bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE ARCHITECT AND THE BEE: SOME REFLECTIONS ON POSTMORTEM PREGNANCY
Authors: NELSON HILDE LINDEMANN 
Published: October 2007

ABSTRACTDo physicians have a duty to sustain the pregnancies of women who die during the first or second trimester? Physicians cannot simply assume that the woman would have wished the pregnancy to continue, nor (in the U. S., at any rate) is it clear that the state has any interest in fetal life before viability. The conditions for beneficence‐based duties of fetal rescue will often be unmet, both because sustaining the pregnancy is not always a clear gain to the born child and because it may impose a substantial burden on the benefactor. And duties of special relationship cannot readily be applied in these cases, as it is difficult to see how the relationship between someone who no longer exists and someone who does not yet exist can breed special duties. Further, to draw on Marx's distinction between the architect, who builds purposefully, and the bee, who cannot help what she is doing, I argue that human pregnancy is in a number of respects purposeful, creative, and deliberate, and that postmortem pregnancy, which follows the model of the bee, is a destructive icon that undercuts women's agency.
MEDICAL EXPERIMENTATION, INFORMED CONSENT AND USING PEOPLE
Authors: COCKING DE AN , OAKLEY JU STIN 
Published: October 2007

ABSTRACTIn this paper we argue that the standard focus on problems of informed consent in debates about the ethics of human experimentation is inadequate because it fails to capture a more fundamental way in which such experiments may be wrong. Taking clinical trials as our case in point, we suggest that it is the moral offence of using people as mere means which better characterizes what is wrong with violations of personal autonomy in certain kinds of clinical trials. This account also helps bring out another important way in which the autonomy of the participants in clinical trials my be violated, even in cases where they have given informed consent to their involvement. Where relevant information about the trial is framed in such a way as to induce a patient's participation by appeal to their nonrational preferences, this is also a violation of their autonomy, and one which is distinct from a failure of informed consent. The underlying wrongness of both kinds of violations, we argue, is plausibly captured by the moral offence of using people as mere means.
KILLING, LETTING DIE AND MORAL PERCEPTION
Authors: GILLETT GRANT 
Published: October 2007

ABSTRACTThere are a number of arguments that purport to show, in general terms, that there is no difference between killing and letting die. These are used to justify active euthanasia on the basis of the reasons given for allowing patients to die. I argue that the general and abstract arguments fail to take account of the complex and particular situations which are found in the care of those with terminal illness. When in such situations, there are perceptions and intuitions available that do not easily find propositional form but lead most of those whose practice is in the care of the dying to resist active euthanasia. I make a plea for their intuitions to be heeded above the sterile voice of abstract premises and arguments by examining the completeness of the outline form of the pro‐euthanasia argument. In doing so, I make use of Nussbaum's discussion of moral perception and general claims to be found in the literature of moral particularism.
VALUE THEORY AND THE BEST INTERESTS STANDARD1
Authors: DEGRAZIA DAVID 
Published: October 2007

AbstractThe idea of a patient's best interests raises issues in prudential value theory–the study of what makes up an individual's ultimate (nonmoral) good or well‐being. While this connection may strike a philosopher as obvious, the literature on the best interests standard reveals almost no engagement of recent work in value theory. There seems to be a growing sentiment among bioethicists that their work is independent of philosophical theorizing. Is this sentiment wrong in the present case? Does value theory make a significant difference in interpreting best interests? In pursuing this question, I begin with a quick sketch of broad kinds of value theories, identifying representatives that are plausible enough to count as contenders. I then explore what each account suggests in (1) neonatal treatment decisions, and (2) decisions for patients in persistent vegetative states. I conclude that while these accounts converge somewhat in their interpretations of best interests, they also have importantly different implications.
THE METAPHYSICS OF BRAIN DEATH
Authors: MCMAHAN JEFF 
Published: October 2007

AbstractThe dominant conception of brain death as the death of the whole brain constitutes an unstable compromise between the view that a person ceases to exist when she irreversibly loses the capacity for consciousness and the view that a human organism dies only when it ceases to function in an integrated way. I argue that no single criterion of death captures the importance we attribute both to the loss of the capacity for consciousness and to the loss of functioning of the organism as a whole. This is because the person or self is one thing and the human organism is another. We require a separate account of death for each. Only if we systematically distinguish between persons and human organisms will we be able to provide plausible accounts both of the conditions of our ceasing to exist and of when it is that we begin to exist. This paper, in short, argues for a form of mind‐body dualism and draws out some of its implications for various practical moral problems.
THE FIFTH FREEDOM
Authors: KINCAID‐SMITH PRISCILLA 
Published: October 2007

AbstractWomen in developing countries suffer considerable moribidity and mortality due to inability to control their own fertility and lack of access to family planning services. Over 500,000 deaths each year are related to pregnancy. Two thirds of these maternal deaths could be prevented by providing contraception to those women who wish to use it in developing countries. There is no tenable ethical defence of cultural and religious behaviour which denies a woman a choice as to whether she will undertake a pregnancy or not. Implementation of the principles of the programme ofactionfrom the 1994 Cairo Population Conference would, through empowering women to control their own fertility, have a huge impact on maternal health in the developing world.
THE NON‐IDENTITY PROBLEM AND GENETIC HARMS – THE CASE OF WRONGFUL HANDICAPS
Authors: BROCK DAN W. 
Published: October 2007

AbstractThe Human Genome Project will produce information permitting increasing opportunities to prevent genetically transmitted harms, most of which will be compatible with a life worth living, through avoiding conception or terminating a pregnancy. Failure to prevent these harms when it is possible for parents to do so without substantial burdens or costs to themselves or others are what J call “wrongful handicaps”. Derek Parfit has developed a systematic difficulty for any such cases being wrongs — when the harm could be prevented only by preventing the existence of the individual who would have a worthwhile life even with the handicap, then bringing him into existence with the handicap does not make him worse off and so does not wrong him. I argue that a non “person‐affecting” principle requiring the avoidance of suffering and limited opportunity correctly accounts for cases of wrongful handicaps without requiring that the individuals with the handicap have been made worse off and therefore wronged. It is an advantage, not a difficulty, of this account that it does not imply that the person with the handicap has been wronged or is a victim with a special moral complaint.
PATERNALISM AND THE ARGUMENT FROM ILLITERACY
Authors: LUNA FLORENCIA 
Published: October 2007

AbstractThroughout this essay, I will consider an argument frequently used to justify paternalistic behavior toward a specific class of persons: illiterate people. The argument states that illiterate people are uneducated, lack information and understanding, and are thus unable to make decisions. Therefore, it is argued, paternalism in their case is justified. The conclusion is that illiterate persons cannot be autonomous. The justification for this view is based on an a priori attitude: since it is impossible to communicate, physicians should decide which kind of treatment the illiterate patient should receive. This argument is frequently used even though its proponents may not be aware of its implications. Given the importance and uncritical acceptance this argument has in Argentina, and also in other Latin American countries, I think it is relevant to analyze carefully what it means. I propose a thorough analysis of this argument, of its implications and an evaluation of whether it is acceptable.
HIV +/AIDS RELATED BIOETHICAL ISSUES IN JAPAN
Authors: HOSHINO KAZUMASA 
Published: October 2007

AbstractAnnual and cumulative incidences of HIV + and AIDS in patients reported by the AIDS Surveillance Committee of the Ministry of Health and Welfare are cited to illustrate some characteristics in Japan: nearly 59% of either HIV + or AIDS patients were infected through injection of blood products or by blood transfusion. A number of plaintiffs have sued the Japanese government and pharmaceutical companies since 1989, but no judicial decisions have yet been made. The incidence of HIV decreases for each of the following routes of infection: the second highest route of transmission being heterosexual, followed by bisexual and unconfirmed or unknown cases, and less frequently homosexual, drug use and lastly via vertical transmission. The most serious bioethical problems with HIV + and AIDs patients in Japan is the social segregation of these patients. There are many emotional fears among the general public and medical personnel about AIDS because of their inadequate scientific knowledge of this disease. The Japan Hospital Association is doing The Stop AIDS Campaign and made several surveys. Japan has become increasingly aware of the importance of AIDS education and a great deal of effort is being made to enhance bioethical considerations.
FUTILITY AND THE OBLIGATIONS OF PHYSICIANS
Authors: WILSON BRADLEY E. 
Published: October 2007

ABSTRACTIt is becoming increasingly common (at least in the United States) for doctors to appeal to futility judgments as the basis for certain types of clinical decisions, such as the decision to withhold CPR. The clinical use of futility judgments raises two basic questions regarding futility. First, how is the concept of futility to be understood? Secondly, once we have a clearer understanding of futility, what role should determinations of futility play in clinical decision‐making? Much of the discussion about the concept of futility has centered on the value‐ladenness of futility judgments. I argue that futility determinations need to be distinguished from two other types of value‐based judgments, namely, identification of the goals of treatment and treatment decisions based on an assessment of the benefits and burdens of treatment. If this distinction is sound, it suggests a very limited role for futility determinations in clinical decisionmaking, a role which should serve to promote communication between doctor and patient.
WOMEN AND AIDS: THE ETHICS OF EXAGGERATED HARM
Authors: MERTZ† DAVID , SUSHINSKY† MARY ANN , SCHÜKLENK UDO 
Published: October 2007

ABSTRACTThis article examines the way in which some biomedical ethicists have constructed sexually transmitted AIDS as a significant threat to women's health. We demonstrate that the familiar claim that‘women are the fastest growing group'— whether of HIV‐infected or of AIDS patients — is misleading because it obscures the distinction between proportional rate of growth and absolute increase. Feminist ethicists have suggested that misogyny of a male dominated health care system has led to underreporting of women AIDS cases in order to support these feminists’claim of AIDS being a real threat to women's health. Given the apparent rarity of tertiary transmissions of AIDS, the assertion that most or even many women are at significant risk for AIDS seem wrong. Particularly disturbing in this campaign is the fact that the theme of‘risky sex’has been extended all the way to lesbians, even though their risk to acquire AIDS sexually is non‐existent to minuscule. We argue that actual harm is done to women by this exaggeration of their risk of contracting AIDS sexually. The scare has led to misappropriations of scarce health care funds. AIDS disproportionately affects women who inject drugs, and who suffer other diseases, poverty and malnutrition. It would have been better to concentrate health care efforts in this area instead of‘educating’women not at risk for AIDS how to prevent the acquisition of this disease. Unjustifiable AIDS anxiety has been created in women and has resulted in millions of unnecessary HIV‐tests, and many broken relationships. This anxiety has inevitably reduced the pleasure of having sex for many women. We reject the kind of‘victim ideology’that lies at the heart of this strategy which has, unfortunately, been supported by a number of influential feminist ethicists.
BIOETHICS: AN AFRICAN PERSPECTIVE
Authors: TANGWA GODFREY B. 
Published: October 2007

ABSTRACTIn this paper I have attempted to open a window on an African approach to Bioethics — that of the Nso’of the Bamenda Highlands of Kamerun—from the vantage position of someone who has familiarity with both African and Western cultures. Because of its scientific‐cum‐technological sophistication and its proselytising character, Western culture, as well as Western systems of thought and practice, have greatly affected and influenced other cultures, particularly African culture. But Western culture, systems of thought and practice, have been higly impervious and immune to influences from other cultures, philosophies, systems of thought and practice, even where these might have been salutary and enriching to Western culture and systems. What I have here termed Nso’eco‐bio‐communitarianism clearly indicates a viable alternative world‐view within which some of the bioethical perplexities and controversies of today might be more satisfactorily resolved than within a Western framework. I have further attempted to show, by way of example, how, within such a world‐view, abortion and suicide, for instance, would be disapproved of while euthanasia, in its etymological purity, is approved of.
COMMUNITY AND JUSTICE: THE CHALLENGES OF BICULTURAL PARTNERSHIP TO POLICY ON ASSISTED REPRODUCTIVE TECHNOLOGY
Authors: NICHOLAS BARBARA 
Published: October 2007

ABSTRACTListening to other cultures offers challenges to our fundamental assumptions and world views. In New zealand public policy on Assisted Reproductive Technology (AR T) is being worked out in a society committed to the development of bicultural partnership honouring the Treaty of Waitangi, a treaty with the indigenous people.Strong claims to the cultural significance of genetic heritage by Maori have made apparent to non‐Maori (Pakeha) their own assumptions. These claims also resist reductive understandings of genetics.In this paper I review, as a Pakeha ethicist, initiatives taken in New zealand, and the impact of bicultural development on public policy on ART. I also discuss some of the issues this raises for western bioethics as it relates to non‐western approaches and include reference to the significance of genetic heritage as it is affecting guidelines for donor insemination and surrogacy.
EXPERIENCES AND ATTITUDES TOWARDS END‐OF‐LIFE DECISIONS AMONGST DANISH PHYSICIANS
Authors: FOLKER ANNA P. , HOLTUG NILS , JENSEN ANNETTE B. , KAPPEL KLEMENS , NIELSEN JESPER K. , NORUP MICHAEL 
Published: October 2007

ABSTRACTIn this survey we have investigated the experiences and attitudes of Danish physicians regarding end‐of life decisions. Most respondents have made decisions that involve hastening the death of a patient, and almost all find it acceptable to do so. Such decisions are made more often, and considered ethically more acceptable, with the informed consent of the patient than without. But both non‐resuscitation decisions, and decisions to provide pain relief in doses that will shorten the patient's life, have been made and found acceptable by at least 50% of the respondents, even when there is no informed consent. Furthermore, 12% have doubled morphine dosages with fixed intervals, thus providing doses substantially higher than that necessary to control pain, without the informed consent of the patient. Two per cent have helped in assisted suicide, and 5% have administered a lethal injection at the patient's request. Respectively 37% and 34% find these last two practices ethically acceptable. Amongst those that do not find them acceptable, the most important reasons to be opposed are, the doctrine of double effect, the doctrine of doing and allowing, and the view that human life is sacred. Amongst supporters, the most important reasons mentioned are, that the patient's right to self‐determination should be respected, the view that a patient should not be forced to suffer, and the view that the patient has a right to be helped to a dignified death.
WHAT IS THE GOOD OF HEALTH CARE?
Authors: HARRIS JOHN 
Published: October 2007

ABSTRACTThis paper sets out to discuss what precisely is meant by “benefit” when we talk of the requirement that the health care system concern itself with health gain or with maximising beneficial health care. In particular I argue that in discharging the duty to do what is most beneficial we need to choose between rival conceptions of what is meant by beneficial. One is the patient's conception of benefit and the second is the provider's or funder's conception of benefit. I argue that it is the patient's conception of benefit which is paramount and that if this is followed it commits us to a conception of patient care which must be blind to prognosis in so far as prognosis is thought to bear upon issues of prioritisation or resource allocation.
CHOOSING THE BEST: AGAINST PATERNALISTIC PRACTICE GUIDELINES
Authors: SAVULESCU JULIAN 
Published: October 2007

ABSTRACTIsobel Ross rightly points out that providing information is not enough to guarantee that patients will choose the best course of action. She argues that to adequately protect patients’interests, we need practice guidelines to‘ensure that dangerous and unnecessarily risky procedures are excluded from practice’. What constitutes an‘unnecessarily risky procedure’is to be determined by a group of reasonable doctors. At one point, Ross suggests that such guidelines are‘presumptive’rather than ‘absolute’. But this is really a concession to patient variability. She intends that certain procedures are ruled out on paternalistic grounds.I will argue that practice guidelines are desirable but should not determine practice. We should not rule out procedures on paternalistic grounds.
ON A ROMANIAN ATTEMPT TO LEGISLATE ON MEDICALLY ASSISTED HUMAN REPRODUCTION
Authors: CUTAS DANIELA E. 
Published: October 2007

ABSTRACTThe paper presents and briefly analyses some of the provisions of a Romanian legislative proposal which arrived at the Presidency for ratification twice, in slightly different forms, and which was rejected twice: the first time at the Presidency in October 2004, and the second at the Constitutional Court in July 2005. The proposal was finally dropped in February 2006. My intention here is to point to some of the most problematic deficiencies of the legislative document in the hope that this may assist with future debates and regulations on assisted reproduction either in Romania or elsewhere. I have isolated the features to be discussed under two headings: (1) whose are the rights to reproduce, that the document claimed to ‘acknowledge, regulate and guarantee’ and (2) what is the status of the embryo, the child and the surrogate mother?
MAKING A CLEAN BREAK: ADDICTION AND ULYSSES CONTRACTS
Authors: ANDREOU CHRISOULA 
Published: October 2007

ABSTRACTI examine current models of self‐destructive addictive behaviour, and argue that there is an important place for Ulysses contracts in coping with addictive behaviour that stems from certain problematic preference structures. Given the relevant preference structures, interference based on a Ulysses contract need not involve questionably favouring an agent's past preferences over her current preferences, but can actually be justified in terms of the agent's current concerns and commitments.
Higher retention after a new take‐home computerised test
Authors: Park Jooyong , Choi Byung‐Chul 
Published: October 2007

AbstractA new computerised testing system was used at home to promote learning and also to save classroom instruction time. The testing system combined the features of short‐answer and multiple‐choice formats. The questions of the multiple‐choice problems were presented without the options so that students had to generate answers for themselves; they could click for the options when they were ready, and could choose one of the options within a brief, specified time period. One hundred thirty‐eight Korean sixth‐grade students (12‐year olds) were divided into two groups: the experimental group took the intervening test on social studies using the new computerised testing method, and the control group used a computerised version of the traditional multiple‐choice method. A few days after the intervening computerised test, a recall posttest was given in paper‐and‐pencil format. The mean posttest score was greater for the experimental group than for the control group. Implications of the result are discussed.
Beyond critical thinking skills: Investigating the relationship between critical thinking skills and dispositions through different online instructional strategies
Authors: Yang Ya‐Ting C. , Chou Heng‐An 
Published: October 2007

AbstractThe purpose of this study was to investigate (1) the relationship between critical thinking skills (CTS) and critical thinking dispositions (CTD), and (2) the effectiveness of different levels of instructional strategy (asynchronous online discussions (AODs), CTS instruction via AODs, and CTS instruction with CTD cultivation via AODs) in improving students' CTS and CTD. A pretest and posttest quasi‐experimental design was employed to achieve this purpose. The participants in this study were 220 students enrolled in a general education course at a large university in Taiwan. The findings of this study were as follows: (1) the overall relationship between CTS and CTD was positive. However, further analysis of the relationship between the different levels of CTS and CTD showed that only the students with high CTS and medium CTD showed a significant correlation; (2) the enhancement in CTS reinforced CTD, but the improvement in CTD did not increase the level of CTS. In addition, it is recommended that to improve the CTS and CTD of all students (including the students with a high level of CTS), the instructional strategy, CTS instruction with CTD cultivation, be employed.