Background In Switzerland, right-to-die organisations assist their members with suicide by lethal drugs, usually barbiturates. One organisation, Dignitas, has experimented with oxygen deprivation as an alternative to sodium pentobarbital. Objective To analyse the process of assisted suicide by oxygen deprivation with helium and a common face mask and reservoir bag. Method This study examined four cases of assisted suicide by oxygen deprivation using helium delivered via a face mask. Videos of the deaths were provided by the Zurich police. Dignitas provided (...) protocol and consent information. Results One man and three women were assisted to death by oxygen deprivation. There was wide variation in the time to unconsciousness and the time to death, probably due to the poor mask fit. Swiss law prevented attendants from effectively managing the face mask apparatus. Purposeless movements of the extremities were disconcerting for Dignitas attendants, who are accustomed to assisting suicide with barbiturates. None of the dying individuals attempted self-rescue. Conclusions The dying process of oxygen deprivation with helium is potentially quick and appears painless. It also bypasses the prescribing role of physicians, effectively demedicalising assisted suicide. Oxygen deprivation with a face mask is not acceptable because leaks are difficult to control and it may not eliminate rebreathing. These factors will extend time to unconsciousness and time to death. A hood method could reduce the problem of mask fit. With a hood, a flow rate of helium sufficient to provide continuous washout of expired gases would remedy problems observed with the mask. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:F. R. Leavis (Modern Cultural Theorists)Stephen OgdenF. R. Leavis (Modern Cultural Theorists), by Anne Samson; x & 196 pp. Toronto: University of Toronto Press, 1992, $45.00 cloth, $16.95 paper.If it is an overstatement to say that the waves of change currently disturbing the teaching of English in universities originated from the splash made by F. R. Leavis at Cambridge beginning in 1933, Anne Samson’s account of the theorist’s (...) influence scarcely admits it. Her chapter titles—“Leavis and the Growth of English Studies,” “English as a University Subject,” “Literary ‘Theory’ and Constituting the Canon”—indicate not only the range of issues connected with F. R. Leavis’s name but also his significant involvement in their genesis.Samson’s book portrays Leavis as the efficient cause in the establishment of university English as a critical, or more accurately a diagnostic, enterprise. At an early professional cost (he was denied faculty appointment at Cambridge for five years), Leavis helped cut English curricula free from philology, languages, and classical studies; a responsibility Samson partially excuses by connecting Leavis’s motivating principles back through Matthew Arnold to Dickens and Carlyle and even to one “Reverend H. J. Rose, a leading figure in the founding of King’s College, London... declaring in a sermon delivered in 1826 that literature teaches ‘the wisdom of men better and wiser than ourselves’ and prepares for the ‘examination of those moral and intellectual truths which are not only the worthiest exercise of our reason, but most concern our future destiny’” (p. 12).This moralism Samson sees as the central and redeeming principle in Leavis’s system. Specifically, she identifies the Condition of England debate—over the state of culture and economics in a “‘technologico-Benthamite world’” (p. 63)—as the key to Leavis’s literary criticism, his influential journal Scrutiny, and his wide-ranging reform endeavors. “Literature mattered to Leavis because he believed it to be the means, above all others, of combating the ills of a mechanised, constantly changing world and of restoring the heritage of those dispossessed by the machine” (p. 3).Professionally asserting the primacy of criticism over scholarship, then in his writings making no distinction between the literary and the social, Leavis ultimately refused any separation between literature and life. Samson carefully [End Page 360] traces this development in Leavis’s general theory in order to bring out its easily-overlooked implication for the social position of a literary academic. She quotes this crucial passage from Leavis: “The critic... is as much concerned with the health of the mind as any doctor with the health of the body. To set up as a critic is to set up as a judge of values... For the arts are inevitably and quite apart from any intentions of the artist an appraisal of existence” (pp. 15–16). No longer a mere scholar, or the type of irrelevant empiric Leavis so hated in the person of C. P. Snow, the Leavisite theorist is the grand physician diagnosing all society’s ills. Literary artists and their writings, so far from forming the most important part of literature, become perfectly irrelevant—“quite apart”—with the medicocritic prescribing universally “of existence.”Samson’s treatment of Leavis is analytical, though enjoyably and consistently biographical. For instance, her final, and largest, chapter shows the moralist model of the literary critic (the “judge of values”) in action by detailing the history of Leavis’s complete reversal of estimation between T. S. Eliot and D. H. Lawrence. Leavis originally gave Eliot “hero-worship” (p. 162) and dismissed Lawrence as “mechanical” (p. 157). But concurrent with Eliot’s progress to Anglo-Catholicism, Leavis’s moral judgments overturned and, true to type, he increasingly censured Eliot’s writings by diagnosing problems in the man, while he grew to idolize Lawrence; ironically for “rescuing life from... inner mechanisation” (p. 169).Such inconstancy, here expressed in every word, Samson sees as an historical mark of character which places Leavis among the “Great Men of Ideas” (p. 172).Stephen OgdenSimon Fraser UniversityCopyright © 1995 The Johns Hopkins University Press... (shrink)

We report the results of a randomized trial to assess the impact of an innovative ethics curriculum on the knowledge and confidence of 85 medical house officers in a university hospital programme, as well as their responses to a simulated clinical case. Twenty-five per cent of the house officers received a lecture series, 25 per cent received lectures and case conferences, with an ethicist in attendance, and 50 per cent served as controls. A post-intervention questionnaire was administered. Knowledge scores did (...) not differ among the groups. Confidence regarding ethical issues was significantly greater in the aggregate intervention group compared to the control group. Confidence regarding procedural issues related to ethics was significantly higher for the EI group than for the controls. Responses to a simulated case showed that significantly fewer house officers in the EI group would intubate a patient for whom such therapy would be futile. We conclude that ethics education can have an impact on house officers' confidence and their responses to a simulated case, and that the EI was more effective than the LI. Such results have implications regarding the implementation of ethics education during residency. (shrink)

We show there is only one consistent way to update a probability assignment, that given by Bayes's rule. The price of inconsistent updating is a loss of efficiency. The implications of this for the problem of induction are discussed.

Requests by patients or their families for treatment which the patient's physician considers to be "inappropriate" are becoming more frequent than refusals of treatment which the physician considers appropriate. Such requests are often based on the patient's religious beliefs about the attributes of God (sovereignty, omnipotence), the attributes of persons (sanctity of life), or the individual's personal relationship with God (communication, commands, etc). We present four such cases and discuss some of the basic religious tenets of the three Abrahamic faith (...) traditions as they relate to such requests. We suggest that religious reasons for requesting "inappropriate" treatment are "special" and deserve serious consideration. We offer guidance to assist clinicians and clinical ethicists as they attempt to resolve these conflicts, emphasising the importance of understanding the religious beliefs of the patient/surrogate and suggesting the assistance of a religious interpreter. We suggest open discussion with patients and families of both the clinical situation and the theological basis for these requests. We also suggest that clinicians use additional religious doctrines or principles from patients' own traditions to balance the reasons behind the requests. We conclude that most persistent requests for "inappropriate" treatment should be honoured. (shrink)

Professor R. J. Getty has drawn attention to a tenth- or early eleventh-century manuscript of Statius’ Thebaid, hitherto examined only in Book I, namely Turonensis . Dr. Klotz, in his Teubner edition of 1908, gave citations from Book I, and wrote , ‘dolendum est sane de hoc codice primum tantum librum innotuisse, sed cum Roffensis libri maxime affinis accuratiorem notitiam haberemus, collatione quamvis -aegre careri posse nobis visum est.’ I have collated both T and Roffensis in full, and find firstly (...) that the citations of r by Klotz are far from accurate, especially in the last six books, and secondly that while it is indeed true thatT and r are very closely related, T is a much better representative than r of their common source. (shrink)

Responding to the interlocutors, Ricoeur, utilizing Kantian aesthetic theory, addresses the nature of the work of art, its universality and communicability, and explores its temporality — its ‘transhistoricity’ — by utilizing concepts derived from medieval philosophy, including ‘sempiternality’ and ‘monstration’. He expands on hermeneutics, defends it against charges of relativism, expatiates on the danger of aestheticism, and explains the value of mimesis in art. He explores the different art forms, focusing with Merleau-Ponty on Cézanne as a model of the ‘ipseity’ (...) of the artist; and he dwells particularly on the singularity of music and its ‘pathic’ moods. A discussion of literature culminates in an emphasis on the special importance of Holocaust texts. (shrink)

It has been alleged that Bayesian usage of prior probabilities allows one to obtain empirical statements on the basis of no evidence whatever. We examine this charge with reference to several examples from the literature, arguing, first, that the difference between probabilities based on weighty evidence and those based on little evidence can be drawn in terms of the variance of a distribution. Moreover, qua summaries of vague prior knowledge, prior distributions only transmit the empirical information therein contained and, therefore, (...) their consequences for long-run frequency behavior are "a priori" in at best a Pickwickian sense. (shrink)

In Nazi Germany, approximately 200 000 mentally ill people were murdered under the guise of euthanasia. Relatively little is known regarding the fate of the Jewish mentally ill patients targeted in this process, long before the Holocaust officially began. For the Nazis, Jewish mentally ill patients were doubly cursed since they embodied both “precarious genes” and “racial toxin”. To preserve the memory of the victims, Yad Vashem, the leading institution dedicated to documentation of the Holocaust, actively collects information and documents (...) the fate of victims in an open online database. Recently, a list of approximately 1200 names of Jewish mentally ill euthanasia victims has been compiled from hospital archives. Their fate remains unknown to surviving family members. Given the duty to preserve medical confidentiality, can this list be publicised for public interest and for notifying families—publicising names and death circumstances, including where “killed” would immediately indicate that the person had had a mental illness? Does the right to medical confidentiality lapse upon death? Is time elapsed since death a factor? Can opposing obligations of preserving victims’ memory over-ride medical confidentiality? What if a family member objects to a grandparent’s name being exposed on the list of mentally ill patients? This article considers these issues as well as the “rational” and “non-rational” factors in ethical decisional making surrounding this unique dilemma. Several possible solutions are proposed including preserving the list in a locked database for access by families and researchers, publicising in the media that such a list exists, publishing the information online without any identifiers and submitting the information to historians, allowing them to process the data as they see fit. (shrink)

XLRI, in association with a few Tata Group companies, established the XLRI-JRD Tata Foundation in Business Ethics in 1991 to mark their long-standing commitment and contribution to business ethics in India. The foundation seeks to address this by publicly affirming the urgent need for ethics in business and the need to bring about a conducive culture in which it can thrive.