Clinical Ethics Consultation (CEC) aims to resolve ethical dilemmas at the bedside. Through a structured process, CEC allows practitioners and patients to consult ethicists at times of moral conflict or uncertainty. Over the past few decades, CEC has become an invaluable part of healthcare practice. In Saudi Arabia, however, CEC services remain inexplicably underutilized. This study attempts to understand the factors associated with Saudi physicians’ utilization of CEC to better meet the needs of practitioners and patients. Results indicate that although (...) physicians routinely experience moral dilemmas, they seldom request a CEC. This is not due to unfamiliarity, lack of accessibility, or suspicion of ethical expertise. Rather, reluctance is likely due to an ingrained medical cultural stronghold that pressures practitioners to act heroically, and to resolve ethical dilemmas independently. Recommendations to improve the utilization of CEC services include wider availability, active collaborations with clinical practitioners, routine quality improvements, and managerial and national support. (shrink)

Open theists argue that God's relationship to time, as conceived in classical theism, is erroneous. They explain that it is contradictory for an atemporal being to act in a temporal universe, including experiencing its temporal successions. Contrary to the atemporalists, redemptive history has shown that God interacts with humans in time. This relational nature of God nullifies the classical notion of God as timelessly eternal. Therefore, it lacks a philosophical and theological basis. Because God is in time, He does not (...) know all future contingencies and, therefore, changes. This study examines open theism's appropriation of the A and B theories of time to the divine-human relationship. The study argues that divine temporality does not solve the tension of divine-human relationships, especially in relation to the future. Further, historical divine temporality does not negate the fact of divine atemporality. It mainly stems from God's choice to create temporal creatures and His relationship with them. Furthermore, if it is not logically and metaphysically contradictory for an omnipresent being to act in space, then it follows that an atemporal being can act in time. Whether time is understood from the metric or psychological point of view, it does not transcend God, and therefore, the limitation it places on human creatures with respect to the future does not apply to God. Lastly, although a few philosophers reject the notion of eternity as timelessly eternal, the doctrine has a philosophical and theological basis in the Scripture. (shrink)

Despite drives’ importance for Nietzsche’s explanation of individuals’ values, controversies persist over how to interpret Nietzsche’s attribution of normative capacities to the drives themselves. On one reading, drives evaluate their aims and recognize the normative authority of other drives’ aims. On another, drives’ normative properties reduce to nonnormative, causal properties. Neither approach is satisfying. The former commits Nietzsche to the homuncular fallacy by granting drives complex cognitive capacities. The latter reading either commits Nietzsche to the naturalistic fallacy, having him derive (...) normative conclusions from descriptive premises, or eliminates normativity from his thought altogether. In response to this impasse, this article advances a Leibniz-informed interpretation of Nietzsche’s drive psychology. By construing the normative and efficient causal orders as parallel modes of explanation distinguished by one’s perspective, a Leibniz-informed reading captures the benefits of extant interpretations while avoiding their drawbacks. (shrink)

David Chalmers appears to assume that we can meaningfully discuss what goes on in human heads without paying any attention to the words in which we couch our statements. This paper challenges this assumption and argues that the initial problem is that of metalanguage: if we want to say something clear and valid about us humans, we must think about ourselves outside conceptual English created by one particular history and culture and try to think from a global, panhuman point of (...) view. This means that instead of relying on untranslatable English words such as 'consciousness' and 'experience' we must try to rely on panhuman concepts expressed in cross-translatable words such as THINK, KNOW, and FEEL (Wierzbicka, 2018). The paper argues that after 'a hundred years of consciousness studies' it is time to try to say something about us (humans), about how we think and how we differ from cats and bats, in words that are clear, stable, and human rather than parochially English. (shrink)

From the diverse work and often competing insights of women's human rights activists, Brooke Ackerly has written a feminist and a universal theory of human rights that bridges the relativists' concerns about universalizing from particulars and the activists' commitment to justice. Unlike universal theories that rely on shared commitments to divine authority or to an 'enlightened' way of reasoning, Ackerly's theory relies on rigorous methodological attention to difference and disagreement. She sets out human rights as at once a research ethic, (...) a tool for criticism of injustice and a call to recognize our obligations to promote justice through our actions. This book will be of great interest to political theorists, feminist and gender studies scholars and researchers of social movements. (shrink)

The growing gap between demands and resources is putting immense pressure on all government spending in Sweden. The gap is especially apparent in care and services for elderly people in light of the rapid aging of the population. The article considers the decisions and priorities concerning resource allocation in the welfare sector in general and in elderly care in particular. The aim is to describe the political and administrative setting and to provide a conceptual structure that outlines the nature of (...) the problem. Various levels of decision making are identified and discussed in the context of political accountability. Current transitions in elderly care are described with respect to service provision, marketisation, coverage rates, and eligibility standards. Basic principles of distribution are highlighted in order to clarify some central concepts of efficiency and justice, and a number of strategies for actual prioritising are identified. The article concludes with an endorsement of more conscious decisions in resource allocation. Existing knowledge and information concerning the effects of various strategies must be utilised, and the values and assumptions used for setting priorities must be made explicit. (shrink)

Robert Veatch has proposed a model of the doctor-patient relationship that has as its foundation the sharing of values between the doctor and the patient. This paper uses qualitative research conducted with six doctors involved in the long term, specialised care of HIV positive patients in South Australia to explore the practical application of Veatch’s value sharing model in that setting. The research found that the doctors in this study linked “values” with sexual identity such that they defined value sharing, (...) in part, as a shared set of values and beliefs about sexual identity and practices. They voluntarily identified themselves as either homosexual or heterosexual and they regarded the relation between their own sexual identity and that of their patients as important for the provision of quality care. None of the doctors thought that value sharing, in the way they defined it, was essential to the clinical relationship, but the homosexual doctors attributed a greater degree of importance to it than their heterosexual colleagues. (shrink)

IN A recent work I have attempted to show that visual space tends to have a Euclidean geometrical structure only when the environment is filled with a repetitive pattern of regularly faceted objects carpentered to exhibit simple standard Euclidean shapes, and tends to have a hyperbolic structure when vision is deprived of these clues. I conclude that visual perception--and by analogy, all perception--is hermeneutic as well as causal: it responds to structures in the flow of optical energy, but the character (...) of its response is also hermeneutical, that is, it has the capacity to "read" the appropriate structures in the World, and to form perceptual judgments of the World about which these "speak." The clues that are "read" perceptually as giving a Euclidean visual space are engineered objects, such as streets and buildings with repetitive architectural elements. These scientific artifacts of human culture belong to a family of readable technologies central to the phenomenological and existential-hermeneutical analysis of natural science. (shrink)

In recent years attention to the philosophical and literary production of P. A. Florenskii has become commonplace. The thinker's intellectual legacy is very great. In September 1919, Florenskii wrote a prospectus for a collection of his own writings, which would have amounted to nineteen volumes. The collection was not published, for a number of reasons; nonetheless, many of the philosopher's works did come out during his lifetime. Florenskii's writing, published in small editions and scattered among various journals, are still quite (...) inaccessible to readers. (shrink)