Patients who are dying of cancer usually give up eating and then stop drinking. This raises ethical dilemmas about providing nutritional support and fluid replacement. The decision-making process should be based on a knowledge of the risks and benefits of giving or withholding treatments. There is no clear evidence that increased nutritional support or fluid therapy alters comfort, mental status or survival of patients who are dying. Rarely, subcutaneous fluid administration in the dying patient may be justified if the family (...) remain distressed despite due consideration of the lack of medical benefit versus the risks. Some cancer patients who are not imminently dying become dehydrated from reversible conditions such as hypercalcaemia. This may mimic the effects of advanced cancer. These conditions should be sought and fluid replacement therapy should be given along with the specific treatments for the condition. (shrink)

A unifying theory of general anesthetic-induced unconsciousness must explain the common mechanism through which various anesthetic agents produce unconsciousness. Functional-brain-imaging data obtained from 11 volunteers during general anesthesia showed specific suppression of regional thalamic and midbrain reticular formation activity across two different commonly used volatile agents. These findings are discussed in relation to findings from sleep neurophysiology and the implications of this work for consciousness research. It is hypothesized that the essential common neurophysiologic mechanism underlying anesthetic-induced unconsciousness is, as with (...) sleep-induced unconsciousness, a hyperpolarization block of thalamocortical neurons. A model of anesthetic-induced unconsciousness is introduced to explain how the plethora of effects anesthetics have on cellular functioning ultimately all converge on a single neuroanatomic/neurophysiologic system, thus providing for a unitary physiologic theory of narcosis related to consciousness. (shrink)

R. J. Hankinson traces the history of ancient Greek thinking about causation and explanation, from its earliest beginnings through more than a thousand years to the middle of the first millennium of the Christian era. He examines ways in which the Ancient Greeks dealt with questions about how and why things happen as and when they do, about the basic constitution and structure of things, about function and purpose, laws of nature, chance, coincidence, and responsibility.

This article presents the new German law on advance directives from 1 September 2009. The history of the parliamentary process of this law is described, the present regulations are explained, their relevance for medical practice discussed and shortcomings are identified. Finally, the new law is compared with other regulations in the international context. Previously established legal practice in Germany has now become largely confirmed by the new law: An advanced directive must be respected in any decision concerning medical treatment, regardless (...) of the stage of the illness. It can be informally revoked at any time, even with limited decision-making capacity. Nobody may be obliged to issue a directive in any way. Advance directives do not need notarisation or routine updating after certain time intervals. Provided that the patient, who is no longer mentally competent, has issued a lasting power of attorney, or provided that the patient has been appointed a healthcare proxy by the courts, this authorised surrogate must assert the patient's will. The role of the guardianship court is clarified: it only needs to be involved in cases of disagreement as to the patient's will. The new German law thus combines more legal certainty with a liberal emphasis on patient autonomy and flexible, adaptable regulations. (shrink)

This is a new release of the original 1960 edition.

In our pursuit of a good life (eubios), both individuals and societies, need to educate themselves on the pursuit of love of life in all domains, self-love, love of others, loving good and love of life. In this paper I reflect on my own journey through growing up in Christchurch, and experiences around the world, that are the basis for that conclusion. In our efforts to pursuit bioethics education we can enhance peaceful and harmonius coexistence in our world, through nurturing (...) good decisions that we should all make. (shrink)

The four short works in Untimely Meditations were published by Nietzsche between 1873 and 1876.They deal with such broad topics as the relationship between popular and genuine culture, strategies for cultural reform, the task of philosophy, the nature of education, and the relationship between art, science and life. They also include Nietzsche's earliest statement of his own understanding of human selfhood as a process of endlessly 'becoming who one is'. As Daniel Breazeale shows in his introduction to this new edition (...) of R. J. Hollingdale's translation of the essays, these four early texts are key documents for understanding the development of Nietzsche's thought and clearly anticipate many of the themes of his later writings. Nietzsche himself always cherished his Untimely Meditations and believed that they provide valuable evidence of his 'becoming and self-overcoming' and constitute a 'public pledge' concerning his own distinctive task as a philosopher. (shrink)

Sonja Plischke’s Die Seleukiden und Iran is an attempt to study Seleucid empire building in Iran. In view of the fact that indigenous written sources from Iran are practically absent, Plischke decided to include Babylonia in this work, since the written cuneiform evidence from that region is fairly abundant. She detects some general tendencies—such as religious policy and the general wish to connect the different parts of the empire—supported by a personal conception of Seleucid kingship, beside more specific treatment of (...) different regions. In my view, the Seleucids probably did not pay sufficient attention to the East, so that their control weakened. I take the opportunity to discuss the Babylonian sources, correct errors in Plischke’s use of them, and adduce some new publications. (shrink)

Ethics edifies to the extent it takes seriously the munus propheticum Jesu Christi. Though many assume ethical action indicates behaviour realising Jesus Christ, this is problematic because it implies he is otherwise mute and absent. Paul Lehmann offers a refreshing alternative when he argues that the principal concern of ethics is alignment with all that God in Christ is doing now to make and keep human life human. Lehmann thus recasts the question ‘What am I to do?’ by taking seriously (...) the presence and activity of the One who summons human beings to participate in his work. In a manner consistent with the christological foundations of Dietrich Bonhoeffer’s Ethics , Lehmann’s proposals evoke an ethic shaped by and subject to the self-disclosure and radiance of the triune God. (shrink)

Compact quantum systems have underlying compact kinematical Lie algebras, in contrast to familiar noncompact quantum systems built on the Weyl-Heisenberg algebra. Pauli asked in the latter case: to what extent does knowledge of the probability distributions in coordinate and momentum space determine the state vector? The analogous question for compact quantum systems is raised, and some preliminary results are obtained.

FAO has a unique and essential rolein addressing the ethical problems facinghumanity and in making these problems intoopportunities for practical resolution. A broadrange of ethical issues in agriculture,fisheries, and forestry were identified byanalysis of the literature and by interviewswith FAO staff. Issues include sharing accessto and preserving natural resources,introduction of new technology, conservatismover the use of genetic engineering, ethics inanimal agriculture, access to information, foodsecurity, sustainable rural development,ensuring participation of all people indecision making and in receiving benefits ofagriculture, reducing corruption, (...) andinvolvement of private and public sectors indecision making. Rather than viewing theseissues as problems, they should be viewed asopportunities for debate, learning aboutothers' views, and resolution. The UnitedNations has an important role to play in howdecisions are made in the global ethical debatein food and agriculture. The ethical role ofFAO is to promote global food security,balanced conservation, management andutilization of natural resources, andsustainable rural development. FAO should fullyand publicly assume its ethicalresponsibilities, gathering and sharinginformation on ethics in its areas of mandate,acting as an interactive forum, and providingexpert guidance on policy options and choicesbased on practical ethical analysis. (shrink)

Philosophy &Public Affairs, Volume 47, Issue 1, Page 72-103, Winter 2019.

_The Sceptics_ is the first comprehensive, up-to-date treatment of Greek scepticism, from the beginnings of epistemology with Xenophanes, to the final full development of Pyrrhonism as presented in the work of Sextus Empiricus. Tracing the evolution of scepticism from 500 B.C to A.D 200, this clear and rigorous analysis presents the arguments of the Greek sceptics in their historical context and provides an in-depth study of the various strands of the sceptical tradition.