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“Risk” is all about living a faith filled life. Within the pages of this work you will discover the year-by-year history of the ups and downs of the happenings regarding Foursquare Church. There are no sure things in this crazy epic journey called life. The only constant we can hang our hope upon is the name of Jesus. Christ has called us to live beyond what we can see and lean only to what He has said. In the parable of (...) the talents Jesus was very clear about how He felt regarding those who would not risk. In Matthew 25:28-30 He states, “‘Take the thousand and give it to the one who risked the most and get rid of this “play-it-safe-mentality” who won’t go out on a limb. Jesus rewards those who Risk. Foursquare Church and its history is one successive detail regarding progressive risking on God and his faithfulness to reward said risk. I invite you to read and risk on God. You will find great joy in discovering the rewards of a life that is lived by faith. (shrink)

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Entendendo a identidade como construção ideológica, esta pesquisa busca refletir sobre a identidade dos professores de língua portuguesa construída nos Parâmetros Curriculares Nacionais e nas Orientações Curriculares Nacionais para o ensino de língua portuguesa, os quais impõem uma nova postura teórica e prática a estes profissionais. Dito de outra forma, pretende-se apresentar e discutir os resultados de uma análise discursiva das representações da (s) identidade (s) e competências atribuídas aos professores, enfatizando as representações sociais da profissão do professor na sociedade (...) contemporânea brasileira, abrindo a possibilidade para questionarmos a identidade unificada e transparente que os documentos oficiais desenham para os professores. (shrink)

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Anselmo de Cantuária investiga no Proslogion (caps. 5-12) se o conteúdo de nossas palavras se refere de modo adequado à substância criadora. Essa obra de Anselmo pode ser considerada como uma meditação realizada por um espírito que busca entender aquilo que inicialmente crê a respeito do ser divino. O Proslogion nos oferecerá um caminho para pensar o sentido da busca de razões no domínio exclusivo da fé, do esforço da palavra humana para encontrar aquilo que já fora dito por outra (...) palavra. Este artigo visa a explicitar o sentido dessa racionalidade, naquilo que diz respeito aos "nomes divinos". A designação id quod summum omnium (Proslogion, cap.5) retoma um tema já presente na reflexão anselmiana e impõe ao teólogo um desafio: articular, sob a dialética do melius, o modo propriamente humano de a criatura referir-se a Deus, reconhecido como maius e distante de qualquer relação de continuidade com o mundo. In his Proslogion (chapter 5-12), Anselm of Canterbury investigates whether the content of our words refers in an adequate way to the creative substance. This work of Anselm may be considered as the meditation of a soul who seeks to understand that which it already believes about the divine being. The Proslogion offers us a way to think about the meaning of the search for reasons within the domain of faith, and about the power of human words to find out what has already said in other words. This article attempts to explain the meaning of this rationality with respect to 'divine names'. The designation id quod summum omnium (Proslogion, chapter 5) takes up a theme presented earlier in Anselm's reflections, and it imposes on the theologian a challenge: to articulate, within the melius dialectic, the properly human way of referring to God, recognized as maius and distant from any relation of continuity with the world. (shrink)

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As bearing on the time of year of the celebration attended by Simichidas and his friends, I stated, on the authority of Miss Alice Lindsell, that the barley-harvest in Cos is normally over by the end of April; and I added that the barley-harvest ought to fix the time of the events recorded, but that the scene depicted in 131 ff. is evidently much later than April and that the modern dates do not fit T's setting. I was assuming that (...) the threshing and winnowing of the barley, which is the occasion of the festival , took place immediately after it had been carried, but, as Miss Lindsell has pointed out, this assumption has no justification. (shrink)

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resumo No chama do período do “estrutura l i s mo” defendeu-se a id é ia de que havia uma oposição ent re essa filosof ia e o idealismo, especia l mente o ide a l i s mo subjetivo. O propósito deste texto é defender a tese oposta, de que há um forte elo interno entre o criticismo kantiano e o método estrutural em história da filosofia. Esse elo é partic u l a r me nte visível no estrutura (...) l i s mo e na Dia no e m á t ica de Gueroult e também pode ser ilustrado na obra do grande intérprete da filosofia kantiana que é Louis Guillermit. Este aplicou seu método de “elucidação crítica” à interpretação da sistematicida de de todo o período crítico de Ka nt e especia l me nte da constituição pro g ressiva da Estética transcendental nas três Críticas. A eluc idação da gênese das estruturas perma nece int e r na ao sistema ka ntia no, de i xando em aberto a questão da natureza de sua ligação com os sistemas pós-kantianos, mas essa neutralida de é mais apare nte que real, e cons o a nte com a escolha do idealismo kantia no em detrimento do idealismo hegeliano. palavras- chave Estrutura l i s mo; Dia no e m á t ica; elucidação crítica; Ma r t ial Gueroult; Louis Guillermit; Idealismo alemão. (shrink)

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In lieu of an abstract, here is a brief excerpt of the content:134 Feminist Studies 41, no. 1. © 2015 by Gabeba Baderoon Focal Length Gabeba Baderoon I take out the black and white photos I brought with me from Cape Town and haven’t looked at for years and stand them next to one another on the dining room table. In one, my mother in her white coat at the hospital looks up from her notes, distracted, in the grainy matte (...) finish you could ask for in the eighties instead of gloss. Here she is, younger, standing by the window, holding the telephone with its spiraling black cord to her ear, the curtain slanting to the side as she turns away from the camera. I take down from the wall the framed collection of Rafi’s baby photos I’d found wrapped in tissue paper among the tablecloths in the sideboard we inherited from his parents and line us up with each other. There he is, his face fitting into his mother’s shoulder; his brother holding him with hands under the armpits the way he was told; posing by a white door in a hooded woolen coat, his head reaching just above the handle. When I unwrapped them, the tissue paper had only one set of creases, untouched since she packed them for their long journey. In the soft focus of faded paper, I am standing with my back to a VW Beetle I know is pale green, my hands tucked behind me against the bumper, the license plate showing the number from the time before we moved from Uitenhage to Cape Town. In this one, I am on my mother’s lap, leaning against her like gravity. In the photo the focus shifts between my face and my mother’s. She is looking at me, like my father who is taking the picture. My face is clear and hers slightly blurred, as though his eyes are moving between us, as though the camera cannot capture the eye’s oscillation between two people one loves at the same time. One photo had been folded into three, bent once and then again to fit into a pocket, close enough to the skin to warm the paper, and then smoothed out again to fit into a frame. In it, I am turning sideways toward the camera—someone must have called my name—and a line creases just Gabeba Baderoon 135 beneath my eyes. Folded, hidden, forgotten, memory doesn’t come to me straight. The pleat of the curtain as she leans against it, his face in the crook of her shoulder as though he would never leave, me turning toward my name, the paper keeping its original crease. Poetry for Beginners In the evening poetry class for beginners in the community hall during the introductions a girl looking down behind her hair and a thick brown coat she doesn’t take off breathes in deep and risking something says fast my boyfriend’s in prison and I’m here to find out how to write to him through the bars and someone laughs and she pulls herself back into her coat and from inside looks past us and the next week doesn’t come back and I think of her for years and what poetry is I think of her long pause at the beginning her silence before and her silence after and I think this is my origin where poetry is risk, is betrayal and the memory of the first question how not to be alone 136 Gabeba Baderoon ID Photos In the small caravan parked permanently next to the Traffic Department with the handwritten sign ID Photos Taken Here its wheels rusted into place the young old photographer with dreadlocks and a tired poet’s face is shaking his head from side to side muttering some version of no just before me a woman in a long black skirt and black veil unties the loop of fabric knotted behind her head and her face briefly emerges the young old photographer sees everything hundreds of unclaimed photos line the inside of his caravan the making of identity interrupted and turned into small sad signs of something else we don’t look at... (shrink)

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This chapter contains sections titled: Introduction: The Design Argument The Design Argument in Antiquity Christian Authors Hume's Onslaught William Paley's Natural Theology The Bridgewater Treatises Intelligent Design: A Political Movement Eyes to See No “There” There Blood and Tears Gambling to Non‐existence Natural Selection Natural Selection and Design Postscript: Counterpoint Notes References.

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This chapter contains sections titled: Introduction: The Design Argument The Design Argument in Antiquity Christian Authors Hume's Onslaught William Paley's Natural Theology The Bridgewater Treatises Intelligent Design: A Political Movement Eyes to See No “There” There Blood and Tears Gambling to Non‐existence Natural Selection Natural Selection and Design Postscript: Counterpoint Notes References.

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The ninth volume of the new edition of the Opera omnia of Erasmus is the third tome of the fourth ordo 'moralia continens' and entirely devoted to the edition of the Moriae encomium by Clarence H. Miller. It was Erasmus' own wish that the Moriae encomium should be published under this 'ordo'; v. Ep. I to Botzheim, 30 January 15 2 3, p. 40, II. 9-10; and Ep. 2283 to Boece, 15 March 1530, 1. 1°4. For the editorial principles of (...) the new Erasmus edition we refer the reader to the General introduction of volume 1,1 and to the Prefaces of the other volumes published until now. To our deep regret we have to report the death of Professor S. L. Greenslade, a member ofthe 'Conseil International', and of Professor Myron P. Gilmore. The passing away of these eminent scholars and devoted friends of our new edition is a heavy loss to our project. As new members of the 'Conseil International' were elected C. Augustijn, Amsterdam, Ch. Bene, Grenoble, V. Branca, Venice, Mrs. M. Cytowska, Warsaw, F. Heinimann, Basle. The editorial board was also enlarged; the new membres are: C. L. Heesakkers, Leyden, H. J. de Jonge, Leyden, J. Trapman, The Hague Ooint-Secretary). The editorial board and the editor of the present volume thank all libraries who put books, photostats, microfilms and bibliographical material at their disposal. Referring to the copyright notice on the verso of the title page, and to the agreements made with the authors, the editorial board feels bound to repeat that no part of the volumes which have appeared or will appear under its responsibility can be published without prior permission of the copyright owner. (shrink)

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This research examines the novel No Time Like the Present (NTLP) by Nadine Gordimer as a material object. This novel outlines the conditions and situation of the post-apartheid South African country with various post-colonial problems. Centered on the life of a mixed family, black and white, with the characters of former independence fighter Umkhonto, the novel shows how the tortured and fragmented essence of a country struggles to define itself as a post-apartheid nation. In this regard, as an implication of (...) this problem, this research formulates two problems, (1) How do the colonial memory and trauma contructed in NTLP novel? And (2) How are the subject efforts to accept and recover from the trauma? To solve those problems, this research uses Postcolonial Trauma perpective of Step Craps and combined with reconciliation theory from Dominick LaCapra as a formal object. The aims of this research to (1) describe the construction of memory and colonial trauma through narrative witnessing that has an impact on the existence of the traumatic subject in the novel, and (2) explain the traumatized subjects efforts to survive through recovery and acceptance of the trauma experienced. This research is qualitative-descriptive by analyzing data using phenomenological method. The method used to analyze the events as well as traumatic experiences constructed in literary texts. The research resulted, (1) the construction of traumatic memories originating from apartheid events is narrated in various forms of torture carried out by the white regime, both directly against Umkhonto and South African society in general, including arrests and killings, segregation and cladestine life, invasions home, and cultural racism. This experience in turn causes collective trauma, which is narrated in symptoms such as the inability of the subject, feelings of inferiority, self-loathing, to Xenophobia. Furthermore, (2) in the efforts of reconciliation, social, political, economic, and other transformations and reforms, it encourages traumatic subjects to persist in the present and in the future, even though the past is still haunted. As an entity that represents the collectivism of the South African people, Umkhonto demonstrates persistence, reconnecting experiences, knowledge and feelings between them through acceptance of reality, selecting the right listeners or mates, and working towards voting rights in elections. (shrink)

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Resumen A diferencia de trabajos anteriores sobre el universalismo y el colonialismo en el pensamiento filosófico y político de Žižek, el presente artículo se basa en profundas coincidencias con este pensamiento, así como en irreductibles discrepancias con respecto a muchos de sus detractores. Todo esto no impide que se disienta con respecto a dos puntos fundamentales del filósofo esloveno: su posición universalista abiertamente eurocéntrica y su concepción positiva del colonialismo. La doble divergencia es resumida y justificada en las siguientes doce (...) tesis y en las objeciones que plantean a lo que se juzga inaceptable en el pensamiento žižekiano: 1) la conciencia y la crítica del horror colonial no son legados europeos; 2) el colonialismo es él mismo opresión; 3) hay otros orígenes fuera de Europa; 4) nunca se pierden todas las raíces; 5) lo aparente puede ser lo universal; 6) el capitalismo nunca supera su particularidad; 7) el capitalismo sigue comportando la colonialidad; 8) la modernidad capitalista incluye una otredad que no es ni anterior ni posterior; 9) la otredad sabe cómo explotar lo europeo que la explota; 10) un sujeto puede encontrarse en más de un universo; 11) no todo es comparable al ello fuera de Europa y Estados Unidos; y 12) es Europa la que se distorsiona al reflejarse en Estados Unidos.Unlike earlier work on universalism and colonialism in Žižek’s philosophical and political thought, this article draws on deep coincidences with this thought, as well as irreducible disagreements with many of its detractors. All this does not prevent that there are also divergences with respect to the two fundamental points of the Slovenian philosopher: his universalist openly Eurocentric position and his positive conception of colonialism. The double divergence is summarized and justified in the following twelve theses and in the objections they raise to what is deemed unacceptable in Žižekian thought: 1) the consciousness and critique of colonial horror are not European legacies; 2) colonialism is itself oppression; 3) there are other origins outside of Europe; 4) all roots are never lost; 5) the apparent can be the universal; 6) capitalism never overcomes its particularity; 7) capitalism continues to involve coloniality; 8) capitalist modernity includes an otherness that is neither anterior nor posterior; 9) otherness knows how to exploit the European that exploits it; 10) a subject can be found in more than one universe; 11) not everything is comparable to the id outside of Europe and the United States; and 12) it is Europe that is distorted when reflected in the United States. (shrink)

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Five years have elapsed since the publication of No Free Lunch. In that time, intelligent design (ID) has gone from a little-known and marginalized alternative to standard evolutionary theory to a national and international phenomenon that everyone with an interest in the biological origins debate is talking about. Gone is the former dichotomy between creationism and evolution. Leaving aside creationism’s insistence on treating Genesis as a scientific text and treating the detection and application of design as a research tool for (...) science, ID has carved out its own conceptual space and place at the table of scientific discussion. Five years ago critics of ID regularly leveled the charge that ID has no peer-reviewed publications in the biological literature. That charge is no longer supportable, with pro-ID research appearing in such journals as Protein Science, Journal of Molecular Biology, and Proceedings of the Biological Society of Washington (for details, see my expert witness report for the Dover case at www.designinference.com). (shrink)

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Este ensaio estabelece uma comparação estética e fenomenológica entre os pensamentos de Yves-Klein e Merleau-Ponty. Se o pintor materializou as suas reflexões e concepções em obra pictórica, o fenomenólogo francês dissertou na escrita filosófica o resultado da sua reflexão. Da análise conjunta entre um e outro resulta esta fenomenologia e estética comparativa que apresenta alguns conceitos fundamentais que alimentaram essas reflexões, tais como a visibilidade, o corpo, o mundo. Assim, para além dessa comparação, este ensaio viabiliza o diálogo entre ambos. (...) Palavras-chave: Corpo. Mundo. Visibilidade. Merleau-Ponty. Yves Klein -/- Abstract:This essay establishes an aesthetic and phenomenological comparison between the thoughts of Yves-Klein and Merleau-Ponty. If the painter materialized his reflections and concepts in pictorial work, the French phenomenologist disserted in the philosophical writing the result of his reflection. From the joint analysis between one and the other, this phenomenology and comparative aesthetics results, which presents some fundamental concepts that fed these reflections such as visibility, the body, the world. Thus, in addition to this comparison, this essay enables the dialogue between both. Keywords: Body. World. Visibility. Merleau-Ponty. Yves Klein. (shrink)

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The scholia to Wasps gloss τραχήλια variously as τὰ ἄκρα καὶ τὰ εὐτελῆ κρέα , τὰ ἀποβαλλόμενα τῶν ὄψων , ὀστράκιόν τι βραχὺ τελέως , and εὐτελὲς προσόψημα ἐν λοπαδίσκοις σκευαζόμενον . These might all be guesses, but the absence of the definite article in the original text shows that Bdelycleon's reference is to something more generic than ‘the backbones’ in the next verse. The ancient commentators were thus probably right not to interpret the word ‘bits of neck’, vel sim., (...) as if this were a diminutive of τράχηλος . Instead, these must be ‘tail-ends’ of food, scraps and leftovers of a sort that might be fed to a dog; compare Hippocrates, Epidemiae 7.62 , where βόεια τραχήλια are mentioned along with ham as part of the diet of a man recovering from illness. (shrink)

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The Health System Food and Nutrition Units are designed to produce and offer balanced meals, establishing dietary patterns, maintaining and restoring the health of the individual. The control of dirty in leftover ingestion can lower costs and organic waste. The objective of the study is to quantify and analyze the leftover intake i meals served to patients, and ingestion of dirty leftovers in collective meals of a Food and Nutrition Unit, located in the Southwest of Paraná. The data were collected (...) in two weeks, being developed in two stages. The first was the determination of the leftover ingestion and dirty remains of the healthy collective, and the second quantification of the rest intake by the patients community. Two scales were used to obtain the total weight of the food distributed in the cafeteria. Vats were weighed, before and after lunch. The garbage bags were weighed in order to quantify the leftover ingestion. The results of total leftovers showed an average of 44.71 kg / day, with a percentage of 44.19% being unacceptable. The leftover intake presented 8.72%, being classified as bad with this waste331 people could be fed. In order to measure the leftover intake by the diseased community, the weights of three lunch boxes were collected; the number of boxes wss added, resulting in kilos of food distributed for the day. Weighing the bags of garbage, was 19.02 kg / day, representing 28.36% of leftover ingestion, being above the acceptable of up to 20%. Based on this data, 148 people could be fed, making it necessary to take in consideration organoleptic criteria, satisfaction surveys, their preferences and nutritional needs, both for the healthy and the diseased group. (shrink)

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We work with a large spatialized array of individuals in an environment of drifting food sources and predators. The behavior of each individual is generated by its simple neural net; individuals are capable of making one of two sounds and are capable of responding to sounds from their immediate neighbors by opening their mouths or hiding. An individual whose mouth is open in the presence of food is “fed” and gains points; an individual who fails to hide when a predator (...) is present is “hurt” by losing points. Opening mouths, hiding, and making sounds each exact an energy cost. There is no direct evolutionary gain for acts of cooperation or “successful communication” per se. In such an environment we start with a spatialized array of neural nets with randomized weights. Using standard learning algorithms, our individuals “train up” on the behavior of successful neighbors at regular intervals. Given that simple setup, will a community of neural nets evolve a simple language for signaling the presence of food and predators? With important qualifications, the answer is “yes.” In a simple spatial environment, pursuing individualistic gains and using partial training on successful neighbors, randomized neural nets can learn to communicate. (shrink)

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Background The enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems. Objective The present study investigated the relationship between nurses’ clinical competence, moral identity, and moral injury during the COVID-19 outbreak. Research design This cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data collection tools. (...) Participants and research context: The research population for this study consisted of all frontline nurses ( n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak. Ethical considerations The present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021. Results According to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence. Conclusion According to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses’ clinical competence and the overall quality of care they provide. (shrink)

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BackgroundExpanded access is the use of investigational drugs (IDs) outside of clinical trials. Generally it is performed in patients with serious and life-threatening diseases who cannot be treated satisfactorily with authorized drugs. Legal regulations of expanded access to IDs have been introduced among others in the USA, the European Union (EU), Canada and Australia. In addition, in the USA an alternative to expanded access is treatment under the Right-to-Try law. However, the treatment use of IDs is inherently associated with a (...) number of ethically relevant problems.Main textThe objective of this article is to present a coherent framework made up of eight requirements which have to be met for any treatment use of an ID to be ethical. These include a justified need for the use of an ID, no threat to clinical development of the ID, adequate scientific evidence to support the treatment, patient’s benefit as the primary goal of the use of an ID, informed decision of a patient, fair access of patients to IDs, independent review, as well as the dissemination of treatment results.ConclusionsWhile this framework is essentially consistent with the legal regulations of expanded access of the USA, the EU, Canada and Australia, it is substantially wider in scope because it addresses some important issues that are not covered by the regulations. Overall, the framework that we developed minimizes the risks and threats, and maximizes potential benefits to each of the four key stakeholders involved in the treatment use of IDs including patients, doctors, drug manufacturers, and society at large. (shrink)

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Literary criticism on Ferrara kropak, an early Javanese code of Muslim ethics.

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This chapter provides an analysis of the long process of introducing an electronic identity for online authentication in Germany. This process is described as a multi-facet innovation, involving actors from different policy fields shifting over time. The eID process started in the late ‘90s in the context of eGovernment and eCommerce with the legislation on e-signatures, which were supposed to allow for online authentication of citizens. When after 5 years it was recognized that this was not the case, a new (...) digital ID card, which had meanwhile been announced, was chosen as token for the eID. This process was dominated by the concerns for visual inspection and border control, including the storage of digital fingerprints. Under the leadership of the Ministry of the Interior (BMI) and technical guidance of the Federal Agency for Information Security (BSI), technical specifications have to a large extent been adopted from the electronic passport, which had been smoothly introduced 2 years before. However, in the legislative process some concern regarding digital fingerprints on the eID card was raised and led to an opt-in solution. In 2009, a bill on the new ID card was passed which regulates the eID function for online authentication as well. This is characterized as a radical innovation by introducing a double-sided, mutual authentication of the citizen and the service provider and implementing the principle of proportionality regarding the access of service providers to data on the chip. At the time of writing, field tests are conducted. Roll-out of the new eID card is to start in November 2010. Therefore no figures about adoption can be provided here. (shrink)

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Photo ID 71252867© Stepan Popov| Dreamstime.com Abstract While Medical Assistance in Dying (MAiD) has been legalized in Canada since 2016, it still excludes eligibility for persons who have mental illness as a sole underlying medical condition. This temporary exclusion was set to expire on March 17th, 2024, but was set 3 years further back by the Government of Canada to March 17th, 2027. This paper presents a critical appraisal of the case of MAiD for individuals with mental illness as the (...) sole underlying medical condition through the analysis of three ethical theories: principlism, deontology, and utilitarianism. Through evidence and discussion, it will be demonstrated that MAiD, in this context, may be ethically justifiable on the grounds of upholding human rights, protecting dignity, and minimizing suffering. Introduction In June of 2016, Medical Assistance in Dying (MAiD) was legalized in Canada.[1] Throughout the first six years, a temporary exclusion of eligibility for persons suffering solely from mental illness was extended.[2] The exclusion of mental illness as a sole underlying medical condition was set to expire on March 17, 2024.[3] However, on February 1, 2024, just over a month before the set expiration, the Government of Canada once again extended the exclusion, this time setting it back three years to March 17, 2027. There are currently several countries that allow MAiD for mental illness, including Belgium, the Netherlands, and Luxembourg.[4] Some countries, like Spain,[5] do not give specific guidance, leaving the matter under discussion by ethicists and courts. In these countries, there are specific (although different) requirements for the process; overall, for mental illness, the illness must be verifiable and not simply related to a perception of satisfaction with the length of life. This extension ignited discussion on whether MAiD for persons who have mental illness as a sole underlying medical condition in Canada is ethically acceptable. As a complex, multi-faceted, and interdisciplinary issue, ethicists assessing MAiD must take into account various moral obligations and considerations. This paper analyses MAiD in this context through the application of three ethical theories: principlism, deontology, and utilitarianism. This paper concludes that, based on the current evidence and knowledge of this developing situation, MAiD for persons with mental illness in Canada may be ethically justified on the grounds of upholding human rights, labour obligations, and dignity. Through the exploration of research and discussions, it will be demonstrated that society at large ought to protect liberty and act towards relieving suffering, thereby supporting the potential eligibility of MAiD for persons who have mental illness. Principlism: The Capacity and Ability to Assess and Decide for One’s Own Life Principlism is the application of four principles: autonomy, beneficence, non-maleficence, and justice. Principlism supports permitting MAiD for mental illness due to the importance of autonomy in decision-making, equitable and just practices for MAiD assessors, and reducing suffering for patients and their family member(s) and/or friend(s). Carter v. Canada, the Canadian Supreme Court ruling of 2015—which changed Canadian law to allow for MAiD—held that the prohibition of MAiD infringed on Canadians’ right to “life, liberty, and the security of the person.” In a unanimous decision, the Supreme Court of Canada decided that the criminal prohibition of MAiD violates the Canadian Charter of Rights and Freedoms.[6] The Court concluded that the criminal law prohibiting MAiD interfered with people’s autonomy and dignity, which are protected by the rights of liberty and security of the person.[7] The ruling emphasized that Canada’s constitution reflects the fundamental importance of individual autonomy in personal decision-making. Research provides evidence that MAiD improves autonomy: A study among psychiatric patients found that 8 of 48 psychiatric patients said the mere option of accessing MAiD was enough to assess their future options for living wholly.[8] These findings complement a study entailing interviews with 30 adults who have mental illness, which emphasized that the ability to access MAiD allows individuals to analyze their quality of life, envision their desired future, and make decisions accordingly.[9] Although not all participants agreed that mental illness as the only underlying medical condition was appropriate for MAiD eligibility, many participants agreed that patient autonomy in decision-making was paramount and should be respected. However, autonomy as an ethical principle does not immediately grant all persons with mental illness the option to access MAiD. There are multiple eligibility criteria for those who wish to receive MAiD, which still must be approved and assessed. Currently, eligibility criteria for MAiD states that individuals must “give informed consent to receive MAiD, meaning that the person has consented to receiving MAiD after they have received all information needed to make this decision.”[10] Consent requires capability or capacity, which is the ability to understand relevant information, appreciate its potential consequences, and make an informed decision for oneself.[11] Like for many other diseases, disabilities, and conditions, patient capability is determined on a case-by-case basis.[12] Given the stigma surrounding those struggling with mental health, this thorough case-by-case examination of an individual patient’s capability and capacity without prejudice or partiality should lead to equitable and fair treatment. Without appropriate testing, those with mental illness could be wrongly stripped of their decision-making power. Arguments against MAiD for those with mental illness have raised concerns about the potential for individuals to harm themselves and others. A survey of MAiD providers demonstrated that physicians believed that the bereavement experience following MAiD is challenging and profoundly distinct and that bereavement support for all members involved should be required.[13] However, while watching one die (of MAiD) may cause harm to their families, friends, and support system at large, it is also important to recognize that watching someone suffer and struggle through their mental health journey also poses significant harm. Qualitative studies in Ontario, Canada, have interviewed family members of persons with mental illness as a sole medical condition, and interviewees shared that witnessing the illness and its impacts on their close one's lives was a very difficult experience.[14] As it relates to MAiD, participants emphasized that those living with mental illness are in the best position to understand their own pain and suffering and, in turn, make their own decisions about relief.[15] In an interview, a MAiD provider stated that MAiD may provide less suffering and more peace, and that, although it “depends on the family,... usually the family is more prepared and at peace.”[16] On the contrary, a person who has mental illness may perceive choosing MAiD as beneficial to their family member(s) and/or friend(s). Among those who died by MAiD in 2021, 35.7 percent reported that they perceived themselves as a burden on their family and friends.[17] While some authors report their concerns regarding such social burden as a potential driving factor for MAiD requests, others report that there are other additional burdens associated with requesting MAiD that may be financial, societal, and personal.[18] As such, the extension of MAiD eligibility to those with mental illness will likely only allow a small number of people to be granted MAiD.[19] Many others will be diverted to appropriate services and treatments. Patients’ decision to choose MAID noted their ability to make choices about their own care, reflecting the value of autonomy.[20] Although it is difficult to determine what is good for families in individual cases, MAiD presents an option that is both beneficent and non-maleficent. Therefore, these arguments satisfy the principles which do not necessarily conflict with MAiD. Deontology: The Duty to Recognize Vulnerability and Relieve Suffering The argument here begins with the fundamental focus of deontology—that moral duty lies in an action rather than in its consequences. Further discussion is required to analyze the impact of MAiD on healthcare workers. The Canadian Medical Association (CMA) Code of Ethics and Professionalism requires physicians to abide by virtues, commitments, and responsibilities in delivering health care and service.[21] The code states that “a compassionate physician recognizes suffering and vulnerability, … and alleviate[s] the patient’s suffering.”[22] In the context of MAiD for persons with mental illness as a sole underlying medical condition, vulnerabilities could be wide in range. Many Canadians are concerned with the interaction between mental health and other social determinants of health, such as the lack of medical, disability, financial, housing, and social support and resources.[23] As a result, another layer to the ethical issue arises: Does permitting MAiD for mental illness treat the symptoms of the issue rather than the root problem itself (social, economic, and systemic inequities)? Some argue against MAiD, stating that the nation should first focus on developing better quality care and service.[24] Others support MAiD as a potential harm reduction approach, given that most of these unjust conditions require a higher level of long-term structural and public policy overhaul.[25] The CMA Code also calls upon physicians to recognize and alleviate patients’ suffering. Some argue that while physicians and medical professionals do work to relieve suffering, they are trained to do so through a primary care-based diagnose-and-treat approach.[26] Studies that have captured Canadian physicians’ experiences providing MAiD report that, although physicians stated that the work was rewarding, it came with many challenges, including strained relationships with coworkers, increased workload, and inadequate compensation.[27] Physicians report that a part of the problem is that MAiD rules are written by lawyers and experts who are removed from its reality in medical practice. As a result, there is a lack of clarity surrounding practice norms and a lack of support for physicians.[28] Thus, while healthcare practitioners have a duty to relieve patients’ suffering, they should feel adequately trained and supported in doing so. If physicians and healthcare professionals recognize vulnerability and relieve suffering, then they should act accordingly, regardless of potential associations or outcomes. Making persons with mental illness eligible for MAiD ensures that treatment to relieve their suffering is available. However, it is imperative that there are sufficient resources and support available to healthcare professionals to ensure that they feel prepared and supported to provide MAiD, should they wish to do so. Utilitarianism: Minimizing Intolerable Suffering and Dying with Dignity Overall, utilitarianism is largely concerned with the greatest happiness principle—to increase the amount of happiness for the greatest number of people. So far, this paper has analyzed individual, family, and practitioner-based ethical considerations. But if MAiD were to be extended to those with mental illness as a singular underlying medical condition, what implications would this have for the world and society at large? There is a global drive toward authorizing organized ending of life, with an increasing number of countries legalizing MAiD.[29] The medical system is generally seen as a safe and appropriate system to carry out MAiD, especially when suicide and self-harm are regarded as “alternatives.” Yet despite these worldwide efforts, many argue through the theory of utilitarianism that the inability to see long-term consequences renders MAiD a premature solution, particularly for those who are unable or unwilling to seek other forms of potentially healing treatment or for those who may undergo MAiD only for a technological innovation or biomedical advancement to later come along as a potential cure.[30] While it is true that MAiD does not prevent these “premature deaths,” it is also true that it does not claim to.[31] MAiD provides an option to alleviate intolerable suffering. Some individuals with severe mental illness do describe their condition as intolerable suffering. MAiD is seen as an option to minimize suffering. It can also be seen as a way to die with dignity and relief.[32] While predicting outcomes is difficult, extending MAiD eligibility for persons experiencing mental illness does not undermine its ability to end suffering. It allows eligible individuals to take charge of their health, their life, and their future. Conclusion Based on the current evidence, allowing MAiD for persons with mental illness as their sole underlying medical condition presents as an ethically justifiable action. The right to self-determination and fair accessibility demonstrates that there is more harm done by prohibiting MAiD for mental illness than allowing it. Such liberty is a right, and in the context of relieving suffering, it is a duty that healthcare workers must uphold, although the ability to opt out of providing MAiD is well established. Thus, to recognize vulnerability and relieve suffering means to provide methods, such as MAiD, for those deeply impacted by mental illness. These justifications stand at both the individual level and for society at large. Nevertheless, it remains imperative to take an upstream approach that addresses the social determinants of health and aims to prevent mental illness and promote long-term, beneficial social change for those suffering, struggling, and vulnerable in our communities. - [1] Jaro Kotalik and David W. Shannon, Medical Assistance in Dying (MAID) in Canada Key Multidisciplinary Perspectives, 1st ed. 2023., The International Library of Bioethics, 104 (Cham: Springer International Publishing, 2023), https://doi.org/10.1007/978-3-031-30002-8. [2] Department of Justice Government of Canada, “Canada’s Medical Assistance in Dying (MAID) Law,” February 21, 2024, https://www.justice.gc.ca/eng/cj-jp/ad-am/bk-di.html. [3] Health Canada, “Final Report of the Expert Panel on MAiD and Mental Illness,” transparency - other, May 13, 2022, https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advi sory-bodies/expert-panel-maid-mental-illness/final-report-expert-panel-maid-mental-illness.html. [4] Federal Public Service (FPS) Health Belgium, “Federal Commission for the Control and Evaluation of Euthanasia,” n.d., https://consultativebodies.health.belgium.be/en/advisory-and-consultative-bodies/federal-commission- control-and-evaluation-euthanasia.; Government of Netherlands, “Is Euthanasia Allowed in the Netherlands?,” n.d., https://www.government.nl/topics/euthanasia/is-euthanasia-allowed.; “Information on Requesting Euthanasia or Assisted Suicide,” n.d., https://guichet.public.lu/en/citoyens/sante/fin-vie/euthanasie/euthanasie-assistance-suicide.html. [5] Luis Espericueta, First official report on euthanasia in Spain: A comparison with the Canadian and New Zealand experiences, Medicina Clínica (English Edition), Volume 161, Issue 10, 2023, Pages 445-447, ISSN 2387-0206, https://doi.org/10.1016/j.medcle.2023.06.021. [6] Government of Canada, “The Canadian Charter of Rights and Freedoms,” March 15, 2021, https://www.justice.gc.ca/eng/csj-sjc/rfc-dlc/ccrf-ccdl/. [7] Supreme Court of Canada, “Carter v. Canada,” Constitutional Law, 2015, https://scc-csc.lexum.com/scc-csc/scc-csc/en/item/14637/index.do.; Kotalik and Shannon, Medical Assistance in Dying (MAID) in Canada Key Multidisciplinary Perspectives. [8] Karandeep Sonu Gaind, “What Does ‘Irremediability’ in Mental Illness Mean?,” Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie 65, no. 9 (September 2020): 604–6, https://doi.org/10.1177/0706743720928656; Lieve Thienpont et al., “Euthanasia Requests, Procedures and Outcomes for 100 Belgian Patients Suffering from Psychiatric Disorders: A Retrospective, Descriptive Study,” BMJ Open 5, no. 7 (July 27, 2015): e007454, https://doi.org/10.1136/bmjopen-2014-007454. [9] Hamer Bastidas-Bilbao et al., “Walking Alongside: Views of Family Members on Medical Assistance in Dying for Mental Illness as the Sole Underlying Medical Condition,” Qualitative Health Research 33 (September 29, 2023), https://doi.org/10.1177/10497323231197365. [10] Government of Canada, “Canada’s Medical Assistance in Dying (MAID) Law.” [11] Commission sur les soins de fin de vie, “Les conditions de l’admissibilité à l’aide médicale à mourir au Québec: la constance dans l’évolution de la loi concernant les soins de fin de vie,” June 9, 2023, https://csfv.gouv.qc.ca/ fileadmin/docs/autres_rapports/csfv_lcsfv_conditions_ amm_2023-06-29.pdf.; Trudo Lemmens, “When Death Becomes Therapy: Canada’s Troubling Normalization of Health Care Provider Ending of Life,” The American Journal of Bioethics 23, no. 11 (November 2, 2023): 79–84, https://doi.org/10.1080/15265161.2023.2265265. [12] Justine Dembo, Udo Schuklenk, and Jonathan Reggler, “‘For Their Own Good’: A Response to Popular Arguments Against Permitting Medical Assistance in Dying (MAID) Where Mental Illness Is the Sole Underlying Condition,” Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie 63, no. 7 (July 2018): 451–56, https://doi.org/10.1177/0706743718766055. [13] Konia Trouton et al., “Attitudes and Expectations Regarding Bereavement Support for Patients, Family Members, and Friends: Findings from a Survey of MAID Providers,” British Columbia Medical Journal 62, no. 1 (2020). [14] Bastidas-Bilbao et al., “Walking Alongside.” [15] Bastidas-Bilbao et al. [16] Trouton et al., “Attitudes and Expectations Regarding Bereavement Support for Patients, Family Members, and Friends: Findings from a Survey of MAID Providers,” 2020. [17] Ramona Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” Palliative & Supportive Care 21, no. 5 (October 2023): 871–78, https://doi.org/10.1017/S1478951523001025; Health Canada, “Third Annual Report on Medical Assistance in Dying in Canada 2021,” report on plans and priorities;transparency - other, July 26, 2022, https://www.canada.ca/en/health-canada/services/publications/health-system-services/annual-report-me dical-assistance-dying-2021.html; Lemmens, “When Death Becomes Therapy.” [18] Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” October 2023.; Bastidas-Bilbao et al., “Walking Alongside.” [19] Olivia Stefanovich, “Opposition Parties Call for Indefinite Pause to MAID Expansion for Mental Illness | CBC News,” Canadian Broadcasting Corporation, January 28, 2024, https://www.cbc.ca/news/politics/special-joint-committee-maid-mental-illness-report-1.7095679; Benjamin Lopez Steven, “Number of Assisted Deaths Jumped More than 30 per Cent in 2022, Report Says | CBC News,” Canadian Broadcasting Corporation, October 27, 2023, https://www.cbc.ca/news/politics/maid-canada-report-2022-1.7009704. [20] Hamer Bastidas-Bilbao et al., “Searching for Relief from Suffering: A Patient-Oriented Qualitative Study on Medical Assistance in Dying for Mental Illness as the Sole Underlying Medical Condition,” Social Science & Medicine 331 (August 1, 2023): 116075, https://doi.org/10.1016/j.socscimed.2023.116075. [21] Canadian Medical Association, “Canadian Medical Association Code of Ethics and Professionalism” (Canada: Canadian Medical Association, December 8, 2018), https://policybase.cma.ca/link/policy13937. [22] Canadian Medical Association. [23] Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” October 2023; Stefanovich, “Opposition Parties Call for Indefinite Pause to MAID Expansion for Mental Illness | CBC News.” [24] John Paul Tasker, “Liberal Government Promoting a ‘culture of Death’ with Medical Assistance in Dying Law, Conservative MP Says | CBC News,” Canadian Broadcasting Corporation, March 6, 2023, https://www.cbc.ca/news/politics/culture-of-death-medical-assistance-in-dying-mental-illness-1.67695 04. [25] Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” October 2023; Kayla Wiebe and Amy Mullin, “Choosing Death in Unjust Conditions: Hope, Autonomy and Harm Reduction,” Journal of Medical Ethics, April 26, 2023, https://doi.org/10.1136/jme-2022-108871. [26] Ramona Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” Palliative & Supportive Care 21, no. 5 (October 2023): 871–78, https://doi.org/10.1017/S1478951523001025. [27] Konia Trouton et al., “Attitudes and Expectations Regarding Bereavement Support for Patients, Family Members, and Friends: Findings from a Survey of MAID Providers,” British Columbia Medical Journal 62, no. 1 (2020), https://bcmj.org/articles/attitudes-and-expectations-regarding-bereavement-support-patients-family-m embers-and.; William Robert Nielsen, “MAiD in Canada: Ethical Considerations in Medical Assistance in Dying,” Canadian Journal of Bioethics 4, no. 2 (December 9, 2021): 93–98, https://doi.org/10.7202/1084456ar. [28] Coelho et al., “The Realities of Medical Assistance in Dying in Canada,” October 2023. [29] Lemmens, “When Death Becomes Therapy.” [30] William Robert Nielsen, “MAiD in Canada: Ethical Considerations in Medical Assistance in Dying,” Canadian Journal of Bioethics 4, no. 2 (December 1, 2021): 93–98, https://doi.org/10.7202/1084456ar. [31] Steven, “Number of Assisted Deaths Jumped More than 30 per Cent in 2022, Report Says | CBC News.” [32] A. Plaisance et al., “Quebec Population Highly Supportive of Extending Medical Aid in Dying to Incapacitated Persons and People Suffering Only from a Mental Illness: Content Analysis of Attitudes and Representations,” Ethics, Medicine and Public Health 21 (April 1, 2022): 100759, https://doi.org/10.1016/j.jemep.2022.100759. (shrink)

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PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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Ḥanafī jurist Burhān al-Dīn al-Nasafī is one of the most prominent names in the history of the ʿilm al-naẓar’ (Islamic Disputation Theory) particularly due to his seminal work entitled al-Fuṣūl. We have located a manuscript which we will call an Opponent-al-Fuṣūl written by a Shāfiʿī scholar. This manuscript is titled al-Risāla fī qawāʿid ʿilm al-naẓar and it highlights the importance of al-Nasafī’s al-Fuṣūl. The scribe of the manuscript attributes this Opponent-al-Fuṣūl to the famous logician Najm al-Dīn al-Kātibī. Although no mention (...) of such a book belonging to al-Kātibī has been discovered thus far, in this article we will try to demonstrate that the book does indeed belong to him. In addition, we will undertake a comparison of both works, al-Fuṣūl and the Opponent-al-Fuṣūl, with a particular focus on the concepts of talāzum (implication), tanāfī (incompatibility) and dawarān (concomitance). A critical edition of the Opponent-al-Fuṣūl is appended to the article. (shrink)

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Ḥanafī jurist Burhān al-Dīn al-Nasafī is one of the most prominent names in the history of the ʿilm al-naẓar’ particularly due to his seminal work entitled al-Fuṣūl. We have located a manuscript which we will call an Opponent-al-Fuṣūl written by a Shāfiʿī scholar. This manuscript is titled al-Risāla fī qawāʿid ʿilm al-naẓar and it highlights the importance of al-Nasafī’s al-Fuṣūl. The scribe of the manuscript attributes this Opponent-al-Fuṣūl to the famous logician Najm al-Dīn al-Kātibī. Although no mention of such a (...) book belonging to al-Kātibī has been discovered thus far, in this article we will try to demonstrate that the book does indeed belong to him. In addition, we will undertake a comparison of both works, al-Fuṣūl and the Opponent-al-Fuṣūl, with a particular focus on the concepts of talāzum, tanāfī and dawarān. A critical edition of the Opponent-al-Fuṣūl is appended to the article. (shrink)

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Photo ID 222412412 © US Navy Medicine | Dreamstime.com ABSTRACT In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. INTRODUCTION Medical resources in an austere environment without quick recourse for resupply or casualty evacuation are often (...) limited. The shortage extends not only to supplies like blood products and drugs, but physicians and other medical personnel. In the midst of a mass casualty scenario, such as a battle that includes intense ground fighting, the medical staff will stretch scarce resources and triage casualties according to specific criteria. Typically, they proceed by providing care for the most severely wounded first, referred to here as conventional triage. At times, though, the staff may reverse the triage so that soldiers with minor wounds can return to the fight. In a mass casualty situation, when medical personnel apply conventional triage and treat casualties from opposing forces, a dilemma may arise. We argue that it can be permissible for military physicians to prioritize their own soldiers over enemy combatants in a mass casualty triage, where reverse triage does not apply. The case we will focus on is as follows: Battlefield Triage: During combat operations on a remote island in the Pacific Ocean, a compatriot soldier and an enemy combatant arrive at the compatriot soldier country’s medical treatment facility. Both have similar gunshot wounds to the abdomen, and they arrive with similar conditions. Both have low oxygen saturation and excessive blood loss. The sole physician only has enough time to stabilize one person. The scenario is brief, and we are aware that medical rules of eligibility will most often dictate how the physician proceeds,[1] but this scenario is useful in setting up the question we focus on in this paper: would it be wrong to favor the stabilization of a soldier just because the soldier is the physician’s compatriot? In other words, can nationality serve as an ethically justified tiebreaker in a situation such as Battlefield Triage?[2] In a non-military setting, the answer is clear: it would be unethical to treat someone based on non-medical considerations such as nationality. The AMA’s Code of Medical Ethics asserts that physicians have “ethical obligations to place patients’ welfare above their self-interest and above obligations to other groups.”[3] The World Medical Association’s Declaration of Tokyo affirms that “no motive, whether personal, collective or political, shall prevail against this higher purpose” of alleviating distress.[4] Physicians are taught early on that triage decisions must be medically indicated and made without consideration of factors such as race, ethnicity, religion, social status, and nationality. They are taught that public trust and obligations of justice grounded in equality demand that only medical indications be considered. But military physicians in a military setting are beholden to obligations, duties, and responsibilities as members of the military, and when these obligations, duties, and responsibilities conflict, as they do in Battlefield Triage, which loyalties win out and why?[5] Critics of partiality on national grounds argue that partiality undermines public trust in medicine and justice because everyone should be treated equally regardless of nationality.[6] Proponents of partiality argue that military obligations supersede equality and that justice requires partiality in such cases.[7] Despite the critics’ disagreement, both agree that there is a morally right, perhaps even blameless, course of action. Drawing on insights from virtue ethics, we argue that Battlefield Triage is a moral tragedy in which justice is unattainable and there is no action without moral cost. The assumption that there is a morally right choice is flawed. We argue that while no decision in this scenario is free from moral blame, there are reasons to favor treating one’s soldiers over enemy combatants. I. The Case Against Partiality There is a common assumption that there is a morally right or just decision in Battlefield Triage. A number of organizations and scholars claim that it is wrong for military physicians to favor their own soldiers on the grounds of nationality or some form of ‘group membership.’ (In a conflict involving service members from multiple nations working as a coalition, a soldier from an allied country may receive the same priority as the US service member due to ‘group membership.’) The World Medical Association’s WMA Declaration of Lisbon on the Rights of the Patient, which was reaffirmed in 2015, posits that, “[i]n circumstances where a choice must be made between potential patients for a particular treatment that is in limited supply, all such patients are entitled to a fair selection procedure for that treatment. That choice must be based on medical criteria and made without discrimination.”[8] This echoes what was set forth in Article 12 of the Geneva Conventions, which states that “[o]nly urgent medical reasons will authorize priority in the order of treatment to be administered.”[9] The argument for impartiality in Battlefield Triage is that every person is morally equal, and equality entails that medical distribution is, “based on a combination of medical need and urgency.”[10] This is in keeping with the bioethical principles that are generally applied.[11] II. The Case for Partiality On the other side, there are arguments that favoritism is the ethically right decision in Battlefield Triage.[12] The argument asserts that members of the military form a morally significant community of friends and participation in these relationships demands partiality. Just as parents have strong ethical duties to their children and not just any children, military personnel have ethical duties to their group, a group that involves an affirmation of mutual aid and support. Some have termed these ‘associative duties. According to Michael Gross, obligations of friendship, care, and solidarity “leave very little room for generally applicable principles of justice that would obligate a medic to treat enemy or non-compatriot wounded ahead of their compatriots.”[13] This is true in Battlefield Triage, but it may also be true even if the enemy’s soldier were more seriously wounded: “the ethics of small group cohesion, largely an ethics of care, mostly replaces the demands of impartial justice.”[14] In a more recent article, Gross explains that preferential treatment is ethically justified based on fighting capability and “the special obligations people owe friends, family, and, no less, comrades-in-arms.”[15] To not show partiality to the US soldier would be morally wrong on the grounds of friendship and mutual care.[16] III. The Moral Tragedy of Battlefield Triage Defenders and critics of Battlefield Triage favoritism based on nationality both frame their position as just or fair. For example, Justin List argues that physicians are “bound to practice medical neutrality,”[17] Marcus Adams denies that physicians “possess special ethical obligations” to enemy combatants because of their profession.[18] These perspectives assume that there is a morally right decision and that justice is attainable. The assumption that there is or can be a morally right Battlefield Triage decision, and we need to put our heads together to figure it out, remains strongly entrenched. However, the facts of the situation should give us pause; there are too many people and too few resources, and this demands a decision-making process that determines who will receive scarce resources. By its very nature, a battlefield triage decision has to be made based on some characteristic or value, a characteristic or value that will inevitably favor some at the expense of others. This is precisely why competing analyses “in the military context struggle to resolve these conflicts satisfactorily.”[19] Drawing on the insights of virtue ethics, we suggest that Battlefield Triage is a moral tragedy. Virtue ethics suggests that morality is about acting virtuously, which is to say that we should do what a virtuous person would do in the situation. Ethics is about figuring out how a just, wise, compassionate, loving, and fair person would act, and then doing that, as one grows in virtue. But life is not always clear cut, and it is possible that virtuous people may find themselves in a moral tragedy, a situation in which, through no fault of one’s own, a person must make a morally objectionable decision. After the action the virtuous person “emerges having done a terrible thing, the very sort of thing that the callous, dishonest, unjust, or in general vicious agent would characteristically do.”[20] Stated differently, a moral tragedy presents a virtuous person with two or more courses of action, all of which have a moral cost.[21] In Battlefield Triage, no matter how the physician goes about deciding, there is going to be defensible concern from those not saved. The fact that there are more people than can be helped fosters competing values in battlefield triage: maximize lives saved, treat people equally, treat the worse off, and support the war effort. Treating people equally may create tension between treating the worse off, maximizing lives saved, and supporting the war effort. Reverse triage is a case in point, as supporting the war effort conflicts with treating the worse off first, as is a fair lottery system since deploying a lottery may not maximize lives saved or support the war effort. There can be reasons why one person is selected over another, to be sure. Yet, there are reasons for making a decision, and that the decision is subject to legitimate moral concern is another. To recognize the moral tragedy of Battlefield Triage is to recognize the impossibility of acting blamelessly in the situation. In this situation, the virtuous military physician is going to have to sacrifice important values such as justice, compassion, and respect for others, even with a defensible criterion in hand. The physician will grieve this sacrifice accordingly. The physician may find her decision difficult or stressful, and rightly so, because of what her circumstances require of her. This kind of moral tragedy results “in actions which betray and violate the rights of persons to whom there may be a strong duty of care. When this happens, it properly triggers an appropriate moral emotion since our moral integrity has been violated and this affects how we think of ourselves and what we have become.”[22] Rather than view her triage decision as the morally superior choice, the virtuous military physician will view her decisions in these circumstances in a different light: it is the least bad option in a terrible situation, and she did something ethically problematic, something that is contrary to her moral character. She deeply regrets the circumstances in which she had to act. IV. Virtue Ethics A virtue ethicist has insight into how one should go about deciding what to do in a moral tragedy, although virtue ethics may not be as helpful as one may hope. The goal of the virtuous military physician in Battlefield Triage is to adopt the best course of action or the action that she feels she ought to do, all things considered. This does not make her choice devoid of serious wrongdoing—a decision must be made, but that does not make it just. The virtuous military physician will approach the situation with courage, responsibility, and insight. She will think about the decision carefully, wisely, and conscientiously; she will weigh the goods and harms of the choices before her, in conjunction with a proper conception of the good life, human worth, and understanding of her obligations to others—including chain of command, fellow soldiers, and the medical community. She is attuned to the value of human life and has a reasonable idea of the various ways her decisions will affect others. She recognizes that she is in this non-ideal situation through no fault of her own: she is not the one fighting in battles; she is serving her country as a physician, whose job it is to save lives, treat everyone justly, and promote military objectives. She regrets the decision she is forced to make in battlefield triage, acting “with immense regret and pain,” Hursthouse explains, “instead of indifferently or gladly.”[23] This is because, no matter what decision is made, the virtuous military physician “does something terrible or horrible,” something she otherwise would not do and is contrary to her values.[24] V. A Resolvable Moral Tragedy Instead of asking whether there is a morally right decision, in which a decision is morally blameless and above reproach, the virtue ethicist asks whether there is a decision with a convincing rationale, knowing that a decision can have a clear rationale but still be morally tragic. It is perfectly reasonable to think that different virtuous persons will arrive at different courses of action: “two virtuous agents, in the same situation,” Hursthouse writes, “may act differently” in irresolvable moral tragedies, in cases in which there is no clear course of action.[25] Because a person must act in a moral tragedy, one goal is to identify reasons for choosing the chosen action. Some decisions are clearly indefensible—treating neither the compatriot soldier nor the enemy combatant in Battlefield Triage would be wrong—and some decisions are more problematic than others. If the military physician selects to treat the soldier because she does not like the enemy combatant’s skin color, such a reason would be deeply problematic. But much of the debate over how to act in a moral tragedy is not over clearly indefensible or problematic criteria. Instead, the literature is largely about different standards or implementations of justice. Some scholars defend nation-impartial triage as right, while others defend nation-aware triage as right, and each argues that the other side is promoting an unjust or otherwise wrong solution to Battlefield Triage. We suggest that Battlefield Triage is a resolvable moral tragedy and that virtue ethics offers convincing reasons to prefer the treatment of the compatriot soldier rather than the enemy combatant on the grounds of national identity. Virtues are integral to living a good life, a flourishing life, but as Aristotle observed long ago, human beings are inherently social, interdependent and interconnected in profound ways.[26] This goes beyond the obvious fact that we need each other to survive day to day (one person makes clothes, another farms, and another makes tools); the claim is that a good or flourishing life depends in large part on one’s social network or community. This is why many of Aristotle’s moral virtues are other facing: justice, friendship, generosity, and magnanimity, to name a few. Courage, a typically self-facing virtue, is understood by Aristotle to be the virtue that regards one’s fear of death in battle, a battle fought on behalf of one’s city.[27] All of this remains true today. Namely, there is an important sense in which our community matters to our lives: it is easier to live a good, flourishing life if one is part of a good, flourishing community. Our community is made up of smaller groups, and it is more accurate to say that we are simultaneous members of different groups within a broader community. A person may be part of a family, friend group, research team, large state university, city, state, and nation. Groups can function well or not, as we all have experienced, and this suggests that there are virtues or excellences that groups can instantiate. Good groups are unified in purpose, with each member doing their duty alongside others for the attainment of that purpose. Good groups manifest solidarity among their members. Although Aristotle does not list solidarity as a virtue, a number of modern-day virtue ethicists have begun examining how group solidarity can be a virtue that contributes to a good or flourishing life.[28] Solidarity is not conceptualized as an individual virtue, a virtue possessed by a person in isolation of others; instead, it is a collective virtue, a virtue that is shared among members of a defined group with particular ends.[29] “A group has solidarity to the extent that its members are disposed to: (1) share values, aims, or goals; (2) care about those values, aims, or goals; (3) act in accordance with those values, aims, or goals; (4) trust the testimony of other group members with respect to those values, aims, and goals; and (5) feel a sense of belonging to the group.”[30] The virtue of collective or group solidarity involves individuals having special concern for each other, shared aims and values, trust, loyalty, and a sense of belonging with these specific others. There is a oneness to the group in the pursuit of a definite goal or purpose, involving mutual support and affirmation of each member. As such, the group has ends and goods above and beyond the good of each individual person. Sometimes solidarity requires personal sacrifice for the collective (for example, a father sacrificing food so his child can eat). The virtue of collective or group solidarity is important to the military and medical community at every level, and for clear reasons. In the military, there is a clear hierarchy of command, unity of purpose and end, mutual trust and support in complex settings, and so on. Soldiers need to know they can count on one another, and solidarity grounds a soldier’s ability to trust others and be assured of mutual aid. In medicine, solidarity maintains self-regulation of the profession, shared values and goals, as well as public support, not to mention that day-to-day operations require physician trust, engagement, and effort toward the ends of clinical care. Physicians need to work together, along with others, in pursuit of health, and disunity is sowed when there is mistrust, selfishness, or disengagement among the healthcare team and organization. Importantly, just as we are all members of various groups and hence may manifest group solidarity in different settings, the virtuous military physician instantiates collective solidarity with both the medical profession and the military. Her dual loyalty contributes to the moral difficulty of acting in Battlefield Triage. The military physician has competing obligations to distinct groups and cannot satisfy all obligations in Battlefield Triage. Solidarity with the military supports the consideration of favoring the soldier for reasons of national identity, whereas solidarity with the medical community does not. Something has to give, which is why it is a moral tragedy. The virtuous military physician, therefore, must weigh the costs of each course of action. To fulfill her obligations to the medical community would require that she does not use nationality and other non-medical considerations in Battlefield Triage. Since the soldier and enemy combatant are equally injured, justice would demand a random process, perhaps a flip of the coin. Although this may satisfy obligations the military physician has to the medical community, this would be costly to the physician’s military group. If word gets out that the physician decides who to treat based on a coin toss, soldiers, families, and citizens may become frustrated and angry. Soldier morale may go down if it becomes known that a coin flip led to the preventable death of a soldier and the saving of an enemy combatant who had killed (or attempted to kill) other soldiers. As Gross highlights, military solidarity involves a mutual aid promise that military personnel promise to help one another.[31] A military physician is part of the military and, as such, is part of the mutual aid promise, which would appear to be violated if the physician flips a coin. Treating a member of one’s own team may be psychologically more beneficial than treating an enemy combatant and may lead to less moral distress.[32] Finally, treating soldiers rather than enemy combatants promotes broader military and social aims, including returning soldiers to health, maintaining unity of purpose, and minimizing community suffering from a soldier’s death. Favoring members of one’s group, that is, triage based on nationality in Battlefield Triage, would fulfill obligations of military group loyalty, which is contrary to the values and duties of medicine. It does not seem as though showing favoritism in this particular situation is very costly to the medical community or general public, but this is because there is recognition that the physician is in the military. Medicine is impartial to non-medical indications partly because of fairness and to promote public trust in medicine. However, Battlefield Triage is unique, as medicine is being practiced in a non-public, wartime setting. In ordinary circumstances, a patient’s identity is irrelevant, and physicians ought not play favorites. Since Battlefield Triage is not an ordinary circumstance, decisions based on patient identity may not undermine public trust in medicine. In addition, it is contestable that fairness in Battlefield Triage requires that no consideration be paid to one’s nationality. Fairness is about giving each person their due, what is owed to them, and the case can be made that soldiers who place themselves in danger for the sake of the common good or a just cause are owed special attention when they suffer harm in the line of duty. In other words, soldiers voluntarily undergo risk to themselves for the greater good, and society owes them for this sacrifice. This plausibly includes preferential treatment in a situation such as Battlefield Triage. So, while the medical community affirms justice demands non-preferential treatment, the military community can affirm the opposite. The demands of fairness are unclear at best or in conflict in this situation: demands of physician justice decry favoritism, while demands of military justice support favoritism. Triage not based on nationality is arguably unfair and triage based on nationality may not undermine public trust, after all. All things considered, there is a clear rationale for favoring nationality-based preferential treatment in Battlefield Triage. Adopting a nationality-based preference in this situation is more defensible than not. This does not make such a decision ethically right or just. Preference based on nationality is the least bad decision, but it is not morally blameless. It involves one in a serious moral wrong, a wrong otherwise avoided and contrary to one’s character. The virtuous military physician is in a situation in which obligations conflict, and we disagree with Gross, who posits that care of fellow soldiers “is important to the near exclusion of all else.”[33] Gross fails to appreciate the collective virtue of solidarity as applied to those in medicine. The military physician has duties to fellow soldiers but also to fellow physicians, to the medical community, and humanity. To favor a soldier on grounds of nationality violates her duties and responsibilities to this latter group. She is involved in a moral tragedy and can only seek the most just action given the circumstances, yet, at least in virtue ethics, the action remains far from blameless. CONCLUSION We argue that Battlefield Triage is a moral tragedy, meaning that it is a situation in which there is no morally blameless decision and that the demands of justice cannot be satisfied. As such, the virtuous military physician incurs a moral cost to acting as she does—there is a moral residue. However, despite being a moral tragedy, there are clear reasons to act in favor of treating one’s own, considering group solidarity. As such, these kinds of tragedies are resolvable: virtuous military physicians should favor treatment of their own, although they would do so with sorrow. - [1] Militaries set forth medical rules of eligibility or guidelines used to determine whether a person qualifies for specific medical interventions or treatments in certain circumstances, and these guidelines are binding for a military physician. For example, despite opposition from medical organizations, militaries have adopted reverse triage guidelines for military physicians to follow. For ethical discussion, see Falzone, Elisabeth, P. Pasquier, C. Hoffmann, O. Barbier, M. Boutonnet, A. Salvadori, A. Jarrassier, J. Renner, B. Malgras, and S. Mérat. "Triage in military settings." Anaesthesia Critical Care & Pain Medicine 36, no. 1 (2017): 43-51. https://doi.org/10.1016/j.accpm.2016.05.004 [2] There are issues that are related to this, including the triage of civilians and allied soldiers. We set related issues aside for purposes of this paper [3] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [4] American Medical Association, Code of Medical Ethics: Current Opinions with Annotations, 2004–2005 ed. (Chicago, IL: AMA, 2004), 300. [5] This is termed the “dual loyalty” dilemma in military medicine and has been described at length elsewhere: Institute of Medicine (US) Board on Health Sciences Policy. Military Medical Ethics: Issues regarding Dual Loyalties: Workshop Summary. Washington (DC): National Academies Press (US); 2008. Toward a Framework for Resolving Dual Loyalties. Available from: https://www.ncbi.nlm.nih.gov/books/NBK214853/ [6] See Kenneth G. Swan and K.G. Swan, Jr., “Triage: The Past Revisited,” Military Medicine 161:8 (1996): 448–452. https://doi.org/10.1093/milmed/161.8.448; Jerome A. Singh, “American Physicians and dual loyalty obligations in the ‘war on terror,’” BMC Medical Ethics 4.4 (2003): 1–10. https://doi.org/10.1186/1472-6939-4-4; Beam, Thomas E. "Medical Ethics on the Battlefield." Military Medical Ethics: Sect. IV. Medical ethics in the military. Medical ethics on the battlefield: the crucible of military medical ethics 2 (2003): 369-402; Hereth, Blake. "Health justice for unjust combatants." Journal of Military Ethics 20, no. 1 (2021): 67-81. https://doi.org/10.1080/15027570.2021.1949782. [7] See Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. Gross, Michael L. "Comradery, community, and care in military medical ethics." Theoretical medicine and bioethics 32 (2011): 337-350. https://doi.org/10.1007/s11017-011-9189-6. Gross, Michael L. "The limits of impartial medical treatment during armed conflict." In Military medical ethics for the 21st century, pp. 71-84. Routledge, 2016. [8] World Medical Association, WMA Declaration of Lisbon on the Rights of the Patient. 5 December 2022, https://www.wma.net/policies-post/wma-declaration-of-lisbon-on-the-rights-of-the-patient/ [9] Geneva Convention for the Amelioration of the Condition of Wounded, Sick in Armed Forces in the Field. 12 August 1949. https://www.un.org/en/genocideprevention/documents/atrocity-crimes/Doc.30_GC-I-EN.pdf. [10] List, Justin M. "Medical neutrality and political activism: physicians' roles in conflict situations." In Physicians at war: The dual-loyalties challenge, pp. 237-253. Dordrecht: Springer Netherlands, 2008. 240 [11] Beauchamp, T., and J. Childress. 2013. Principles of Biomedical Ethics, 7th ed. Oxford, United Kingdom: Oxford University Press. [12] Adams, Marcus P. "Triage priorities and military physicians." In Physicians at war: The dual-loyalties challenge, pp. 215-236. Dordrecht: Springer Netherlands, 2008. [13] Gross, "Comradery, community, and care in military medical ethics," 347. [14] Gross, “Comradery, community, and care in military medical ethics,” 349. [15] Gross, Michael L. "When medical ethics and military ethics collide." Narrative inquiry in bioethics 13, no. 3 (2023): 199-204. 202 https://dx.doi.org/10.1353/nib.2023.a924191 [16] Our argument draws on virtue ethics, from which care ethics derives, and it is worth clarifying how our argument relates to Gross’s. We do not think that the virtue of friendship grounds triage decisions, for we think it is unlikely that the physician and wounded soldier are friends. Instead, as explained below, we think the collective virtue of group solidarity better captures the moral significance of group loyalty and that Gross would agree with us. But since military physicians are part of distinct groups, with competing obligations, the military physician will be forced to sacrifice a value in battlefield triage cases. In other words, we think Gross downplays the dual group membership of a military physician. [17] List,”Medical neutrality and political activism,” 250. [18] Adams,”Triage priorities and military physicians,” 235. [19] London, Leslie, Leonard S. Rubenstein, Laurel Baldwin-Ragaven, and Adriaan Van Es. "Dual loyalty among military health professionals: human rights and ethics in times of armed conflict." Cambridge Quarterly of Healthcare Ethics 15, no. 4 (2006): 381-391. 383. [20] Hursthouse, R. On Virtue Ethics. OUP 1999. 74 [21] Nussbaum, Martha C. "The costs of tragedy: Some moral limits of cost-benefit analysis." The Journal of Legal Studies 29, no. S2 (2000): 1005-1036, 1007. [22] De Wijze, S. (2005). Tragic-remorse–the anguish of dirty hands. Ethical theory and moral practice, 7(5), 453-471, 457. https://doi.org/10.1007/s10677-005-6836-x [23] Hursthouse, 73 [24] Hursthouse, 81 [25] Hursthouse, 72 [26] Aristotle, Politics 1253a8. Reeve, C. D. C., Indianapolis: Hackett Publishing Co., 2017 [27] Aristotle, Nicomachean Ethics. III.6.114a, 34-35. 2002, Nicomachean Ethics, Christopher Rowe (trans.), Oxford: Oxford University Press [28] Byerly, T. Ryan, and Meghan Byerly. "Collective virtue." The Journal of Value Inquiry 50, no. 1 (2016): 33-50. https://doi.org/10.1007/s10790-015-9484-y; Federico, Veronica. "Conclusion: solidarity as a public virtue." Solidarity as a Public Virtue (2018): 495-542. https://doi.org/10.5771/9783845290058. Rehg, William. "Solidarity and the common good: An analytic framework." Journal of Social Philosophy 38, no. 1 (2007): 7-21. https://doi.org/10.1111/j.1467-9833.2007.00363.x [29] Byerly and Byerly. "Collective virtue." 43 [30] Battaly, Heather. "Solidarity: Virtue or vice?." In Social virtue epistemology, pp. 303-324. Routledge, 2022. 304 [31] Ibid., 2011: 341 [32] It might be thought that displaying altruism by helping an enemy combatant at the expense of one’s fellow soldier may be psychologically satisfiying. For evidence that military physicians find it difficult to treat enemy combatants, see Lundberg, Kristina, Sofia Kjellström, Anders Jonsson, and Lars Sandman. "Experiences of Swedish military medical personnel in combat zones: adapting to competing loyalties." Military medicine 179, no. 8 (2014): 821-826. https://doi.org/10.7205/MILMED-D-14-00038. Lamblin, Antoine, Clément Derkenne, Marion Trousselard, and Marie-Ange Einaudi. "Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study." BMC Medical Ethics 22 (2021): 1-13. https://doi.org/10.1186/s12910-021-00723-2 [33] Ibid., 2011: 344. (shrink)

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Photo ID 279661800 © Sidewaypics|Dreamstime.com ABSTRACT Decolonization is complex, vast, and the subject of an ongoing academic debate. While the many efforts to decolonize or dismantle the vestiges of colonialism that remain are laudable, they can also reinforce what they seek to end. For decolonization to be impactful, it must be done with epistemic and cultural humility, requiring decolonial scholars, project leaders, and well-meaning people to be more sensitive to those impacted by colonization and not regularly included in the discourse. (...) INTRODUCTION Decolonization is complex. To successfully achieve decolonization, projects should incorporate the voices of those subjugated or silenced. Including such voices requires sincerely exploring who has been affected by colonialism or neocolonialism and how, as well as cultural sensitivity. In its basic use, decolonization refers to countries under colonial rule gaining independence or freedom from forms of subjugation. Additionally, scholars use the term to refer to efforts to dismantle neocolonialism and vestiges of colonialism. The process includes de-silencing subjugated voices.[1] I use decolonization in the latter way to refer to countries with technical independence. While arguably colonization ended formally with independence from colonizing powers, neocolonialism is the indirect, informal, and sometimes subtle control of the people, their economy, and political life despite formal independence from colonizing authorities. I conceptualize neocolonialism as a system that involves direct and involuntary control of another’s political, economic, or social life, impacting their worldview and ways of encountering the world. Decolonization may target actions, places, or systems like health care or AI to overcome the ills of colonialism and neocolonialism. It also may target knowledge and require rethinking how people develop their knowledge base. For example, if people grew up seeing an outside colonizer as superior, they would need to change their knowledge of superiority. Decolonization may target power, for example, changing who owns and distributes COVID-19 vaccines and who distributors exclude in the distribution of vaccines. Decolonization could require looking at those disempowered in the distribution process. Additionally, decolonization may target autonomy of persons by freeing people, ensuring human and individual rights, and respecting cultural traditions. Decolonization projects that try to de-silence by including the voices of those affected by colonialism and neocolonialism must examine inclusiveness in the context of the culture of the subrogated individuals. Examples of decolonization projects include making datasets inclusive of diverse peoples and places, returning to traditional food and eating practices, making sure hospitals in developing countries are led by locals and respectful of cultural traditions, returning unethically obtained artefacts or objects. Another project would be laying the groundwork for equality in formerly colonized countries to ensure that business ownership, education, and financial success will flow fairly to those previously victimized by colonization. Summarily, there are many strategies for decolonizing. However, it is worth asking whether the strategies have risks that undermine the goal of decolonization. I. Understanding Decolonization Discourses Many fields, from AI to politics, economics, health care, aviation, and academia, discuss decolonization. The content of the discourse on decolonization depends on the region and field discussing it. Rather than just reporting on decolonization, the discussions may be calls to action. For example, decolonization discourses reflect activism for cognitive justice, such as equal consideration of Indian or African knowledge systems in global health discourses.[2] In politics and political science, some scholars frame decolonization as an anti-western, anti-colonial movement by Africans to emancipate Africa/ns from subjugation or shift the continent to postcolonialism and post-neo-colonialism. This framing walls off non-African participants and may undermine their capacity to benefit the conversation.[3] There are other political scientists who actively support decolonization and see it as a field of activism in support of anyone and countries where colonization harmed people and development.[4] The point is that two ways of conceptualizing decolonization in politics and political science are discernible. One conceptualization is less inclusive since it alienates scholars and professionals from Western, high-income, or developed countries. The other is more inclusive. In humanitarian studies, including philosophy, some decolonization articles and conversations are efforts to end the destructive force of colonization. They focus on either the form, such as ecocide, genocide, and many others, or the geographic location, such as Africa, Asia, Latin America, and Oceania.[5] Finally, the feelings one brings into this conversation can adversely impact how one engages in them and who they listen to or are willing to hear from. For example, anger, rage, bitterness, and hatred are emotions that are not uncommon in spaces of decolonization conversations. Decolonization conversations that originate from a place of negativity risk deepening the psychological state of victimhood and prevent people from disrupting constructively or critically engaging in the conversation.[6] II. Understanding Decolonization Strategies Decolonization strategies mainly aim to de-silence victims of domination or subjugation. People have proposed many strategies for decolonizing. These strategies may be informed by what the target is for decolonization. Decolonization can target power relations in global health. For example, during the COVID-19 pandemic, public health organizations noted the power imbalance in vaccine distribution. Decolonization could involve de-silencing those affected by neocolonialism to bring about a more balanced distribution of power and a more fair distribution of the vaccine. By analyzing who was adversely impacted by the distribution and who ought to wield power, those engaged in decolonizing advocated for positive change and equitable power relations. Equally, when being is the target of decolonization, the language of unlearning or relearning and mental decolonization take centre stage in the decolonization discourse. For example, the quest to decolonize colonized minds aims to demythologize African inferiority and Western superiority. Demythologizing African inferiority enables those engaged in the decolonization discourse to cultivate and foster African agency.[7] Finally, when knowledge production is the target of decolonization, scholars use inclusion and cognitive justice. For example, they try to alter the knowledge that underlies global health ethics.[8] “[D]decolonizing researchers aim to respectfully understand and integrate theory from Other(ed) perspectives, while also critically examining the underlying assumptions that inform their Western research framework.”[9] One common strategy that scholars use in decolonization is inclusion. It is worth asking, does including people who have been subrogated foster decolonization? Whether that is effective depends on whether included people are more heard or whether the strategies to include them create new forms of silencing. III. Inclusion and the Quest to Decolonize Evaluating how effective inclusion is in the quest to de-silence subjugated voices is important. First, inclusive strategies are not neutral. They are epistemically situated. This situatedness constrains meaning-making in different ways: how and what questions are asked, how social roles are constructed, organized or assigned, and who is admitted to the room where these conversations occur.[10] Inclusion strategies may reinforce (unchallenged) assumptions. For example, to address prejudices and stereotypes in global health images, Arsenii Alenichev and his colleagues[11] successfully inverted “one stereotypical global health image” by prompting a generative AI to produce “an image of a traditional Indian or African healer healing a White Child.” Although there were some problems with the image of the White child, this innovation is a significant, useful effort to de-embed or strip global health images of problematic pictures that mythologize White superiority and Black inferiority. Yet it is possible that using categories like traditional Indian or African reinforces unchallenged assumptions, raising key questions regarding how language and words create new stereotypes. It is common to define traditional as non-conventional, unorthodox, and informal. Yet studies continue to reveal that non-scientifically appraised healing approaches in India or Africa are not only effective but also real, meaningful, fundamental, and primary care-seeking behaviours in many communities in these regions.[12] Suppose inclusive strategies are not un-situated. These conversations may be had within the structures, language, and spaces built by or connected to colonialism. The spaces, language, places, and structures in which these conversations occur can limit who can participate and how they participate. Importantly, some conditions are not conducive to participation as equals. The allocated time for the discussion could also constrain how individuals express themselves. It is unclear who is ultimately heard. Furthermore, epistemic situatedness of inclusion can impact decolonization conversations when participants are beneficiaries of, products of, and trained by structures and systems they seek to dismantle. To enhance the decolonization project and its goals, a pressing task is to unveil and question how the circumstances may inhibit activism. If the vestiges of colonialism continue to structure the decolonization discourse invisibly, the vestiges may undermine decolonization. For example, a public health discussion that includes white Western doctors and Western pharmaceutical executives in Africa may have many local Africans at the table but could still effectively devalue their input based on built-in assumptions and biases that are vestiges of colonialism. Second, exclusion and inclusion are also not binary. Individuals may experience exclusion, even while included (the phenomenon called internal exclusion). In other words, inclusion can fail to be substantial or become a means of enhancing optics, “a way of (un)consciously weakening the radical claims being pursued.”[13] For example, in South Africa, many institutions have made significant efforts to diversify their faculties due to the promulgation of the Employment Equity Act 55.[14] The act requires South African institutions to implement employment equity that redresses the history of harmful discrimination in the country. The act further requires transforming departments and institutional administrations. Although many recognize and support the need to transform departments in South Africa, the rhetoric of transformation departs sharply from the lived experiences.[15] This misalignment between the plan and practice is evident in the underrepresentation of black people and females in senior management teams, professorships in many universities and health departments, and positions of power in some South African institutions. Those selected in the transformation of the departments have also complained of being overworked. The burden of extra work undermines their ability to develop agency and voice in the space they now occupy or fulfil key requirements that have implications for their career trajectory.[16] This is called the minority tax. Notably, "the minority tax… is the burden of extra responsibilities [placed] on faculty of colour to achieve diversity and inclusion and contributes to attrition and impedes academic promotion."[17] One challenge for decolonializing projects will be for decolonial scholars and those selected for decolonization objectives to have the humility to decline invitations, requests, roles, and platforms for which they are either unqualified or lack the capacity to fulfil. At its heart, decolonization strategies must empower those included rather than weaken them. Finally, inclusion can lead to a phenomenon known as elite capture.[18] Elite capture occurs when socially advantaged individuals in a group monopolize or exploit activism to their own benefit at the expense of the larger, struggling group. Elite capture weakens decolonization efforts from within, revealing that those likely to benefit from global inclusive efforts are those who fulfil globally constructed standards, those “already present in the room.” There is no better strategy to weaken decolonial movements than weakening the project from within by strategically positioning individuals who share physical properties with the victims of exclusion and silencing but intellectually, behaviourally, psychologically, and emotionally share more common ground with the colonizer. Such insiders may be unaware they are furthering neocolonial conditions rather than decolonizing. In relation to decolonization, particularly in global health, elite capture reveals that those whose voices are loudest in the room are not necessarily those more impacted by colonialism. They may benefit more from reinforcing colonialism. Opportunism weakens meaningful activism from within, preventing good initiatives and strategies from having their intended impact or taking substantive root.[19] This paper cannot do justice to elite capture, but it is worth noting its negative impacts. IV. Improving the Impact of Decolonization To end neo-colonialism, it is important to understand how it manifests and what to do at each level. Beyond the academic discourse, many tangible efforts exist to decolonize through de-silencing. Examples of these efforts include the ME2 movement that seeks to centre the concerns and experiences of sexually abused or harassed victims in the public discourse. At the funding level, many grant-awarding agencies like Wellcome Trust have dedicated huge budgets to studies that help them understand how they may have perpetrated colonialism or neocolonialism and what they can do differently going forward.[20] In South Africa, promulgating the Employment Equity Act 55 was a tangible attempt to entrench decolonization concerns in a country's regulatory framework. Yet, these decolonization efforts could fail to be substantive if they do not reflect cultural sensitivity. Two key components of cultural sensitivity are worth highlighting here: epistemic and cultural humility. Epistemic humility is an intellectual virtue described as knowing one’s limitations and the limitations of the learning methods employed. At its simplest, it is the ability to admit when one is wrong. Cultural humility includes genuine attempts to learn about and embrace other cultures. Epistemic and cultural humility are signs of academic excellence and strength. Epistemic and cultural humility seriously acknowledge how the state of our knowledge, cognitive limitations, experiences, and backgrounds, while constraining us, also invite us to listen, learn, grow, and change. The limitations-owing account of epistemic and cultural humility suggests that “a person who is aware of her cognitive limitations and owns them is much better positioned to achieve such epistemic goods as true beliefs and understanding than someone who… simply has insight into the epistemic status of her beliefs.”[21] Epistemic and cultural humility may help prevent decolonization projects that unintentionally reinforce what they seek to dismantle. Epistemic humility calls on decolonizers to defer tasks for which they are not qualified to suitably qualified persons. Beyond this, humility supports brave scholarship that imagines and reimagines how featuring the same voices, faces, and perspectives possibly introduces new forms of domination or silencing. Cultural knowledge can lead to a more intentional way of seeking out the right people or a more diverse group than those frequently featured in decolonization conversations. This would give others more opportunities to navigate these spaces and should do so in ways that are familiar to them. One ought to be more sensitive to those who would ordinarily not be included in these conversations. Unless we radically and boldly reimagine these discussions, we risk alienating those most negatively impacted by neocolonialism. CONCLUSION Decolonization conversations are complex and the subject of academic debate. The strategies employed to decolonize can harm or help the victims of neo-colonialism. Inclusion of previously silenced individuals may not be enough to overcome the vestiges of colonialism, leading to a false inclusion, where those included feel excluded or contribute in ways reflecting their own biases and circumstances. Inclusion of an elite or people who do not truly represent the subjugated can lead to elite capture. For decolonization strategies to be impactful, for example, in the context of global health, project leaders and participants must engage in conversations employing epistemic and cultural humility. In many ways, epistemic and cultural humility can help us demythologize our assumptions of any cultural superiority or cognitive authority, allowing for diverse voices, cultures, and perspectives to emerge without domination. - [1] Caesar Atuire & Olivia Rutazibwa. 2021. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization [Online]. Available from: https://law.yale.edu/yls-today/news/african-reading-covid-19-pandemic-and-stakes-decolonization [Accessed July 29, 2021 2021]. [2] Bridget Pratt & Jantina De Vries 2023. Where is knowledge from the Global South? An account of epistemic justice for a global bioethics. Journal of Medical Ethics, medethics-2022-108291. [3] Anye-Nkwenti Nyamnjoh 2023. Is decolonisation Africanisation? The politics of belonging in the truly African university. Social Dynamics, 1-20. [4] Rianna Oelofsen 2015. Decolonisation of the African mind and intellectual landscape. Phronimon, 16, 130-146. [5] Caesar Atuire & Olivia Rutazibwa. 2021. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization. An African Reading of the Covid-19 Pandemic and the Stakes of Decolonization [Online]. Available from: https://law.yale.edu/yls-today/news/african-reading-covid-19-pandemic-and-stakes-decolonization [Accessed July 29, 2021 2021]. [6] Pedro Alexis Tabensky 2008. The Postcolonial Heart of African Philosophy. South African Journal of Philosophy, 27, 285-295. [7] Nicholas M. Creary 2012. African Intellectuals and Decolonization, Ohio, Ohio University Press. [8] Bridget Pratt & Jantina De Vries 2023. Where is knowledge from the Global South? An account of epistemic justice for a global bioethics. Journal of Medical Ethics, medethics-2022-108291. [9] Vivetha Thambinathan & Elizabeth Anne Kinsella 2021. Decolonizing Methodologies in Qualitative Research: Creating Spaces for Transformative Praxis. International Journal of Qualitative Methods, 20, 16094069211014766. [10] Abimbola Seye 2023. Knowledge from the global South is in the global South. Journal of Medical Ethics, 49, 337. [11] A. Alenichev, P. Kingori & K. P. Grietens 2023. Reflections before the storm: the AI reproduction of biased imagery in global health visuals. Lancet Glob Health. [12] Jonathan K. Burns & Andrew Tomita 2015. Traditional and religious healers in the pathway to care for people with mental disorders in Africa: a systematic review and meta-analysis. Social Psychiatry and Psychiatric Epidemiology, 50, 867-877. [13] Anye-Nkwenti Nyamnjoh & Cornelius Ewuoso 2023. What type of inclusion does epistemic injustice require? Journal of Medical Ethics, jme-2023-109091. [14] 1998. Employment Equity Act. In: GOVERNMENT, S. A. (ed.) 19370. [15] Dina Zoe Belluigi & Gladman Thondhlana 2019. ‘Why mouth all the pieties?’ Black and women academics’ revelations about discourses of ‘transformation’ at an historically white South African university. Higher Education, 78, 947-963. [16] Juliet Ramohai & Khomotso Marumo 2016. Women in Senior Positions in South African Higher Education: A Reflection on Voice and Agency. 231, 135-157. [17] J. Trejo 2020. The burden of service for faculty of color to achieve diversity and inclusion: the minority tax. Mol Biol Cell, 31, 2752-2754. [18] Olufemi Taiwo 2020. Being-in-the-Room Privilege: Elite Capture and Epistemic Deference. The Philosopher, 108, 7. [19] Margarita Kurbatova & Elena Kagan 2016. Opportunism of University Lecturers As a Way to Adaptate the External Control Activities Strengthening. Journal of Institutional Studies, 8, 116-136. [20] Jeremy Farrar. 2022. An update on Wellcome's anti-racist programme. An update on Wellcome's anti-racist programme [Online]. Available from: https://wellcome.org/news/update-wellcomes-anti-racism-programme [Accessed August 10, 2022 2022]. [21] Katherine Dormandy 2018. Does Epistemic Humility Threaten Religious Beliefs? Journal of Psychology and Theology, 46, 292-304. (shrink)

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For naturalism, fed on recent cosmological speculations, mankind is in a position similar to that of a set of people living on a frozen lake, surrounded by cliffs over which there is no escape, yet knowing that little by little the ice is melting, and the inevitable day drawing near when the last film of it will disappear, and to be drowned ignominiously will be the human creature’s portion. The merrier the skating, the warmer and more sparkling the sun by (...) day, and the ruddier the bonfires at night, the more poignant the sadness with which one must take in the meaning of the total situation. —William James, The Varieties of Religious Experience1. (shrink)

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Bu kitapta, Ebû İshâk es-Saffâr’ın (öl. 534/1139) kelâmî görüşleri, Telḫîṣü’l-edille li-ḳavâʿidi’t-tevḥîd adlı eserinde Allah’ın isimlerinin anlamlarını açıklarken yaptığı yorumlar çerçevesinde ele alınmaktadır. Ebû İshâk es-Saffâr, 6./12. yüzyıl Hanefî-Mâtürîdî âlimlerinden biridir. Kelâma dair Telḫîṣü’l-edille eserinde esmâ-i hüsnâ konusuna ayrıntılı olarak yer vermektedir. İki cilt hâlinde yayımlanan bu eserin yaklaşık üçte birlik bir kısmını esmâ-i hüsnâ konusu oluşturmaktadır. Bu kısım incelendiğinde, Saffâr’ın Allah’ın varlığı, birliği ve sıfatları ile ilgili konular başta olmak üzere pek çok konuyu 175 esmâ-i hüsnâya dayanarak izah ettiği görülmektedir. (...) O, esmâ-i hüsnâ bölümünde yer vermediği bazı isimlere ise müstakil başlıklar altında değinmektedir. Örneğin el-Mütekkelim ismi kelâm sıfatını bağlamında ve halku’l-Kur’ân ile icâz’ul-Kur’ân gibi konularla ilişkili bir şekilde ele almaktadır. Bu isimler de listeye dahil edildiğinde sayı 178’e ulaşmaktadır. Bu durumda eserin yarısını esmâ-i hüsnâ konusu teşkil etmektedir. -/- Saffâr, esmâ-i hüsnâ bölümünde alfabetik bir sıra içerisinde ele aldığı ilâhî isimleri öncelikle lugavî (semantik) yönden izah etmektedir. Sonrasında ise değerlendirdiği ilahî ismi, bir kelâm konusu ile bağlantı kurarak kelâmî perspektifle açıklamaktadır Esmâ-i hüsnâ temelinde ele alınan konuların hilâfet meselesi hariç diğer kelâm bahislerini kapsadığı görülmektedir. Saffâr öncesi Hanefî-Mâtürîdî kelâm literatürü içinde esmâ-i hüsnânın bu kadar kapsamlı ele alındığı başka bir eser bilinmemektedir. -/- Bu kitap; üç ana bölümden oluşmaktadır. “Metodolojik Çerçeve” başlıklı giriş bölümünde çalışmanın konusu, önemi, amacı, yöntemi ve kaynakları hakkında bilgi verilmiştir. Birinci bölümde Saffâr’ın yaşadığı sosyokültürel çevre olan Mâverâünnehir bölgesi ile Buhara ve Merv şehirlerinin siyasî, sosyal ve dinî durumu ortaya konulmaya çalışılmıştır. İkinci bölümde esmâ-i hüsna konusunun anlaşılmasına temel oluşturan isim, tesmiye, müsemmâ, sıfat ve vasf gibi kavramlar ile esmâ-i hüsnânın sayısı ve ihsâsı gibi kelâmî tartışmalara değinilmiştir. Sonrasında Saffâr öncesi dönemde kaleme alınan esmâ-i hüsnâ litaratürü hakkında bilgi verilmiştir. Bölüm sonuna Saffâr’ın rivayet ettiği 178 ilahî isme dair ayrıntılı bir tablo eklenmiştir. Üçüncü bölümde öncelikle, Saffâr’ın esmâ-i hüsnâyı izah ederken dikkate aldığı kelâmî ilkeler tespit edilmeye çalışılmıştır. Sonrasında ise Saffâr’ın Telḫîṣü’l-edille’de ilâhî isimleri açıklarken ortaya koyduğu kelâmî görüş ve değerlendirmeler belirlenerek sistematik bir şekilde kategorize edilmiştir. Bu kapsamda ele alınan her konunun sonuna ilgili ilâhî isimleri ve bağlantılı olduğu tartışmaları içeren tablolar eklenmiştir. Sonuç bölümünde ise Saffâr’ın esmâ-i hüsnâ anlayışına dayanan kelâm yöntemine dair ulaştığımız sonuçlara yer verilmiştir. Bu kitapta onun, esmâ-i hüsnânın %75’inde kelâmî yorumlarda bulunduğu ve bilgi-varlık bahsinden âhiret hayatına kadar bütün kelâm konularını esmâ-i hüsnâ ile bağlantılı yorumladığı tespit edilmiştir. Ulaşılan bu sonuçlar, Saffâr’ın kelâm anlayışının ilâhî isimlerin yorumuna dayandığını ortaya koymaktadır. [his book discusses the theological views of Abū Isḥāq al-Ṣaffār d. 534/1139), within the framework of his comments on the meanings of Allah’s names, provided in his work titled Talkhīṣ al-adilla. Abū Isḥāq al-Ṣaffār is one of the Ḥanafite-Māturīdite scholars in the 6th/12th century. In his work titled Talkhīṣ al-adilla li-qawāʿid al-tawḥīd on kalām, he spared extensive space for al-asmāʾ al-husnā. Approximately one third of this work, published in two volumes, is devoted to al-asmāʾ al-husnā. An examination of the related section reveals that al-Ṣaffār explains many issues, particularly those related to the existence, unity and attributes of Allah, based on 175 al-asmāʾ al-husnā. He mentions some of the names that he does not include in the al-asmāʾ al-husnā section under separate headings. For example, the name al-Mutakallim is addressed within the context of the attribute of kalām and in relation to subjects, such as the khalq al-Qurʾān and i‘jaz al-Qurʾān. Upon the addition of these names to the list, the number names reaches 178. This means that half of the work deals with the subject of al-asmāʾ al-husnā. -/- al-Ṣaffār lists the divine names in alphabetical order and explains them semantically in the chapter of al-asmāʾ al-husnā. Then he goes on to clarify each divine name through a theological lens with a specific reference to the subject of kalām. In the pre-Saffar Ḥanafite-Māturīdite theological literature, there is no other work that addresses al-asmāʾ al-husnā in such an extensive way. -/- This book consists of three main sections. The first section titled “Methodological Framework”, elaborates on the focus, significance, purpose and method of the study, along with the sources used. The first part describes the political, social and religious status of Transoxiana (Mā-warāʾ al-Nahr) region and the cities of Bukhara and Marw, the sociocultural environment in which Saffar lived. The second chapter addresses various concepts, which promote the understanding of al-asmāʾ al-husnā, such as name, tasmiya, musammā, attribute and qualification in addition to the theological debates such as the number and iḥṣāʾ of al-asmāʾ al-husnā. Then, it provides information about the al-asmāʾ al-husnā literature produced in the pre- Ṣaffār period. The end of each chapter comes with a detailed table with the 178 divine names mentioned by al-Ṣaffār. In the third chapter, the author initially discusses the theological principles that al-Ṣaffār considered while explaining the essence of al-asmāʾ al-husnā. This section also determines and systematically categorizes the theological views and evaluations put forward by al-Ṣaffār while explaining the divine names in Talkhīṣ al-adilla. The tables with the divine names and the related discussions can be seen at the end of the discussion for each subject. The last section presents the conclusions reached, regarding the kalām method based on al-Ṣaffār’s understanding of the essence of al-asmāʾ al-husnā. The present study revealed that he made theological interpretations in 75% of the al-asmāʾ al-husnā and interpreted all theological issues ranging from the subjects of knowledge and existence to the Afterlife in connection with the al-asmāʾ al-husnā. These results indicate that al-Ṣaffār's understanding of kalām is based on the interpretation of the divine names.]. (shrink)

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When you type the word “serendipity” in a word-processor application such as Microsoft Word, the autocorrection engine suggests you choose other words like “luck” or “fate”. This correcting act turns out to be incorrect. However, it points to the reality that serendipity is not a familiar English word and can be misunderstood easily. Serendipity is a very much scientific concept as it has been found useful in numerous scientific discoveries, pharmaceutical innovations, and numerous humankind’s technical and technological advances. Therefore, there (...) have been many books written around the concept. So why do we need this additional book? This is not just another book about serendipity. It has evolved from the Editor’s question lingering for a decade after finishing his widely cited article (coauthored with Prof. Nancy K. Napier of Boise State University, ID, USA) “Serendipity as a strategic advantage?” in T. Wilkinson’s edited volume Strategic Management in the 21st Century, published by Praeger. The Editor and contributing authors have tried to achieve the following in this title. Demystifying the Serendipity Myth The phenomenon of serendipity has always been thought of as a “miracle”. It is the mystery of human innovation and one of the ultimate secrets of our society. But serendipity is not just a lucky coincidence nor any hidden conspiracy. This book explores the science of the information process behind this seemingly miraculous phenomenon. It connects human society with nature, going back to the root of our existence and looking at the flame of survival to discover the harmony in making creativity. Presenting the nuts and bolts of being an adventurer of science The authors present their conceptual investigations into serendipity’s nature and its mechanism by examining interesting real events and stories. The content is thought-provoking, and readers are led to question and explore their own life stories and problems along the journey of reading this book. Catching an elusive high-value target requires great strategies and efforts. But there are no dark secrets here because this is the “way of nature” – how we humans have always strived for innovation without realizing the blueprints behind such processes. Unlike other books on serendipity, this book will show you that a powerful “secret” is closer than you think. Delivering practical uses for different audiences By understanding the conditionality and survival drivers of serendipity, individuals or organizations can make better decisions on creating the right environment to facilitate the encounter and attainment of this valuable phenomenon. For scientists: With clear explanations of the information processes underlying serendipity, flexible theoretical frameworks of mindsponge and the 3D principle of creativity, researchers are provided with the tools they need to dig deeper into their own fields of study and find practical applications, be it psychology, economics, sociology, or anything that involves innovation (which is, in fact, every scientific discipline). For curious casual readers: Everybody needs innovation to make breakthroughs or spice up one’s life. If you think great ideas come to people randomly from an unknown fairy place, this book will convince you otherwise without taking away that awe and wonder. But above all, you will know how to become more creative, scientifically and straightforwardly, with no snake oil and no weird tricks. For ambitious business people: The flame that brought about great successes throughout human history is within you. But you can only use it if you understand it. While others wait for serendipity to come, you will be able to actively hunt for those precious moments. As it has always been: the best hunters triumph, not the passive wanderers. And in this age of information chaos, finding the golden fruits is not easy. Those from information technology know this problem well, and this book is the treasure map that they have been seeking to navigate that stormy ocean looking for jewels. Like a kingfisher tracking its prey through the water, waiting to gracefully strike, with serendipity, a person seizes the prize of creativity amid the chaos of life. ¤ ¤ ¤ Official introduction: The book explores the nature, underlying causes, and the information processing mechanism of serendipity. It proposes that natural or social survival demands drive serendipity, and serendipity is conditional on the environment and the mindset, on both individual and collective levels. From Darwin's evolution theory to Sun Tzu's war tactics, major innovations throughout human history are unified by this key concept. In the rapidly changing world, information is abundant but rather chaotic. The adaptive power of serendipity allows people to notice treasures within this wild sea, but only for those who understand how it works. To increase the probability of encountering and attaining serendipity, one should employ the mindsponge mechanism and the 3D process of creativity, for without these frameworks, serendipity is truly an elusive target. The book also discusses methods to build environments and cultures rich in navigational and useful information to maximize the chance of finding and capitalizing on serendipity. As a skill, serendipity has a resemblance to how kingfishers observe and hunt their prey. (shrink)

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Este artículo tiene como objetivo presentar un manuscrito conservado en la biblioteca de la Universidad de Bengasi (Libia) que contiene el Kitāb al-Ǧawhara fī nasab al-nabī ṣallā Allāh ʽalayhi wa-sallam wa-aṣḥābihi al-ʽašara por Abū ʽAbd Allāh Muḥammad b. Abī Bakr b. ʽAbd Allāh b. Mūsà al-Anṣārī al-Barrī al-Tilimsānī (596/1200-681/1282). Aunque ha sido mencionado en algunas publicaciones, no llamó la atención de los especialistas de la historia cultural de al-Andalus. Debido a la situación actual de la institución de conservación, no ha (...) sido posible ver ni ofrecer reproducciones. Aun así, como se cedió una fotografía para un catálogo, el último folio resultó muy útil. Se hace constar claramente el origen de la obra, que fue copiada en Menorca por su propio autor en el año 645/1248. Además, se puede observar que fue ofrecido como regalo a Saʽīd b. Ḥakam al-Qurašī, el gobernador de la isla, que fundó una biblioteca cuya riqueza fue celebrada por los autores medievales. En el estado actual del conocimiento, se trata precisamente del quinto manuscrito identificado, encontrándose hoy los otros cuatro en la Real Biblioteca del Monasterio de San Lorenzo de El Escorial. La historia del manuscrito permanece oscura, aunque se puede dar por establecido que reapareció en Libia a mediados del siglo XIX, siendo entonces propiedad de Muḥammad b. ʽAlī al-Sanūsī, fundador de la poderosa ṭarīqa al-Sanūsiyya. (shrink)

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Although by no means a genius, Comenius’s teacher, Johann Heinrich Alsted, was in one sense a prodigy. His great Encyclopaedia of 1630 was fi rst sketched out in his Panacea philosophica of 1610, when the young Herborner was only 22 years old; and in the larger Artium liberalium ac facultatum omnium systema mnemonicum, completed the previous year, its origins are traced back further still, to the outset of his studies in the Herborn academy in 1602, at the tender age of (...) fourteen. More specifi cally, Alsted reveals that his encyclopaedic project began as a commonplace book collected in no small part from his father’s table talk, his mother’s precepts and practice, his grandfather’s library, and the extraordinarily rich collection of pedagogical theorists in his immediate family circle. This paper traces Alsted’s genealogy as a bibliographical as well as a biographical exercise: that is, as a means not merely of revealing his bloodlines, but of tracing the intellectual genealogy of an individual at once deeply rooted in the Reformed academic and clerical community of Hesse and the Wetterau and impatient to break free of established orthodoxies in pursuit of a fresh intellectual synthesis. Tracing the tangled roots of this genealogy back several generations reveals that Alsted’s yearning for further reformation fed upon lengthy familial engagement with various strands of Renaissance humanism, Reformed theology, Ramist pedagogy, Paracelsian medicine, and perhaps even millenarianism. (shrink)

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Timon is an ancient Greek skeptic fed up with dogmatic nonsense about the beginnings of the universe. One night, he dreams of a boisterous "Battle of Brains" between history's major religious and philosophical authorities. Highly satirical, IN THE BEGINNING depicts this battle in a clear and readable style, faithfully detailing each contender's cosmology, including wisecracks and barbs aimed at rival sages. Timon himself pulls no punches in attempting to resolve the debate, even bashing belief itself. A simple spectator, however, gets (...) to throw the last punch when he divulges "The Real Truth of Everything.". (shrink)

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ACCORDING to Plato's famous myth, two gifts of the gods equipped man for living: the one, arts and inventions to supply him with the means of livelihood; the other, reverence and justice to be the ordering principles of societies and the bonds of friendship and conciliation. Agencies for mastery over nature and agencies for cooperation among men remain the two great sources of human power. But after two thousand years, it is possible to note an interesting fact as to their (...) relative order of development in civilization. Nearly all the great skills and inventions that had been acquired up to the eighteenth century were brought into man's service at a very early date. The use of fire, the arts of weaver, potter, and metal worker, of sailor, hunter, fisher, and sower, early fed man and clothed him. These were carried to higher perfection by Egyptian and Greek, by Tyrian and Florentine, but it would be difficult to point to any great new unlocking of material resources until the days of the chemist and electrician. Domestic animals and crude water mills were for centuries in man's service, and until steam was harnessed, no additions were made of new powers.". (shrink)

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In lieu of an abstract, here is a brief excerpt of the content:Wildman's Effing Theodicy:The Problem of Suffering, the Ground of Being, and the Worship of SuchnessDemian Wheeler (bio)I. Confronting Suffering: Fictional Gods, Monstrous Evils, and Ghostly WhisperersWesley J. Wildman—"the comparing inquirer,"1 "the man who receives too many emails,"2 "the most original, audacious, creative, encyclopedic, and integrative thinker working within and across the fields of philosophy, ethics, theology, and the scientific study of religion in our time"3—is now a novelist! His (...) recently published first novel, The Winding Way Home, is an astounding and achingly beautiful story about a family searching for healing in the face of unspeakable tragedy and crushing grief. Our protagonist is Jesse, a strangely familiar philosopher, polymath, and professor, whose six-year-old daughter, Becca, is abducted from her bedroom in the middle of the night. Needless to say, Becca's disappearance totally shatters the lives of Jesse, his beloved partner Alexandra, and their two boys, Matt and Josh.On the verge of a complete mental breakdown, and desperate to manage the anxiety, uncertainty, terror, and encroaching despair, Jesse begins to engage in a severe form of meditation, deliberately dwelling on images of what Becca might be enduring, however gruesome and devastating. He pictures her dead in the woods, sold to the highestbidder, imprisoned in an attic, abused physically and sexually, buried alive in a crate desperately praying to be rescued, treating each possible future "as a shard-like perspective on a fear-inducing, darkly humming [End Page 20] crystalline monstrosity." For Jesse, this visualization practice is an act of solidarity, not masochism, a way to love his precious little girl as she really is, no matter what she went through or is still going through. Anything less feels like a betrayal, like a "spineless retreat from the reality of Becca's life." Facing the brutal truth about Becca also becomes an integral part of his piety, his worship. As the saga unfolds, Jesse embarks on a weird but wild spiritual quest, a quest to see and surrender to the world in all its wonder and ambiguity, grace and threat, the world that gave him the greatest gift imaginable, Becca, a "beautiful, perfect little being," only to take her away and hand her over to a fate worse than death.4Later in the story, Jesse and Alexandra become foster parents to an abduction survivor named Maddy. Their worst nightmares about what probably happened to Becca actually did happen to Maddy. Stolen from her family at a young age and chained up in a cold, lonely basement, Maddy was subjected to years of torture, malnourishment, deprivation, disease, and rape, forced to bear the children of her captors. Shortly after Maddy and her kids move in, Jesse schedules a meeting with Father Jimmy, "his favorite delusional priest." Jesse admires and appreciates Father Jimmy's intelligence, lovingkindness, and nonjudgmental nature. But he is not bashful about challenging his "supernatural mumbo-jumbo."5 On this particular occasion, they gather to talk about the theological implications of Maddy's horrific life and whatever unthinkable horrors befell Becca. The conversation gets quite heated. Growing increasingly irate, Jesse asks Father Jimmy if he prays for Maddy, Becca, and other missing children and trusts in a God who permits their dreadful circumstances and could do something to ameliorate them. Father Jimmy nods in the affirmative and gently asks a question of his own: "Why would you be angry at a God you don't believe in?" Jesse thunders back:I'm not angry at your fictional God! … I'm angry at you. You worship and pray to a being who allowed Becca and Maddy to be raped and tortured, and in Becca's case probably murdered. And then you offer solace to me and my family in the form of prayers to change this deity's mind about what to do. As if that's supposed to make any of us feel better! Can't you see? You're commending to me a God whose behavior and decisions are so utterly appalling, so completely opposed to the good as I understand it, that I would devote my life to morally resisting this God's depravity... (shrink)

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Since intelligent design (ID) advocates claimed the ubiquitous mouse trap as an example of systems that cannot have evolved, mouse trap history is doubly relevant to studying material culture. On the one hand, debunking ID claims about mouse traps and, by implication, also about other irreducibly complex systems has a high educational value. On the other hand, a case study of mouse trap history may contribute insights to the academic discussion about material culture evolution. Michael Behe argued that mouse traps (...) cannot trap mice with any part missing; therefore, they cannot have a precursor with one part less, therefore, cannot have a continuous history, and therefore, cannot have evolved. The patented and seminal precursor of current flat snap traps, however, had one part less, because spring and striker were formed of one wire. Secondly, historical records that reach back into the Bronze Age suggest that its history continued for a very long time. Thirdly, all prerequisites for evolution (variation, transmission, and selection) abound in mouse trap populations. Hence, Behe’s triple-jump conclusion about mouse traps is false each step. There is no, in principle, impossibility for mouse traps to evolve. An evolutionary account of mouse trap history also has academic merits beyond its educational value. Three important conclusions can be drawn: (1) reticulate phylogenies of artifact systems may be resolvable as overlapping, but branching, phylogenies of parts; (2) homologous ideas may be realized by analogous material, that is, phylogenies of information do not necessarily coincide with those of material parts; (3) recombination of parts between different artifact systems increases the cumulative nature of cultural evolution. (shrink)

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In 1912, Julian Huxley published his first book The Individual in the Animal Kingdom which he dedicated to the then world-famous French philosopher Henri Bergson. Historians have generally adopted one of two attitudes towards Huxley’s early encounter with Bergson. They either dismiss it entirely as unimportant or minimise it, deeming it a youthful indiscretion preceding Huxley’s full conversion to Fisherian Darwinism. Close biographical study and new archive materials demonstrate, however, that neither position is tenable. The Bergsonian elements in play in (...) Julian Huxley’s early works fed into his first ideas about progress in evolution and even his celebrated theories of bird courtship. Furthermore, the view that Huxley rejected Bergson in his later years needs to be revised. Although Huxley ended up claiming that Bergson’s theory of evolution had no explanatory power, he never repudiated the descriptive power of Bergson’s controversial notion of the élan vital. Even into the Modern Synthesis period, Huxley represented his own synthesis as drawing decisively on Bergson’s philosophy. (shrink)

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This article further studies ex ante efficient auctions in the setting of Stegeman (1996 Participation costs and efficient auctions, Journal of Economic Theory 71, 228–259.), where there exist entry costs for bidders who know their valuations. An alternative method is established to address efficient auctions. This method illustrates the intuition why the ex ante efficient allocation is Bayesian implementable through the Stegeman (1996) auction (a second-price auction with a reserve price equal to seller’s valuation and no entry fee). More importantly, (...) our method leads to an alternative ex ante efficient auction that implements uniquely the efficient entry. Thus, this alternative auction solves the entry indeterminacy problem of the Stegeman (1996) auction, which generally induces inefficient entry equilibria besides the efficient ones. (shrink)

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Anti-commodification theorists condemn liberal political philosophers for not being able to justify restricting a market transaction on the basis of what is sold, but only on the basis of how it is sold. The anti-commodification theorist is correct that if this were all the liberal had to say in the face of noxious markets, it would be inadequate: even if everyone has equal bargaining power and no one is misled, there are some goods that should not go to the highest (...)bidder. In this paper, I respond to the anti-commodification critique of liberalism by arguing that the political liberal has the wherewithal to account not only for the conditions under which goods should not be sold, but also for what kinds of goods should not be for sale in a market economy. The political liberal can appeal to a principle of equal basic rights, and to one of sufficiency in basic needs and the social bases of self-respect, I argue, to account for what’s problematic about markets in civic goods, necessary goods, and physical goods including body parts and intimate services. (shrink)

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We study a dynamic auction mechanism in the context of private provision of a discrete public good under incomplete information. The bidders have private valuations, and the cost of the public good is common knowledge. Nobidder is willing to provide the good on her own. We show that a natural application of open ascending auctions in such environments fails dramatically: The probability of provision is zero in any equilibrium. The mechanism effectively auctions off the ‘right’ to be the (...) last one to contribute, but intuition suggests that neither player wishes to be the last one to contribute. Since the player who contributes first has the advantage of being able to free ride on the contributions of the other players, no player wants to ‘win’ the auction. (shrink)

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Negative people/wildlife interaction has raised public interest in wildlife population control. We present a contingent valuation study of alternative deer control measures considered for Hilton Head Island, SC. Lethal control usig sharpshooters and nonlethal immuno-contraception techniques are evaluated. A mail-back survey was used to collect resident willingness-to-pay information for reduced deer densities and consequent property damage. Residents are unwilling to spend more for the nonlethal alternative. The estimated WTP appears theoretically consistent as increasing levels of abatement for both lethal and (...) nonlethal alternatives demonstrate diminishing marginal benefits. Over 60% of respondents bid zero regardless of control measure, suggesting a referendum would fail. However, only half of these zero bidders expressed no problem with deer, while the other half bid zero because of distaste for the control alternative, safety concerns, or doubt about effectiveness. Inclusion of these responses as legitimate zero bids depressed mean WTP estimates from 22 to 31%. (shrink)

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PurposeThe purpose of this paper is to present implications of the seller's ability to bid in the four classical auction forms, with independent private values: English, Dutch, first‐ and second‐price auctions.Design/methodology/approachUnder each auction form, the identity of the winningbidder and the expected winning bid are compared between the case when the seller may bid and when he cannot, using equilibriumbidder strategies. The seller's incentive to bid is evaluated.FindingsThe strategies and the welfare results differ with auction type (...) and underlying information assumptions – bidders are either aware or unaware of the seller's ability to bid. In the Dutch and the first‐price auctions, seller‐bidding does not affect any classical results. In the English and the second‐price auctions, it leads to no lower expected prices than without it and higher prices with positive probability. In the English and the second‐price auctions, the seller bids above his reservation value and may unintentionally win the auction. These auctions result in inefficiency with positive probability.Practical implicationsThe English and the second‐price auctions are the most common real‐world auctions. In these auctions, the seller's ability to bid – secretly or publicly – redistributes welfare among participants and introduces a possibility of inefficiency. Making this ability publicly known does not solve the latter problem. Auctioneers must prevent the seller from bidding, or must select a different auction form when seller‐bidding is anticipated.Originality/valueThe paper clarifies to regulators, auction designers, bidders, and other readers which auction forms are susceptible to subversion by seller‐bidding and what the potential damages are. (shrink)

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This argument map represents the argumentation of Sparrow, R. . "Just say No" to Drones. IEEE Technology and Society Magazine, M 1932-4529/12, 56-63. doi: 10.1109/MTS.2012.2185275. The argument map is open for debate in AGORA-net, search for map ID 9712.

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