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Concept: Concepts in ethics

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The previous article in this law column considered a patient’s right to give a real consent before a district nurse could proceed with care and treatment. This article considers the district nurse’s rights and responsibilities when considering withdrawing or withholding clinically-assisted nutrition and hydration. It focuses on recent cases in the Court of Protection, M v A Hospital [2017] , and High Court, NHS Trust v Mr Y & Mrs Y [2017] , and on the need to bring such cases to court before treatment is withdrawn.

Concepts: Hospital, Law, Human rights, Concepts in ethics, National Health Service, Withdrawal, Rights, Civil and political rights

7

Which emotional experiences should people pursue to optimize happiness? According to traditional subjective well-being research, the more pleasant emotions we experience, the happier we are. According to Aristotle, the more we experience the emotions we want to experience, the happier we are. We tested both predictions in a cross-cultural sample of 2,324 participants from 8 countries around the world. We assessed experienced emotions, desired emotions, and indices of well-being and depressive symptoms. Across cultures, happier people were those who more often experienced emotions they wanted to experience, whether these were pleasant (e.g., love) or unpleasant (e.g., hatred). This pattern applied even to people who wanted to feel less pleasant or more unpleasant emotions than they actually felt. Controlling for differences in experienced and desired emotions left the pattern unchanged. These findings suggest that happiness involves experiencing emotions that feel right, whether they feel good or not. (PsycINFO Database Record

Concepts: Empiricism, Experience, Concepts in ethics, Emotion, Love, Feeling, Core issues in ethics, Happiness

4

The hedonic principle maintains that humans strive to maximize pleasant feelings and avoid unpleasant feelings. Surprisingly, and contrary to hedonic logic, previous experiments have demonstrated a relationship between picture viewing time and arousal (activation) but not with valence (pleasure vs. displeasure), suggesting that arousal rather than the hedonic principle accounts for how individuals choose to spend their time. In 2 experiments we investigated the arousal and hedonic principles underlying viewing time behavior while controlling for familiarity with stimuli, picture complexity, and demand characteristics. Under ad libitum conditions of picture viewing, we found strong relationships between viewing time, valence, and facial corrugator electomyographic (EMG) activity with familiar but not novel pictures. Viewing time of novel stimuli was largely associated with arousal and visual complexity. We conclude that only after initial information about the stimulus is gathered, where we choose to spend our time is guided by the hedonic principle. (PsycINFO Database Record © 2014 APA, all rights reserved).

Concepts: Relationship, Concepts in ethics, Suffering, All rights reserved, Valence, Utilitarianism, Pleasure, Hedonism

3

Over 90% of the organs transplanted in China before 2010 were procured from prisoners. Although Chinese officials announced in December 2014 that the country would completely cease using organs harvested from prisoners, no regulatory adjustments or changes in China’s organ donation laws followed. As a result, the use of prisoner organs remains legal in China if consent is obtained.

Concepts: Law, Human rights, Concepts in ethics, Human anatomy, United Nations, North Korea, Vietnam, Karl Marx

2

Alberto Giubilini and Francesco Minerva’s recent infanticide proposal is predicated on their personism and actualism. According to these related ideas, human beings achieve their moral status in virtue of the degree to which they are capable of laying value upon their lives or exhibiting certain qualities or being desirable to third-party family members. This article challenges these criteria, suggesting that these and related ideas are rely on arbitrary and discriminatory notions of human moral status. Our propensity to sleep, fall unconscious, pass out and so on, demonstrates that we often exhibit our status as ‘potential persons’ who are not in the condition of attributing any value to their own existence. Our abilities, age and desirability can and do fluctuate. The equal dignity principle, distinguished in turn from both the excesses of vitalism and consequentialism, is analysed and defended in the context of human rights logic and law. The normalisation of non- and involuntary euthanasia, via such emerging practices as the self-styled Groningen Protocol, is considered. Substituted consent to the euthanasia of babies and others is scrutinised and the implications of institutionalising non-voluntary euthanasia in the context of financial, research and political interests are considered. The impact on the medical and legal professions, carers, families and societies, as well as public attitudes more generally, is discussed. It is suggested that eroding the value of human life carries with it significant destructive long-term implications. To elevate some, often short-term, implications while ignoring others demonstrates the irrational nature of the effort to institutionalise euthanasia.

Concepts: Human, Sociology, Law, Human rights, Ontology, Concepts in ethics, Morality, Involuntary euthanasia

1

The principle of the child’s right to an open future was first proposed by the legal philosopher Joel Feinberg and developed further by bioethicist Dena Davis. The principle holds that children possess a unique class of rights called rights in trust-rights that they cannot yet exercise, but which they will be able to exercise when they reach maturity. Parents should not, therefore, take actions that permanently foreclose on or pre-empt the future options of their children, but leave them the greatest possible scope for exercising personal life choices in adulthood. Davis particularly applies the principle to genetic counselling, arguing that parents should not take deliberate steps to create physically abnormal children, and to religion, arguing that while parents are entitled to bring their children up in accordance with their own values, they are not entitled to inflict physical or mental harm, neither by omission nor commission. In this paper, I aim to elucidate the open future principle, and consider whether it is applicable to non-therapeutic circumcision of boys, whether performed for cultural/religious or for prophylactic/health reasons. I argue that the principle is highly applicable to non-therapeutic circumcision, and conclude that non-therapeutic circumcision would be a violation of the child’s right to an open future, and thus objectionable from both an ethical and a human rights perspective.

Concepts: Law, Human rights, Concepts in ethics, Ethics, The Child, Social philosophy, Rights, Economic, social and cultural rights

0

Treatment informed consent aims to preserve the autonomy of patients in the clinician - patient relationship so as to ensure valid consent. An acceptable method of evaluating understanding of consent information is by assessing the extent of recall by patients of the pieces information believed to have been passed across. When concerns are not satisfactorily addressed from the patients' perspective, recall of consent information may be low.

Concepts: Clinical trial, Patient, Informed consent, Hospital, Autonomy, Concepts in ethics

0

The achievement of speech intelligibility by persons with Down syndrome facilitates their participation in society. Denial of speech therapy services by virtue of low cognitive skills is a violation of their fundamental human rights as proclaimed in the Universal Declaration of Human Rights in general and in Article 19 in particular. Here, we describe the differential response of an adolescent with Down syndrome to three speech therapy interventions and demonstrate the use of a single subject randomisation design to identify effective treatments for children with complex communication disorders.

Concepts: Law, Human rights, Concepts in ethics, United Nations, Universal Declaration of Human Rights, Rights, Economic, social and cultural rights, Amnesty International

0

Women and girls with disabilities have historically been denied the freedom to make their own choices in matters relating to their reproduction. In the healthcare sector they experience multiple discriminatory practices. Women and girls with intellectual disabilities are particularly vulnerable to coerced or forced medical interventions. The present article considers the contribution the Convention on the Rights of Persons with Disabilities makes towards affirming the rights of women and girls with disabilities to enjoy reproductive autonomy, including autonomy related to reproductive health, on an equal basis with individuals without disabilities. The Convention is paradigm-setting in its maximal approach to affirming the rights of individuals with disabilities to make autonomous choices under conditions of equality and non-discrimination. The Convention is the first human rights treaty to clearly affirm that impairment of decision-making skills is not a justification for depriving a person with cognitive or intellectual disability of legal capacity. This article is protected by copyright. All rights reserved.

Concepts: Human, Law, Human rights, Autonomy, Concepts in ethics, Individualism, Reproductive rights, Women's rights

0

Brain-computer interfaces (BCIs) can enable communication for persons in severe paralysis including locked-in syndrome (LIS); that is, being unable to move or speak while aware. In cases of complete loss of muscle control, termed “complete locked-in syndrome,” a BCI may be the only viable solution to restore communication. However, a widespread ignorance regarding quality of life in LIS, current BCIs, and their potential as an assistive technology for persons in LIS, needlessly causes a harmful situation for this cohort. In addition to their medical condition, these persons also face social barriers often perceived as more impairing than their physical condition. Through social exclusion, stigmatization, and frequently being underestimated in their abilities, these persons are being locked out in addition to being locked-in. In this article, we (1) show how persons in LIS are being locked out, including how key issues addressed in the existing literature on ethics, LIS, and BCIs for communication, such as autonomy, quality of life, and advance directives, may reinforce these confinements; (2) show how these practices violate the United Nations Convention on the Rights of Persons with Disabilities, and suggest that we have a moral responsibility to prevent and stop this exclusion; and (3) discuss the role of BCIs for communication as one means to this end and suggest that a novel approach to BCI research is necessary to acknowledge the moral responsibility toward the end users and avoid violating the human rights of persons in LIS.

Concepts: Life, Muscle, Sociology, Human rights, Concepts in ethics, Disability, United Nations, Social philosophy