birth.4 This might take account of difficulties in raising …. (shrink)

Three of the four commentators endorse our concerns about intervention by the Roman Catholic church as anamicus curiaein civil litigation, with few reservations. One commentary rejects our arguments in toto. We deal first with the three commentaries that support our arguments; secondly, with the reservations and qualifications in those commentaries, and thirdly, with the commentary that totally rejects our arguments.

In the clinical setting, not enough attention is paid to the role that emotion plays. It is at worst ignored or avoided, isolating those who are suffering, at best treated as something to help another to endure. This is the result, in part, of an impoverished idea that views emotion as mere feelings. However, emotions are not just feelings, they are cognitive. If we look beneath the surface, emotions can provide information about values and beliefs, some of which may be (...) false or unreasonable. When they are motivating decisions that seriously affect the lives of others, there is a moral obligation to ferret them out and correct or deal with them. Attention needs to be paid to the emotions of healthcare providers as well as to the emotions of patients and their loved ones, and more done to train healthcare providers to deal effectively and productively with emotion – their own and others’. A son tearfully requests everything be done for his dying father. He fears limiting treatment means his father will be ignored. A physician orders another course of chemotherapy because she cannot bear for this patient to die. The patient, fearing he will painfully suffocate to death, agrees. Paying attention to emotions and bringing to light the beliefs and values behind them can only enhance the care and consideration of all involved. (shrink)

The number of admissions to hospitals of patients without a proxy decision maker is rising. Very often these patients need fairly immediate medical intervention for which informed consent—or informed refusal—is required. Many have recommended that there be a process in place to make these decisions, and that it include a variety of perspectives. People are particularly wary of relying solely on medical staff to make these decisions. The University Hospitals Case Medical Center recruits community members from its Ethics Committee to (...) serve on a subcommittee, the Patients Without Proxies (PWP) Committee, which works with medical staff during the decision-making process for these patients. Generally, the community members go to the bedside to observe patients. This article looks at how those unused to observing hospitalized patients who are sick and/or dying are affected, comparing them to mock jurors in a research study who are exposed to graphic photographs related to a fabricated crime scene. Judgments made by the mock jurors are affected by viewing such images. The personal experience of witnessing unfamiliar and shocking scenes affects their subsequent judgments. While it may be difficult to tease out whether observing patients causes PWP members to be benefited or harmed, they are affected by what they see. If a variety of perspectives is desirable to reduce possible bias or error, this article argues that at least one community member should refrain from seeing the patient in order to add a different and valuable voice to the decision-making process. Members of the subcommittee base their judgments on the various kinds of information available. Sometimes the things they see, hear, or feel may affect them particularly deeply, and affect their judgments as well. In this article I explore the idea that something like this may be happening in a particular kind of clinical ethics case consultation. (shrink)

For the last fifty years, the United States healthcare system has done an extremely poor job of delivering healthcare in a just and fair manner. The United States holds the dubious distinction of being the only industrialized nation in the world lacking provisions to ensure universal coverage. We attempt to provide some of the reasons this dysfunctional system has persisted and show that healthcare should not be a commodity. We begin with a brief historical overview of healthcare delivery in the (...) United States since WWII. This is followed by a critical analysis of the for-profit model including reasons to support the view that healthcare should not be a free market commodity. We also demonstrate how special interest groups have been able to win support for their practices based on propaganda rather than fact. A brief analysis of the Affordable Care Act is offered along with critical comments regarding its ineffectiveness. We conclude with a brief overview of international approaches that have resulted in universal coverage and suggest the United States ought to adopt an approach similar to those outlined so that it no longer stands as the only industrialized nation to ignore the glaring problems that exist. (shrink)

We examine ethical considerations in access to facial transplantation (FT), with implications for promoting health equity. As a form of vascularised composite allotransplantation, FT is still considered innovative with a relatively low volume of procedures performed to date by a small number of active FT programmes worldwide. However, as numbers continue to increase and institutions look to establish new FT programmes, we anticipate that attention will shift from feasibility towards ensuring the benefits of FT are equitably available to those in (...) need. This manuscript assesses barriers to care and their ethical implications across a number of considerations, with the intent of mapping various factors relating to health equity and fair access to FT. Evidence is drawn from an evolving clinical experience as well as published scholarship addressing several dimensions of access to FT. We also explore novel concerns that have yet to be mentioned in the literature. (shrink)

The Ontology for Biomedical Investigations (OBI) is an ontology that provides terms with precisely defined meanings to describe all aspects of how investigations in the biological and medical domains are conducted. OBI re-uses ontologies that provide a representation of biomedical knowledge from the Open Biological and Biomedical Ontologies (OBO) project and adds the ability to describe how this knowledge was derived. We here describe the state of OBI and several applications that are using it, such as adding semantic expressivity to (...) existing databases, building data entry forms, and enabling interoperability between knowledge resources. OBI covers all phases of the investigation process, such as planning, execution and reporting. It represents information and material entities that participate in these processes, as well as roles and functions. Prior to OBI, it was not possible to use a single internally consistent resource that could be applied to multiple types of experiments for these applications. OBI has made this possible by creating terms for entities involved in biological and medical investigations and by importing parts of other biomedical ontologies such as GO, Chemical Entities of Biological Interest (ChEBI) and Phenotype Attribute and Trait Ontology (PATO) without altering their meaning. OBI is being used in a wide range of projects covering genomics, multi-omics, immunology, and catalogs of services. OBI has also spawned other ontologies (Information Artifact Ontology) and methods for importing parts of ontologies (Minimum information to reference an external ontology term (MIREOT)). The OBI project is an open cross-disciplinary collaborative effort, encompassing multiple research communities from around the globe. To date, OBI has created 2366 classes and 40 relations along with textual and formal definitions. The OBI Consortium maintains a web resource providing details on the people, policies, and issues being addressed in association with OBI. (shrink)

While the Web Ontology Language (OWL) provides a mechanism to import ontologies, this mechanism is not always suitable. Current editing tools present challenges for working with large ontologies an...

The existence of free will has been both an enduring presumption of Western culture and a subject for debate across disciplines for millennia. However, little empirical evidence exists to support the almost unquestioned assumption that, in general, Westerners endorse the existence of free will. The few studies that measure belief in free will have methodological problems that likely resulted in underestimating the true extent of belief. Recently, Rakos et al. (Behavior and Social Issues 17:20–39, 2008 ) found a stronger endorsement (...) of free will when demand characteristics were eliminated. The current study builds on this work by sampling incarcerated adolescents and adults, whose freedom to act is externally constrained. Belief in free will as well as attitudes toward punishment, self-esteem, and locus of control were measured. The results indicate that free will is strongly endorsed in Western society even when freedom to act is severely restricted. However, incarcerated adolescents endorsed free will to a slightly lesser extent than their nonincarcerated counterparts from Rakos et al. (Behavior and Social Issues 17:20–39, 2008 ), while incarcerated and nonincarcerated adults offered equally strong endorsements. The comparable endorsement by adults is consistent with the hypothesis that the belief in agency is an evolutionary adaptation. The small decrease found for incarcerated adolescents may reflect the interaction between developmental factors and the expression of an evolutionary adaptation. Additionally, incarcerated adolescents and adults associated beliefs in free will with viewing punishment as a means of deterrence, rehabilitation, and retribution. Incarcerated adults, but not incarcerated adolescents, associated beliefs in free will with greater self-esteem and with an external locus of control. Finally, though both incarcerated adults and adolescents endorsed free will strongly, the former manifested the belief by emphasizing free agentic choice whereas the latter focused on the personal responsibility that is interwoven with free choice. The implications of these findings are discussed in the context of evolutionary, cultural, and developmental factors. (shrink)

Skene and Parker are demonstrably mistaken in suggesting that the amicus role of Catholic bishops in three cases has been concerned with “developing” the law. In contrast with Skene and Parker’s freestanding conception of legal principle, the Catholic understanding of law’s rational moral foundations has permitted Catholic bishops to defend longstanding legal principle as well as defending the integrity of the church’s health care and welfare services. It is shown that in the three cases under discussion Catholic bishops (...) were providing needed argument otherwise unavailable to the courts in defence of existing statute. In face of the attempts by pressure groups to bypass the legislature and use the courts to subvert fundamental legal principles, the church is perhaps uniquely capable of continuing to provide to the courts rational defences of those principles. (shrink)

In their response, The role of the church in developing the law: response to commentators, Professors Skene and Parker make a number of criticisms of my commentary, some contestable, some plainly mistaken.1Their first criticism is that I am “incorrect” and “misleading” in describing the New South Wales Crimes Act as “[a] statute which provided that abortion was a criminal offence”. They give as their reason that: “The criminal offence created by section 83 of the Crimes Act 1900 is not (...) abortion. It is unlawful abortion. Because the word ‘unlawfully’ appears in the act, it is clear that the law states that it is sometime lawful to undertake an abortion.” They then explain the interpretation of the cognate provision in the Victorian legislation provided by Justice Menhennit in R v Davidson [1969] VR 667.The reason they offer for their criticism fairly summarises the moves made by Macnaghten J in his direction in R v Bourne and by Menhennit J in R v Davidson. But it is far from “clear” that the use of the word “unlawfully” supports those moves. It was and remains a matter of real controversy whether the use of the expression “unlawfully” has the meaning which Menhennit J attached to it.Section 83 of the Crimes Act provided:"Whosoever—unlawfully administers to, or causes to be taken by, any woman, whether with child or not, any drug or noxious thing; or unlawfully uses any instrument or other means, with intent in any such case to procure a miscarriage, shall be liable to penal servitude for ten years."Consider that provision alongside other provisions in the Crimes Act 1900 which also make use of the term …. (shrink)

Abstract I provide an account of the nature of seemings that explains why they are necessary for justification. The account grows out of a picture of cognition that explains what is required for epistemic agency. According to this account, epistemic agency requires (1) possessing the epistemic aims of forming true beliefs and avoiding errors, and (2) having some means of forming beliefs in order to satisfy those aims. I then argue that seeming are motives for belief characterized by their role (...) of providing us with doxastic instructions guided by our epistemic aims. Understanding the nature of seemings allows us to underwrite recent epistemological work by Michael Huemer, and shows why he was right to claim that seemings are the source of all justification. I then look at some objections both to my arguments regarding the connection between seemings and justification, and to Huemer’s related “Principle of Phenomenal Conservatism”. Content Type Journal Article Pages 1-21 DOI 10.1007/s11098-011-9830-2 Authors Matthew Skene, Syracuse University, 8330 E. Quincy Ave., I-307, Denver, CO 80237, USA Journal Philosophical Studies Online ISSN 1573-0883 Print ISSN 0031-8116. (shrink)

The availability of willing providers of medical assistance in dying in Canada has been an issue since a Canadian Supreme Court decision and the subsequent passing of federal legislation, Bill C14, decriminalised MAiD in 2016. Following this legislation, Hamilton Health Sciences in Ontario, Canada, created a team to support access to MAiD for patients. This research used a qualitative, mixed methods approach to data collection, obtaining the narratives of providers and supporters of MAiD practice at HHS. This study occurred at (...) the outset of MAiD practice in 2016, and 1 year later, once MAiD practice was established. Our study reveals that professional identity and values, personal identity and values, experience with death and dying, and organisation context are the most significant contributors to conscientious participation for MAiD providers and supporters. The stories of study participants were used to create a model that provides a framework for values clarification around MAiD practice, and can be used to explore beliefs and reasoning around participation in MAiD across the moral spectrum. This research addresses a significant gap in the literature by advancing our understanding of factors that influence participation in taboo clinical practices. It may be applied practically to help promote reflective practice regarding complex and controversial areas of medicine, to improve interprofessional engagement in MAiD practice and promote the conditions necessary to support moral diversity in our institutions. (shrink)

In debates about the proper analysis of demonstrative expressions, ostensive gestures and speaker intentions are often seen as competing for primary importance in securing reference. Underlying some of these debates is the mistaken assumption that ostensive gestures always make the demonstrated object maximally salient to interlocutors. When we abandon this assumption and focus on an object’s mutually-recognized salience itself, rather than on how the object came to be salient, we can work towards a more promising analysis with a uniform treatment (...) of demonstrative reference whether or not there is an ostensive gesture, and whether reference is ordinary or deferred. (shrink)

Within the class of indexicals, a distinction is often made between “pure” or “automatic” indexicals on one hand, and demonstratives or “discretionary” indexicals on the other. The idea is supposed to be that certain indexicals refer automatically and invariably to a particular feature of the utterance context: ‘I’ refers to the speaker, ‘now’ to the time of utterance, ‘here’ to the place of utterance, etc. Against this view, I present cases where reference shifts from the speaker, time, or place of (...) utterance to some other object, time, or place. I consider and reject the claim that these counterexamples to the automatic indexical theory all involve non-literal uses of indexicals and argue that they cannot be explained away on the grounds that they involve conversational implicature or pretense. (shrink)

There is an expectation that all researchers will act ethically and responsibly in the conduct of research involving humans and animals. While research ethics is mentioned in quality indicators and codes of responsible researcher conduct, it appears to have little profile in doctoral assessment. There seems to be an implicit assumption that ethical competence has been achieved by the end of doctoral candidacy and that there is no need for candidates to report on the ethical dimensions of their study nor (...) for examiners to assess this integral aspect of researcher development. In the context of ensuring that institutions are fulfilling their responsibility of producing ethically sensitive and competent researchers, it is salient to investigate whether doctoral thesis examiners make comment about ethical issues in their reports. This study analysed an archive of examiner reports to identify the frequency, magnitude and nature of examiner comment about ethics. Although comment was rare examiners provided: prescriptive instruction on ethical review processes; formative instruction on the design, conduct, and reporting of research projects; and positive or negative judgments about a candidate's ethical competence, the latter often aligned with meeting, or not meeting, 'doctoral standards'. The scarcity of ethics in examination criteria and examiner reports implies a silence that needs to be addressed to ensure graduating candidates are prepared to conduct ethical and responsible research. (shrink)

This article analyses the recent controversy over single and lesbian women’s right to access reproductive technology. It focuses on the McBain case in relation to the Sex Discrimination Act. As well, it attempts to bring voices that have been ignored into the debate, and reflect on the values that they express.

Fashion design is a feminized occupation, but there is a widespread perception that gay male designers are advantaged in receiving awards, publicity, and praise. This article develops the notion of a “glass runway” to explain this inequality. First, using design canons and lists of award recipients, I show that men, especially gay men, receive more consecration than women. Second, I show how men and women are consecrated differently by analyzing the content of 157 entries in Voguepedia’s design canon and 96 (...) fashion media articles. Attributions of value and legitimacy construct a gendered image of the ideal fashion designer through discourses of art and culture that reinforce essentialist ideas about gender difference. Because cultural value is ambiguous, processes of valorization are shaped by gender essentialism, pushing male cultural producers down the glass runway and into the spotlight of fame, consecration, and legitimation. Finally, the case of fashion design offers insights into how intersecting inequalities can shape the glass runway. Gay designers experience both valorization and discrimination from intersections of gender and sexuality. (shrink)

When new laws are being considered to regulate emerging technologies, it is common to engage in a formal consultation process to assess community views, especially in sensitive areas where views may differ widely. However, it is not clear how we should assess the responses to such consultation. If the respondents with the most extreme views, at either end of the political or ethical spectrum, speak in large numbers or strong language, their submissions surely cannot be added up and given the (...) weight of the majority in determining the course of future action. The ‘silent majority’ of the community may not participate in the consultation process at all. Even if they do participate more fully, it will often not be possible to find a compromise solution that offers something to everyone.Professor Charlesworth considered these issues in his ground-breaking book, Bioethics in a Liberal Society. He said that there are some issues on which community consensus on a core set of values will not be possible. To move forward, a liberal society must accept that there will be a range of views but however discordant those views appear to be, it may still be possible to identify matters on which there is agreement. Those matters may then form the basis of a policy that is widely accepted, even if it is not what the individual participants would have chosen initially. This approach may be illustrated by examining recent community consultation in Australia concerning research involving human embryos. (shrink)

It is commonly said that patients have no right to demand that treatment must be continued when medical carers believe it is “futile” to continue it. There are certainly many judicial statements to this effect, some of which are quoted in this paper. However, there are various ways that courts can intervene, even if they do not order directly that treatment must be provided or continued. First, patients or their representatives may argue the process of decision making was unfair or (...) that they were unfairly discriminated against when treatment has been refused. To date, these arguments have met with limited success so far as enabling patients to have treatment provided or continued against medical advice. More recently, however, some patients have challenged the lawfulness of a proposed treatment regime by advancing human rights arguments, based in turn on a broader aspect of patients’ “best interests” than best medical interests. (shrink)

This paper outlines the current common law principles that protect people’s interests in their bodies, excised body parts and tissue without conferring the rights of full legal ownership. It does not include the recent statutory amendments in jurisdictions such as New South Wales and the United Kingdom. It argues that at common law, people do not own their own bodies or excised bodily material. People can authorise the removal of their bodily material and its use, either during life or after (...) their death, for medical or scientific purposes. Researchers who acquire human bodies, body parts or tissue pursuant to such an authority have a right to possess and use them according to the authorisation they have been given, but their rights fall short of full ownership because they are limited in the way that they can use the material. The legal rights of researchers who develop intellectual property and biological products from excised human tissue can be adequately protected by existing common law principles without the need for a new legal principle that people own body parts and tissue removed from their bodies. (shrink)

This paper describes a half-day class for 200 first year medical students. It is designed like a conference and is intended to raise students’ awareness of legal issues that arise in everyday practice. It uses the Problem Based Learning approach of event-focus, student-guided learning and student teachers. There are three parts.

Recent work has demonstrated that academic research faces serious challenges. Incentives to defend publishable ideas often lead researchers astray. Despite their tendency to produce error, efforts to publish erroneous results typically help a researcher's career. In addition, errors often arise from seemingly innocent methodological assumptions that allow researchers to believe their research is sound. This article discusses this research, as well as research into difficulties facing epistemic rationality caused by nonepistemic incentives. It then applies the lessons of this research to (...) philosophical practice. It explains why philosophy likely suffers from these problems. It then provides an example of a widely shared methodological assumption that allows such research to be pursued and regularly published. It claims that the significance philosophers place on arguments is inappropriate, and that typical evaluations of philosophical arguments involve an instance of the base-rate fallacy. It concludes by discussing whether or not this article is self-defeating. (shrink)

Church leaders often express views on political issues and there is no objection to them doing so. However, when they direct members of Parliament on how they should vote on particular issues and intervene in litigation between private individuals, they contravene the long accepted principle of separation between church and state. That principle was formally acknowledged by Pope Benedict XVI in his most recent Encyclical Letter. The author will give examples of cases in which she believes the Roman Catholic Church (...) has overstepped the mark in intervening in the business of the state. (shrink)

The approach of the courts when considering proprietary interests in human bodily material has been pragmatic and piecemeal. The general principle was initially that such material is not legally ‘property’ that can be ‘owned’, but courts have recognised many exceptions. In determining disputes between individuals in particular cases, they have stated principles that are often inconsistent with those stated in other cases with different facts. Later judges have been constrained by these decisions, especially when made at appellate level. They can (...) distinguish the facts of one case from another to achieve a different outcome, but they cannot state new principles to be applied more widely to promote consistency. This requires the will of Parliament and legislation to introduce new principles. Experience to date suggests that such legislation will need to be wide-ranging and complex, with different principles for different circumstances. There will not be one area of law that answers all the issues that arise. (shrink)

Core indexicals like ‘I’, ‘here’, and ‘now’ sometimes appear to refer to an object, place, or time other than the speaker, location, or time of utterance. This presents well-known problems for Kaplan's view, which treats reference shifting as a violation of the character rules that give the meaning of indexicals. I propose a view according to which indexical reference is essentially a matter of the mutually-accepted perspective of interlocutors. It follows that contexts need not be ‘proper’ in Kaplan's sense, and (...) a successful convergence of perspectives is needed for indexical reference to succeed. I provide reasons for embracing these conclusions. (shrink)

There have long been calls from industry for guidance in implementing strategies for sustainable development. The Circular Economy represents the most recent attempt to conceptualize the integration of economic activity and environmental wellbeing in a sustainable way. This set of ideas has been adopted by China as the basis of their economic development, escalating the concept in minds of western policymakers and NGOs. This paper traces the conceptualisations and origins of the Circular Economy, tracing its meanings, and exploring its antecedents (...) in economics and ecology, and discusses how the Circular Economy has been operationalized in business and policy. The paper finds that while the Circular Economy places emphasis on the redesign of processes and cycling of materials, which may contribute to more sustainable business models, it also encapsulates tensions and limitations. These include an absence of the social dimension inherent in sustainable development that limits its ethical dimensions, and some unintended consequences. This leads us to propose a revised definition of the Circular Economy as “an economic model wherein planning, resourcing, procurement, production and reprocessing are designed and managed, as both process and output, to maximize ecosystem functioning and human well-being”. (shrink)

Effective applications of fMRI to human problems should be valid and helpful. For valid use of fMRI, there should be evidence from multiple sources that there is a relationship between a brain syst...

The present work proposes a reading about the text “The Narrator ” written in 1936, by Walter Benjamin, a commissioned text where he deals with the Art of Narrating and how its conceptual bias innovates/clarifies the modern view on this form of knowledge. We will show the main ideas contained in the author's work, through his reading, and seek at the end a formulation of a critical hermeneutic thought constant in the work. It is not a matter of giving new (...) foundations, concepts or clarifications contained in the work, but purely analyzing what the author proposed. (shrink)