The General Medical Council (GMC) instructs doctors to act ‘reasonably’ in obtaining consent from patients. However, the GMC does not explain what it means to be reasonable: it is left to doctors to figure out the substance of this instruction. The GMC relies on the Supreme Court’s judgment in Montgomery v Lanarkshire Health Board; and it can be assumed that the judges’ idea of reasonability is adopted. The aim of this paper is to flesh out this idea of reasonability. This (...) idea is commonly personified as the audience that has to be satisfied by the doctor’s justification for offering, or withholding, certain treatments and related information. In case law, this audience shifted from a reasonable doctor to a ‘reasonable person in the patient’s position’; and Montgomery expands the audience to include ‘particular’ patients, too. Senior judges have clarified that the reasonable person is a normative ideal, and not a sociological construct; but they do not set out the characteristics of this ideal. John Rawls has conceived the reasonable person-ideal as one that pursues fair terms of co-operation with other members of society. An alternative ideal can be inferred from the feminist ethic of care. However, the reasonable patient from Montgomery does not align with either theoretical ideal; but, instead, is an entirely rational being. Such a conception conflicts with both real-life constraints on rationality and the doctor’s duty to care for the patient, and it challenges the practice of medicine. (shrink)

The General Medical Council renewed its guidance on consent in 2020. In this essay, I argue that the 2020 guidance does not advance on the earlier, 2008 guidance in regard to treatments that doctors are obliged to offer to patients. In both, doctors are instructed to not provide treatments that are not in the overall benefit, or clinical interests, of the patient; although, patients are absolutely entitled to decline treatment. As such, consent has two aspects, and different standards apply to (...) each aspect. To explore this paradigm, I propose the reconceptualisation of consent as a person’s freedom to achieve treatment, using Amartya Sen’s approach. Sen explains that freedom has two aspects: process and opportunity. Accordingly, a patient’s freedom to achieve treatment would comprise a process for the identification of proper treatment, followed by an opportunity for the patient to accept or decline this treatment. As per Sen, the opportunity aspect is to be assessed by the standard of public reason, whereas the standard for the process aspect is variable and contingent on the task at hand. I then use this reconceptualised view of consent to analyse case law. I show that senior judges have conceived the patient’s opportunity to be encompassed in information, which is to be decided by public reason. On the other hand, the process aspect relies on the private reason of medical professionals. Given the nature of professionalism, this reliance is inescapable, and it is maintained in the case law that is cited in both guidances. (shrink)

The decision of the High Court in Bell v Tavistock has excited considerable discussion about lawful consent for puberty-blocking drug treatment for children with gender dysphoria. The present paper draws attention to a wider question that surfaces through this case: is informed decision-making an adequate practical tool for seeking and obtaining patients’ consent for medical treatment? Informed decision-making engages the premises of the rational choice theory: that people will have well-crystallised health goals; and, if they are provided with sufficient information (...) about medical treatments, then they will be able to choose the treatment that satisfies their goals. Whilst appealing, the informed decision-making paradigm is assailed by various fallacies, which apply not only to children but also to adults. In Bell v Tavistock, the High Court seems to have recognised such fallacies, and it rejected informed decision-making as an adequate tool for consent from children with gender dysphoria. Similar considerations apply to adults in various situations. Thus, Bell v Tavistock can be seen as an attempt to refine the views on the consent that were expressed by the Supreme Court in Montgomery. It can be inferred that the Supreme Court did recognise the limitations of informed decision-making, but it did not develop this point. Further work is required to formulate an adequate model of decision-making, and Bell v Tavistock serves as a useful reminder to rethink informed decision-making as the device for consent. (shrink)

Parsa-Parsi et al assert that the International Code of Medical Ethics (ICoME) provides a professional standard that overrides conflicting national legal norms.1 While this claim is made in the context of laws that require doctors to participate in ‘acts of torture, or other cruel, inhuman, or degrading practices and punishments’ (para10 of ICoME), the underlying premise that medical ethics supersedes law requires scrutiny. It is clear that medical ethics and law are linked inextricably, but there is unresolved debate about the (...) sequence of this interaction: should ethics shape law; or is it the converse? Important principles, notably respect for patients’ autonomy, have arisen from case law and subsequently been adopted into medical ethics. As pointed out by Beauchamp and Childress, it is only ‘since the mid-1970s (that) the primary justification advanced for requirements of informed consent has been to protect autonomous choice’ (pg.118).2 Whereas, the legal obligation to respect autonomy can be traced to the early 1900s, in the landmark US case of Schloendorff v Society of New York Hospital : ‘Every human being of adult years and sound mind has a right to determine what shall be done with his own body’.1 Moreover, the term informed consent was born in law: it was coined …. (shrink)

The necessity of consent is widely justified on the basis of the principle of respect for autonomy. Also, it is widely believed that shared decision making (SDM) is the practical device to seek patients’ consent for medical treatment. In this essay, I argue that SDM, while necessary, is insufficient for consent; because, in the paradigm of evidence-based medicine, SDM is contingent upon other practices to identify appropriate treatments that form the subjects of SDM. Indeed, case law emphasises normative decision-making practices (...) that precede SDM. Furthermore, case law supplies a nuanced understanding of SDM, which includes not only exchange of information but also attention to human vulnerability that persists despite formal retention of decision-making capacity. In addition, the law marks out a space in which people with capacity are absolutely entitled to self-determination. Thus, a four-step framework of decision making can be induced from legal doctrine. This legal framework corresponds to a construct of respect for autonomy that draws upon feminist theory. Feminist scholars have objected to the focus on individuals in traditional theories of autonomy; instead, they insist that people have to be considered in the context of their social influences and relationships. Feminists separate out four ideas of autonomy, and these ideas can be used to construct a four-layered model of respect for autonomy, in which each layer corresponds sequentially to a step in the legal framework of decision making. This model of respect for autonomy provides both conceptual clarity and theoretically robust justification for doctors’ various obligations in decision-making practices for consent. (shrink)

The UK Supreme Court’s recent judgement inMcCulloch v Forth Valley Health Boardclarifies the standard for the identification of ‘reasonable’ alternative medical treatments. The required standard is that of a reasonable doctor: treatments that would be accepted as proper by a responsible body of medical opinion. Accordingly, the assessment of consent involves a two-stage test: first, a ‘reasonable doctor’ test for identifying alternative treatments; followed by a ‘reasonable person in the patient’s position’ test for identifying the material risks of these reasonable (...) alternative treatments. The separation of consent into two stages is consistent with not only a certain conception of freedom but also a nuanced construct of respect for autonomy that has a normative base. Furthermore, reliance on a reasonable doctor in the first stage is in keeping with a sociological account of medical professionalism, which posits that only doctors, and none others, can determine what is a proper treatment. Yet, reliance on a reasonable doctor permits a plurality of standards for reasonableness, because differences in opinion among doctors are pervasive. The reasons for some differences might be acceptable as unavoidable imperfections in medical decision-making to a reasonable person. But reasons for other differences might be objectionable; and the resultant inequalities in medical treatments would be considered unfair. One solution is to make the plurality of reasonable alternatives available to the patient, but this would introduce practical uncertainty and it is rejected by the Court. The Court’s approach may be pragmatic; however, it seems to allow avoidable injustice in healthcare. (shrink)

Cox and Fritz state the central problem as the absence of a framework for healthcare policy decisions; but, they overlook the theoretical underpinnings of public law. In response, they propose a two-step procedure to guide fair decision-making. The first step relies on Thomas Scanlon’s ‘contractualism’ for stakeholders to consider whether, or not, they could reasonably reject policy proposals made by others; then in the second step, John Rawls’s principles of justice are applied to these proposals; a fair policy requires to (...) pass both steps. I argue that Cox and Fritz misinterpret Rawls. His theory has two stages: first, public reason is used to generate principles of justice; second, public reason is used to interpret and apply these principles. The second stage requires that proposals are based on the principles of justice from the first stage, and these proposals have to be acceptable to reasonable persons. Thus, Rawls’s theory does not need Scanlonian supplementation. Moreover, the application of Rawls’s theory in Cox and Fritz’s model is confusing. In any case, the problems with applying Rawlsian justice to healthcare can be located elsewhere. First, Rawls’s theory would treat healthcare simply as a ‘primary good’ or resource. Social justice ought to, instead, consider healthcare as an opportunity, in the manner conceived by Amartya Sen. Second, Rawlsian justice rests, ultimately, on the conception of a reasonable person; until and unless the characteristics of reasonable stakeholders are clarified, any model of health justice will remain hostage to the unreasonable. (shrink)

Makin argues that doctors1 should defer to each patient’s attitude to risk, over and above standard, utility-based and outcome-focussed medical decision-making models, in selecting treatment options for that patient.1 Although Makin articulates the problem as a dilemma of whether ‘to give the treatment or to withhold it’, it can be assumed that his question is whether the doctor should offer a certain treatment; because both the General Medical Council and law require doctors to engage patients in shared decision-making (SDM) and (...) to obtain consent before ‘giving’ any treatment. Yet, Makin is correct in asserting that doctors ‘make choices on behalf of their patients on a daily basis’ insofar that doctors do have to make certain a priori decisions. SDM requires a starting point—a range of clinically appropriate or reasonable options—on which patients and doctors can collaboratively deliberate in order to reach a treatment decision; and the doctor has to set out this starting point.2 Thus, Makin’s reductive claim is that doctors should take each patient’s risk attitude into account in setting out the starting points for SDM. In this commentary, I will explore UK case law in response to Makin’s proposal; because, ultimately, doctors have to work within the legal framework. Makin relies on the bioethical principles of respect …. (shrink)

This paper discusses the contribution of a prolific author and an Egyptian scholar Nasr Hamid Abu Zayd and his hermeneutical approach to the Qur’an. The article argues that Abu Zayd is a Muslim reformer of the twentieth century through his takwil. His hermeneutical concept is questioning the “an-nash ” tradition of the Qur’an and the transformation of Arab culture from oral to text-oriented culture in the earliest history of the Qur’an. He differentiates between tanzil to takwil. This article further argues (...) that Abu Zayd’s hermeneutical concept should be understood from the history of revelation which speaks to a particular community and respond to a particular situation. Thus, the Qur’an itself is a living phenomenon and open for interpretation, rather than a closed corpus. (shrink)

This paper discussed the life background of Nasr Hamid Abu Zayd and the hermeneutical method used to the interpretation of the Qur’an. Nasr Hamid Abu Zayd was among productive Muslim scientists. He wrote over twenty-nine works from 1964 to 1999. His works included books and articles. Nasr’sthought was a product of his educational background and religious thought. An interesting discussion of Nasr’s thought was the conceptual discourse. In the historical trajectory of the Arabic world, the text had a crucial position, (...) especially when we saw the development of Islamic literature from pre-Islamic to the Islamic era. The oral tradition was deeply rooted. The text was ultimately believed to have a major influence in the formation of civilization through a hermeneutical approach, developed by modernists such as Nasr Hamid Abu Zayd, which became an attempt to develop an approaching understanding the Qur’an which had been widely opposed among Muslims. Because there was a very basic difference between hermeneutics on the other hand, and tafsir-takwil on the other hand, so it is considered inappropriate to be used to study the Qur’an. Therefore, this paper will discuss the concept of the hermeneutical method of the Qur’an by Nasr Hamid Abu Zayd as a repertoire of Islamic studies. (shrink)

In _Knowing God_, Ismail Lala investigates the nature of God and whether we can truly know Him according to the influential mystic, Muḥyī al-Dīn ibn ʿArabī, and his disciple, ʿAbd al-Razzāq al-Qāshānī.

Muḥyī al-Dīn Ibn ‘Arabī (d. 638/1240) is regarded as one of the foremost mystical thinkers in Islam. This paper explores the ways in which he and his followers distinguish between the reality of Muḥammad (_al-ḥaqīqa al-Muḥammadiyya_) or the light of Muḥammad (_al-nūr al-Muḥammadī_), as the metaphysical reality of Muḥammad, and his metahistorical manifestation as Muḥammad Ibn ‘Abd Allāh. In his metaphysical reality, Muḥammad is the manifestation of the _qur’ān_, which ‘brings together’ the divine and His creation. Muḥammad’s metaphysical reality, as (...) the primary recipient of the divine outpouring, enables further differentiations of the divine to emerge in the form of the universe, and establishes his connection to the divine. Yet the Qur’an is also temporal in terms of being an historical act of revelation. Likewise, Muḥammad Ibn ‘Abd Allāh, in terms of his physical reality, was temporally circumscribed. It is in these ways, argues Ibn ‘Arabī and his acolytes, that Muḥammad, as reality and personality, brings together the divine and the temporal, in the same manner as the _qur’ān_/Qur’an respectively. (shrink)

This study aims to investigate the experiences and problems of foreign nationals in Turkey, concerning microaggressions. Thus, it was aimed to find out which types of microaggressions -and at what frequency- are experienced by people who come to Turkey for different reasons like education, pursuit of a better life or escaping from war. The study was conducted in five different cities of Turkey. Students from primary school to university, teachers, parents and doctors took part in the study. The participants were (...) asked the single question “Do you ever experience deliberate or undeliberate insults, whether verbal or behavioral, targeting your ethnic identity and diversity in Turkey?” The results of the study show that microaggression is a very serious problem in Turkey. It can be gathered from the findings that Turkish people are not as tolerant to foreign people as they used to be. Behaviors that make people of foreign origin feel like second-class citizens and alienated take place quite often. Foreigners are usually connected with negative occurrences and they are reminded that they are not welcome in this country. These people are also accused of causing many misfortunes in the country. The study also exhibits that foreign nationals suffer greatly from prejudices about their cultures and they become the target of explicit and direct insults particularly regarding their race. (shrink)

Moses Maimonides, Mishneh Torah, ed. Rabbi Eliyahu Touger, 18 vols.

Kadim bir dil olan Arapça, İslamiyet’in gelişiyle birlikte kutsal bir kitap olan Kur’an-ı Kerim’in dili olmuş, günümüze kadar varlığını ve önemini korumuştur. Anadili Arapça olmayanlara bu dilin öğretilmesi için farklı coğrafya ve farklı dönemlerde medreselerde veya devletin resmi eğitim kurumlarında Arapça dersleri verilmiştir. Verilen Arapça eğitimlerinde nahiv ve sarf temelli bir eğitim uygulanmıştır. Gramere dayalı bu dil eğitimi İlahiyat veya İslami İlimler fakültelerinde verilen eğitimlerle daha ileri bir seviyeye taşınmaya çalışılmıştır. İlahiyat veya İslami İlimler fakültelerinde verilen Arapça eğitimleri temelde dört (...) beceriyi kazandırma odaklı hazırlanmıştır. Ancak gramer odaklı verilmeye çalışılan Arapça eğitimlerinde hedeflenen başarı elde edilememektedir. Bu araştırmanın konusu, İlahiyat veya İslami İlimler fakültelerinde okutulan Arapça hazırlık eğitiminin değerlendirilmesi ve bu eğitimin kalitesinin arttırılması için yapılması gerekenlerdir. Bu doğrultuda bu çalışmada Bitlis Eren Üniversitesi İslami İlimler Fakültesi %30 Zorunlu Arapça Hazırlık Sınıflarının 2018-2019 Eğitim ve Öğretim Yılında aldıkları Arapça eğitimi model alınmıştır. Hazırlık Sınıflarında Arapça eğitimi alan 90 öğrenciye 33 sorudan oluşan anket uygulanmıştır. Anket sonuçları değerlendirilmiş ve verilen Arapça eğitiminin kalitesi ortaya konulmuştur. Elde edilen sonuçlardan hareketle, verilen eğitimde eksik ve hatalı durumlar tespit edilerek, eğitimin daha kaliteli bir düzeye ulaştırılması için önerilerde bulunulmuştur. Giriş bölümünde İlahiyat veya İslami İlimler fakültelerindeki Arapça eğitimi hakkında bilgiler verilmiştir. Sonrasında çalışmanın amacı, önemi, sınırlılıkları, problemi ve örneklem ortaya konulmuştur. Fakültede uygulanan Arapça hazırlık eğitimi hakkında bilgiler verilmiş ve uygulanan anket çalışmaya eklenmiştir. Son olarak bulgular ve yorumlar verilerek çalışma sonuç ve öneriler ile sonlandırılmıştır. (shrink)

Messianism is an integral component of Abrahamic faiths. Yet the emergence of the Messiah is counterbalanced by the Antichrist. Apocalyptic visions of the future in Judaism, Christianity, and Islam...

We consider a chain of metabolic reactions catalyzed by enzymes, of reversible Michaelis-Menten type with full dynamics, i.e. not reduced with any quasi-steady state approximations. We study the corresponding dynamical system and show its global stability if the equilibrium exists. If the system is open, the equilibrium may not exist. The main tool is monotone systems theory. Finally we study the implications of these results for the study of coupled genetic-metabolic systems.

Karl Popper’s critique of idealism manifests itself with the application of his method, falsificationism, to metaphysics, epistemology, and social and political philosophy. According to Popper, who identifies himself as a philosophical realist, idealism has emerged as a result of the idea that reality cannot be known by reason and of the search for certainty which is erroneous, and it has begotten two mistaken and detrimental views. These views are historicism, the notion that history has an irresistible course, and holism, the (...) notion that social wholes are organic structures that amount to more than the individuals constituting them. Historicism and holism have become the philosophical underpinnings of closed societies throughout history, such as the totalitarian regimes of the 20th century. Therefore, with a practical leaning, Popper actually takes aim at these pernicious consequences of idealism while criticizing it. In this study, idealism and the contours of Popper’s philosophy are examined, and then Popper’s metaphysical, epistemological, social, and political critiques against idealism are investigated. Keywords: Karl Popper, idealism, historicism, holism, falsificationism. (shrink)

Al-Qāḍī al-Nuʿmān, The Disagreements of the Jurists: A Manual of Islamic Legal Theory. Edited and translated by Devin J. Stewart. Library of Arabic Literature. New York: New York University Press, 2015. Pp. xxxviii + 405. $40.

This study is the first part of an attempt to settle a vigorous debate among historians of medieval philosophy by harnessing the resources of analytic philosophy. The debate is about whether Avicenna's epistemology is rationalist or empirical. To settle the debate, I first articulate in this article the three core theses of rationalism and one core thesis of empiricism. Then, I probe Avicenna's epistemology in his major works according to the first core thesis of rationalism (the intuition thesis). In the (...) end, I find Avicenna committed to this thesis in at least one substantive way, namely, in his claim to intuit the intelligible forms or essences. This suffices to count Avicenna as rationalist. In a subsequent article, I shall probe Avicenna's epistemology according to the other two core theses of rationalism, presenting further evidence that he was a rationalist, not an empiricist. (shrink)

The matter of creation is a topic on which the humanity focuses for many centuries. In our opinion, the elements which make this matter important could be evaluated within three categories: The ontological query of the human being arising from the necessity of “knowing”, the obligation of placing the being on the basis of epistemology in terms of the commonality of the quality of being, and creation being the commencement date of universe and human being. Throughout the history, some distinct (...) views related to commencement have been bandied about. In this respect, some theologians and philosophers have determined not only two distinct entities, namely God and the Universe but also two realms of existence which, qualitatively and existentially, have different structures. Philosophers and theologians have searched for the affinities of these two entities. In generally speaking, some of the theologians adopted creating out of nothing (ex nihilo); on the other hand, some others adopted emanation theory. Although the aforesaid two creation explanations are considered to be incompatible with each other; İbn Sînâ (Avicenna) who adopted emanation theory in terms of explaining the creation is claimed that he used the notion of ibdâ‘ (creation) in the meaning of “creating out of nothing” (ex nihilo). In this sense, we face the question whether we could talk about creating out of nothing for İbn Sînâ as a significant problematic to be answered. We, in this paper, aim at discussing the possibility of associating the emanation with ex nihilo. In this respect, taking the criticisms brought by İbn Sînâ, we will make evaluations with reference to the general philosophy of İbn Sînâ. In particular, Kemâlpaşazâde (d. 940/1534) who argued that the notion of“Creation’” was misunderstood by people before shall be our focus. Because Kemalpaşazâde's analysis of the events leading up to his speech reveals a third point of view. In other words, Kemalpaşazâde suggests a new and original approach between philosophical and theological debates. In this article, we are to evaluate the claims in question and present our own solution. (shrink)

ABSTRACT The connection between the unity of God and the multiplicity seen in the universe represents the central concern for the Sufi thinker, Muḥyī al-Dīn ibn ‘Arabī (d. 638/1240). It deeply affected the thought of the Southeast Asian mystic, Ḥamza Fanṣūrī (d. 1590?), and his alleged disciple, Shams al-Dīn al-Sumatra’ī (d. 1630). Traces of this idea, through its popularisation in the poems of Fanṣūrī, exert a powerful influence on the Indonesian intellectual topography to this day. This article investigates the concept (...) of unity and multiplicity, of the One expressed as the many in the phenomenal world, in Ibn ‘Arabī’s Fuṣūṣ al-ḥikam (Ringstones of Wisdom). Through a close textual reading of the chapters of Ādam (Adam) and Ibrāhīm (Abraham) and their various commentaries by the most influential followers of Ibn ‘Arabī, it concludes that the representation of ‘oneness of being’ (waḥdat al-wujūd), which was extensively taught by Fanṣūrī in Aceh, as an erasure of the God-Man divide, is untenable. (shrink)

This study explores the ways in which trust deficit undermines anti-corruption initiatives in a context with systemic corruption. Anti-corruption measures as panacea to systemic corruption are not new, but their effectiveness is debatable. Whilst understanding the causal relationship between corruption and trust remains germane to fighting corruption, a growing number of recent studies advocate better context sensitivity in developing anti-corruption initiatives. Consistent with this, we unpack the perceptions of a significant section of the population in which corruption is rampant to (...) identify factors that could enhance trust in the effectiveness of anti-corruption measures. Using commentaries from Nigerian Netizens on two critical corruption incidents that are significant to corporations, we uncover poignant narratives of perception of incompetence, dishonesty and confusion that undermine the anti-corruption measures in the context. We argue that donors, international organisations and businesses must encourage and support beneficiaries’ governments to secure and sustain trust in the anti-corruption initiatives as a condition for better results. (shrink)