Activists and academics have clamoured for the decolonisation of knowledge, including law. But, unfortunately hardly anyone has put forth strategies for how faculties should decolonise the law. A number of jurists have underscored the necessity to draw on customary laws and traditional values. Still, the #RhodesMustFall movement has, for the most part, been loud on the outcomes, but quiet on the methodologies. Joining the conversation on the decolonisation of epistemologies, this article contributes to the ongoing efforts to sanitise the law (...) by proposing to revive African oral storytelling cultures as a way to analyse the questions of law facing society. To live up to this task, this article adopts decolonial theory and, through stylised examples, illustrates how lawyers and social scientists in Africa can utilise storytelling to contextualise, construct, and comprehend those questions. This article assumes that lawyers can use African storytelling alongside the prevailing doctrinal method. That method, relaying the coloniality of law and captured by the acronym IRAC, rules, application, and conclusion), trains students to approach conflict in society through a highly abstract and decontextualised problem-solving model. Lately, some social scientists have discovered the practicality of storytelling in presenting analysis and research. However, in African oral traditions, stories worked differently from the manner in which those scientists employ them. African storytelling played a leading role, not only in conveying collective wisdom and social memory from one generation to the next, but also as a medium through which communities transmit the values that hold them together.Contribution: This article adds to the scholarship on storytelling and narratology by showing how educators can utilise stories to analyse legal questions. That rich scholarship in the humanities and the social sciences has so far not taken seriously the possibility of using stories to analyse research problems. Instead, scholars focus on storytelling mainly as a way of presenting science, not as an analytical tool. This article bridges that gap and demonstrates the analytical value of storytelling. (shrink)

This article describes the Vaccine/Injury Project Corpus, a collection of legal decisions awarding or denying compensation for health injuries allegedly due to vaccinations, together with models of the logical structure of the reasoning of the factfinders in those cases. This unique corpus provides useful data for formal and informal logic theory, for natural-language research in linguistics, and for artificial intelligence research. More importantly, the article discusses lessons learned from developing protocols for manually extracting the logical structure and generating (...) the logic models. It identifies sub-tasks in the extraction process, discusses challenges to automation, and provides insights into possible solutions for automation. In particular, the framework and strategies developed here, together with the corpus data, should allow “top–down” and contextual approaches to automation, which can supplement “bottom-up” linguistic approaches. Illustrations throughout the article use examples drawn from the Corpus. (shrink)

In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.

Some legal theorists deny that states can conceivably act extra-legally, in the sense of acting contrary to domestic law. This position finds its most robust articulation in the writings of Hans Kelsen, and has more recently been taken up by David Dyzenhaus in the context of his work on emergencies and legality. This paper seeks to demystify their arguments and, ultimately, contend that we can intelligibly speak of the state as a legal wrongdoer or a legally unauthorized actor.

Some legal theorists deny that states can conceivably act extralegally in the sense of acting contrary to domestic law. This position finds its most robust articulation in the writings of Hans Kelsen and has more recently been taken up by David Dyzenhaus in the context of his work on emergencies and legality. This paper seeks to demystify their arguments and ultimately contend that we can intelligibly speak of the state as a legal wrongdoer or a legally unauthorized actor.

This article examines five different Medical-Legal Partnerships associated with Yale Law School in New Haven, Connecticut to illustrate how MLP addresses the social determinants of poor health. These MLPs address varied and distinct health and legal needs of unique patient populations, including: 1) children; 2) immigrants; 3) formerly incarcerated individuals; 4) patients with cancer in palliative care; and 5) veterans. The article charts a research agenda to create the evidence base for quality and evaluation metrics, capacity building, sustainability, (...) and best practices; it also focuses specifically on a research agenda that identifies the value of the lawyers in MLP. Such a focus on the “L” has been lacking and is overdue. (shrink)

Many believe the existence of a moral right to some good should lead to recognition of a corresponding legal right to that good. If, for instance, there is a moral right to healthcare, it is natural to believe countries should recognize a legal right to healthcare. This article demonstrates that justifying legal rights to healthcare is more difficult than many assume. The existence of a moral right is insufficient to justify recognition of a corresponding justiciable constitutional right. (...) Further conditions on when it is appropriate to recognize constitutional rights are rarely satisfied in the healthcare case. And focusing on aspirational or statutory rights presents costs for those seeking to justify legal rights on the basis of corresponding moral ones while maintaining empirical challenges for justifying constitutional rights. This suggests movement from a moral right to a corresponding legal one is far from straightforward and justifies examining alternative means of realizing moral socio‐economic rights such as the proposed moral right to healthcare. (shrink)

This paper argues that abortion access is an important subject for bioethics scholarship and reflects on the relationship between legal frameworks and access to care. The author uses the example of the United Kingdom to examine the benefits and limitations of abortion-permissive legal frameworks in terms of access. These are legal frameworks that enable the provision of abortion but subject to restrictions. An abortion-permissive regime—first in Great Britain and then in Northern Ireland—has gone some way to improving (...) access to care over time. However, aspects of the regime (that lead to its description as permissive rather than supportive of abortion) have the potential to endanger abortion access in the future and so legal reform is necessary. (shrink)

Citizenship is the right to be a citizen of a social, political, or national community. Aristotle was the philosopher who has been talking about citizenship since ancient times. His thoughts are still historical lessons for the operation of states today. In this article, the author focuses on analyzing basic thoughts on Aristotle's citizenship; which are shown in essential points such as (i) Citizenship is clearly shown in the role of the State, (ii) Right to education, (iii) The right to (...) participate in political affairs, (iv) Citizenship is associated with civic obligations. Thereby, the article draws its historical lesson for the current building of law-governed State in Vietnam in the following aspects: (i) Building a solid-state apparatus with a coherent and unified legal system; (ii) All the State's policies must originate from the Vietnamese practice, ensure the people's mastery and protect the people's legitimate interests; (iii) Consolidating and strengthening the relationship between the State and the people. (shrink)

This article seeks to contribute to ongoing debates on the nature and foundations of environmental law. In doing so, the article accepts the claim made in much of the recent analytical environmental law scholarship that the discipline suffers from a lack of coherence. In a response to this claim, the article probes the potential reasons behind this incoherence. In relying on recent scholarship in the disciplines of social psychology and cultural cognition, the article argues that individual understanding of environmental risks (...) in accordance with a priori held beliefs and values aided by cognitive biases, lends support to a scenario of multiple and diverse understandings of environmental problems. This diversity is in turn reflected in both the form and content of environmental law. In a response to this diversity and incoherence, the article identifies the philosophy of pragmatism and argues that a modest interpretation of pragmatism has the potential to alleviate the biases and heuristics that give rise to the individual understanding of environmental risks. (shrink)

This book seeks to reframe our understanding of the lawyer's work by exploring how Martin Luther King, Jr built his advocacy on a coherent set of moral claims regarding the demands of love and justice in light of human nature. King never shirked from staking out challenging claims of moral truth, even while remaining open to working with those who rejected those truths. His example should inspire the legal profession as a reminder that truth-telling, even in a society that (...) often appears morally balkanized, has the capacity to move hearts and minds. At the same time, his example should give the profession pause, for King's success would have been impossible without his substantive views about human nature and the ends of justice. This book is an effort to reframe our conception of morality's relevance to professionalism through the lens provided by the public and prophetic advocacy of Dr King. (shrink)

There is a fine balance between civil liberties and protection of the public’s health.Legislators, especially those in the western United States, are concerned about selling the Model State Act because of the loss of civil liberties. State constitutions give governors broad powers, such as declaring martial law and giving public health leaders the authority to act. State laws should consider issues such as property rights; taking of businesses and supplies; quarantine and isolation; due process; coordination among states, counties and cities; (...) communication systems; conscription of doctors and nurses; and compensation. When two mock emergency response drills were held in New Mexico, concerns arose regarding opening records associated with dams, national laboratories, waste repositories, and three air force bases. (shrink)

There is a fine balance between civil liberties and protection of the public’s health.Legislators, especially those in the western United States, are concerned about selling the Model State Act because of the loss of civil liberties. State constitutions give governors broad powers, such as declaring martial law and giving public health leaders the authority to act. State laws should consider issues such as property rights; taking of businesses and supplies; quarantine and isolation; due process; coordination among states, counties and cities; (...) communication systems; conscription of doctors and nurses; and compensation. When two mock emergency response drills were held in New Mexico, concerns arose regarding opening records associated with dams, national laboratories, waste repositories, and three air force bases. (shrink)

Recent debate over World Health Organization reform has included unprecedented attention to international lawmaking as a future priority function of the Organization. However, the debate is largely focused on the codification of new binding legal instruments. Drawing upon lessons from the success of the Global AIDS Reporting Mechanism, established pursuant to the United Nations' Declaration of Commitment on HIV/AIDS, we argue that effective global health governance requires consideration of a broad range of instruments, both binding and nonbinding. A (...) detailed examination of the Global AIDS Reporting Mechanism reveals that the choice of the nonbinding format makes an important contribution to its effectiveness. For instance, the flexibility and adaptability of the nonbinding format have allowed the global community to: (1) undertake commitments in a timely manner; (2) adapt and experiment in the face of a dynamic pandemic; and (3) grant civil society an unparalleled role in monitoring and reporting on state implementation of global commitments. UNAIDS' institutional support has also played a vital role in ensuring the continuing effectiveness of the Global AIDS Reporting Mechanism. Overall, the experience of the Global AIDS Reporting Mechanism evidences that, at times, nimbler nonbinding instruments can offer benefits over slower, more rigid binding legal approaches to governance, but depend critically, like all instruments, on the perceived legitimacy thereof. (shrink)

An international legal agreement governing the global antimicrobial commons would represent the strongest commitment mechanism for achieving collective action on antimicrobial resistance (AMR). Since AMR has important similarities to climate change—both are common pool resource challenges that require massive, long-term political commitments—the first article in this special issue draws lessons from various climate agreements that could be applicable for developing a grand bargain on AMR. We consider the similarities and differences between the Paris Climate Agreement and current governance (...) structures for AMR, and identify the merits and challenges associated with different international forums for developing a long-term international agreement on AMR. To be effective, fair, and feasible, an enduring legal agreement on AMR will require a combination of universal, differentiated, and individualized requirements, nationally determined contributions that are regularly reviewed and ratcheted up in level of ambition, a regular independent scientific stocktake to support evidence informed policymaking, and a concrete global goal to rally support. (shrink)

In recent debates surrounding World Health Organization reform, international lawmaking has received unprecedented attention as a future priority function of the Organization. Although WHO's constitutional lawmaking authority was historically neglected and even resisted by WHO and its Member States until the adoption of its first treaty a decade ago, the widespread consensus in favor of a central role for lawmaking in visions of a reformed WHO reflects the crystallization of contemporary approaches to global health governance. Today it is widely recognized (...) that the trends toward globalization that have restricted the capacity of sovereign states to protect health through unilateral action alone have made innovative mechanisms to promote global cooperation and coordination, including international lawmaking, an essential component of governance of public health. (shrink)

The Ethical, Legal, and Social Implications (ELSI) program of the Human Genome Project stands as a model for how to organize bioethical inquiry for a rapidly changing field. Neuroscience has experienced significant growth in recent years and there is increasing interest in organizing critical reflection on this field, as evidenced by the creation of “neuroethics.” A nascent framework for reflection on the implications of neuroscience is emerging but significant work remains, given the pace and scope of neuroscientific developments. The (...) adoption of an ELSI program, modeled on that of the ELSI program of the Human Genome Project, promises a way for neuroscience to meet important organizational, educational, and policy objectives. Review of recent criticisms of the HGP ELSI program suggests that an ELSI program for neuroscience would face certain obstacles. Those interested in a neuroscience ELSI program will need to develop appropriate resources to overcome these obstacles. (shrink)

While provisions of youth sports concussion laws are very similar, little is known as to how they are being implemented, factors that promote or impede implementation, or the level of compliance in each jurisdiction. We aimed to describe state experiences with implementation in order to inform ongoing efforts to reduce the harm of sports-related traumatic brain injury and to guide future evaluations of the laws’ impacts and the development of future public health laws. We conducted key-informant interviews in 35 states (...) with recently enacted concussion legislation. States varied considerably in their readiness and capacity for implementation. Factors facilitating implementation included existing partnerships, procedures, and resources; centralized implementation authority; prior related efforts; and involvement in the policymaking process by those now charged with implementation. Inhibitors included ambiguous statutory language, unclear delegation of authority, and compliance difficulties. Ongoing challenges persist, including primary prevention; determining which providers are qualified to make return-to-play assessments and contents of those assessments; compliance difficulties in rural and under-served areas; and unclear responsibility for enforcement. Despite the similarity of youth sports concussion laws, early evidence suggests there is considerable variation in their implementation. These findings are critical for ongoing empirical investigations to accurately evaluate the laws’ provisions and to identify successful legal approaches to protecting young athletes. (shrink)

The Health in All Policies approach aims to integrate health into decisions across sectors to address the social determinants of health and enhance health equity. Jurisdictions interested in implementing this approach may seek clarification about how to operationalize it. Public health legal preparedness provides useful lessons for HiAP. While there are important differences between these two areas, there are also critical similarities. These similarities are particularly important because HiAP and public health preparedness are complementary. Law has been essential (...) in advancing public health preparedness by helping to: prioritize planning; allocate responsibility; enhance collaboration and coordination; establish responsive funding; and emphasize the needs of vulnerable populations. Law can be used similarly to advance HiAP. (shrink)

It’s common to think that animals think. The cat thinks it is time to be fed, the monkey thinks the dominant is a threat. In order to make sense of what the other animals around us do, we ascribe mental states to them. The cat meows at the door because she wants to be let in. The monkey the monkey fails the test because he doesn’t remember the answer. -/- We explain animal actions in terms of their mental states, just (...) as we do with humans. One of us has argued that our science of animal minds requires that animal behavior be explained in such terms, and this doesn’t lead to a problematic use of folk psychology or anthropomorphism (Andrews 2016, 2020). By “anthropomorphism” we mean the attribution of human psychological, social, or normative properties to non-human animals “usually with the implication it is done without sound justification” (Shettleworth 2010, 477). And by “folk psychology” we mean the commonsense practice of seeing action as caused or accompanied by mental states like belief and desire, emotions, and seeing people in terms of their moods or personality traits, as well as categorizing complex behaviors as examples of grieving, communicating, or teaching (Andrews 2012). Psychologists routinely describe human behaviors in folk psychological terms, so it’s not that the categories are unscientific. The issue with using folk psychology to describe animal behavior is whether observable similarities between human and nonhuman behavior warrants thinking they involve the same psychological kind. The use of folk psychology when talking about animals need not be problematically anthropomorphic, though we need some evidentiary basis for filing animal behavior under some folk psychological category. -/- Despite it being commonplace for humans to attribute thoughts to animals, and there being arguments in favor of doing so in science, the nature of these mental states so many are happy to see in other animals remains unclear. To help bring some focus into the discussion, we will examine the attitude of belief. In this chapter we will examine the various possible statuses of animal beliefs, and the implications of those various views for our folk practice as well as our scientific investigations. (shrink)

The legal requirements and justifications for collecting patient-identifiable data without patient consent were examined. The impetus for this arose from legal and ethical issues raised during the development of a population-based disease register. Numerous commentaries and case studies have been discussing the impact of the Data Protection Act 1998 and Caldicott principles of good practice on the uses of personal data. But uncertainty still remains about the legal requirements for processing patient-identifiable data without patient consent for research (...) purposes. This is largely owing to ignorance, or misunderstandings of the implications of the common law duty of confidentiality and section 60 of the Health and Social Care Act 2001. The common law duty of confidentiality states that patient-identifiable data should not be provided to third parties, regardless of compliance with the DPA1998. It is an obligation derived from case law, and is open to interpretation. Compliance with section 60 ensures that collection of patient-identifiable data without patient consent is lawful despite the duty of confidentiality. Fears regarding the duty of confidentiality have resulted in a common misconception that section 60 must be complied with. Although this is not the case, section 60 support does provide the most secure basis in law for collecting such data. Using our own experience in developing a disease register as a backdrop, this article will clarify the procedures, risks and potential costs of applying for section 60 support. (shrink)

Legal inference is fundamental for building and verifying hypotheses in police investigations. In this study, we build a Natural Language Inference dataset in Korean for the legal domain, focusing on criminal court verdicts. We developed an adversarial hypothesis collection tool that can challenge the annotators and give us a deep understanding of the data, and a hypothesis network construction tool with visualized graphs to show a use case scenario of the developed model. The data is augmented using a (...) combination of Easy Data Augmentation approaches and round-trip translation, as crowd-sourcing might not be an option for datasets with sensible data. We extensively discuss challenges we have encountered, such as the annotator’s limited domain knowledge, issues in the data augmentation process, problems with handling long contexts and suggest possible solutions to the issues. Our work shows that creating legal inference datasets with limited resources is feasible and proposes further research in this area. (shrink)

Vaccine mandates played a critical role in the success of New York City’s COVID-19 response. By relying on evidence as a substantive basis for the mandates and adhering to procedural requirements and precedent, New York City leveraged its position and expertise as a local governmental authority to devise mandatory vaccine policies that withstood numerous legal challenges. New York City’s experience highlights the role of municipal government in mounting a meaningful public health response, and the strategies adopted by NYC may (...) provide a blueprint for municipalities around the world facing the ongoing COVID-19 pandemic and the threat of future public health emergencies. (shrink)

Professional, Ethical, Legal, and Educational Lessons in Medicine: A Problem Based Approach provides a comprehensive review of the complex and challenging field of professional medical practice. Its problem-based format incorporates a vast pool of practical, board-exam-style multiple-choice questions for self-assessment, and is an ideal resource for exam preparation as well as ongoing clinical education among trainees and clinicians The practice of medicine is not only about clinical care of patients. Physicians must navigate ethical conundrums, legal pitfalls, and (...) quality improvement issues while maintaining scrupulous professionalism and being exemplary educators. This volume addresses common issues in the realm of professional medical practice not typically covered in other texts. Each of the 73 chapters presents a problem-based case that branches out into an oral board examination type stem questions. A discussion section with brief review articles summarizes the most recent literature. Multiple-choice questions with answers allows for comprehensive self-assessment or interactive group quizzes. This book will appeal to medical and allied health professionals in all specialties of medicine. It is an excellent and hands-on reference for the related but diverse domains associated with professional healthcare practice by students, physicians, and other healthcare providers compacted into one volume. (shrink)

The settlements surrounding the Exxon Valdez oil spill prove to be an interesting case of retributive and corrective justice in regard to damage to the ecology of the commons, particularly in light of the recent Deepwater Horizon spill in the Gulf of Mexico. After reviewing the harm done to the ecology of Prince William Sound by the spill, and an account of Exxon Corporation’s responsibility, I examine the details of the litigation, particularly the Supreme Court decision in this matter. In (...) the early settlement, there is a clear disproportion between damage awards to plaintiffs representing the current economic users of Prince William Sound versus the trustees for the Sound’s commons. I argue that the disproportion reveals not only a thoroughly economic understanding of ecological commons, but bias in the treatment of its current economic users, as opposed to an understanding of such ecologies as true commons shared over generations. I argue that such biases fail reasonable moral tests and do not stand up to common principles of retributive justice. I end by suggesting a legal maneuver to correct such tendencies. (shrink)

:Investigations of large scale industrial accidents generally take one of two alternative approaches to identifying the cause or causes of those destructive events. The first is legal analysis, which focuses on the mechanical failure or human error that immediately preceded the accident. The second is socio-technical reasoning, which centers on the complexities of the interlocking technological and organizational systems that brought about the accident. Both are retrospective, and provide little insight into the means of avoiding industrial accidents in the (...) future. This article looks at six levels of managerial responsibility within a firm, and suggests specific changes at all levels that should logically help in the prevention or mitigation of these high impact/low probability events. The most basic need, however, is for imagination, empathy, and courage at the most senior level of the firm. (shrink)

Opposition to corporate legal rights has become more visible in recent years. Activists seek ways to address the influence of corporations on the state and its ancillary institutions. The most well-known tactics range from Occupy's embrace of anarchic, leaderless horizontalism to the Mayday PAC raising money to elect representatives who support a campaign finance amendment to the US Constitution. The spectrum of political efforts between these two approaches speaks to how the problem of corporate power resonates with many people (...) in the United States. It also, however, demonstrates how "democracy," as the ostensible opposition to corporate politics, can be interpreted as everything from... (shrink)

To subject the international human rights movement to a purely theoretical critique cannot help but suggest a certain mean-spiritedness. After all, no one knows better than those in the front lines of human rights work exactly what, in terms of lives lost and atrocities suffered, the movement has been unable to achieve. The religious workers of the Salvadoran Archdiocese, the legal aid lawyers of Paraguay who affirm conscience over prudence, the founders of the Moscow chapter of Amnesty International, the (...) prisoners in South Africa charged with treason for denouncing apartheid — they and their co-workers hardly need reminding by arm-chair academics that the tools of the human rights movement are laughably weak and that their best efforts save only a selection of individuals in a near-endless stream of victims. (shrink)

Vice crimes, crimes prohibited in part because they are viewed as morally corrupting, engage legal theorists because they reveal importantly contrasting views between liberals and virtue-centered theorists on the very limits of legitimate state action. Yet advocates and opponents alike focus on the role law can play in suppressing personal vice; the role of law is seen as suppressing licentiousness, sloth, greed etc. The most powerful advocates of the position that the law must nurture good character often draw on (...) Aristotelian theories of virtue to ground the connection between law and virtue. While Aristotle believed that law and character were linked, it is ironic to note that he did not argue for the position evidenced in our vice laws that law was likely to succeed in instilling virtue. Indeed, Aristotle thought the project of using law to instill private virtue was nearly certain to fail. Aristotle’s deep concern was not for the way law protected private virtue within each person but the way law had to protect civic virtue between citizens. This article argues that even from its foundations, the project of vice crimes as moral instruction is misconceived. The use of law for overly instrumental or narrow reasons opens law and legal institutions to abuse and factionalism. Lawyers, judges and others specially connected to law must first and foremost aim at addressing “legal vices,” vices internal to the institutions of law. Particularly, increasing factionalism and instrumentalism which disconnects law from the pursuit of the common good threatens our civic bonds. Most importantly, where civic bonds are disrupted, citizens have no reason to remain law abiding. The striking lesson, captured both in ancient philosophy and modern history, is that when legal vices grow unchecked and factions use the law to pursue narrow interests, ultimately law abidingness is corrupted and interest groups harm themselves as much as others. (shrink)

The past few decades have witnessed an extraordinary revival of interest in metanormative non-naturalism. Despite this interest, it is still unclear how to understand the distinctive metaphysical commitments of this view. We illustrate the relevant difficulties by examining what is arguably the most prominent class of contemporary attempts to formulate non-naturalism’s metaphysical commitments. This class of proposals, exemplified in work by Gideon Rosen and Stephanie Leary, characterizes the distinctive metaphysical commitments of non-naturalism in terms of metaphysical grounding and essence. We (...) argue that these proposals overgeneralize: they either misclassify intuitively naturalistic hypotheses about the metaphysics of normativity as “non-naturalist”, or misclassify hypotheses in other areas of metaphysics. We argue that this problem stems from features of grounding itself. We suggest a more promising alternative for formulating non-naturalism, which revolves around the notion of objective similarity between classes of properties. We conclude by drawing some general lessons for inquiry about the metaphysics of normativity, and about metaphysics in general. (shrink)

In early 2013, the Indian government introduced new rules governing the conduct of clinical trials involving human participants. Among other provisions, the law requires that sponsors of research compensate participants who are injured during the course of their research participation. This article examines the effects of India's compensation law and the efforts that policymakers in India have made to tailor the law since its passage. I use the legal concept of acoustic separation as a framework to explain and justify (...) the approach that India has taken in refining its regulation of research related injuries. I conclude that India's example may provide useful lessons for research sponsors and lawmakers in other regulatory states seeking to promote a well-regulated biomedical research industry. (shrink)

The past few decades have witnessed an extraordinary revival of interest in metanormative non-naturalism. Despite this interest, it is still unclear how to understand the distinctive metaphysical commitments of this view. We illustrate the relevant difficulties by examining what is arguably the most prominent class of contemporary attempts to formulate non-naturalism’s metaphysical commitments. This class of proposals, exemplified in work by Gideon Rosen and Stephanie Leary, characterizes the distinctive metaphysical commitments of non-naturalism in terms of metaphysical grounding and essence. We (...) argue that these proposals overgeneralize: they either misclassify intuitively naturalistic hypotheses about the metaphysics of normativity as “non-naturalist”, or misclassify hypotheses in other areas of metaphysics. We argue that this problem stems from features of grounding itself. We suggest a more promising alternative for formulating non-naturalism, which revolves around the notion of objective similarity between classes of properties. We conclude by drawing some general lessons for inquiry about the metaphysics of normativity, and about metaphysics in general. (shrink)

This article reviews the Dutch societal debate on euthanasia/assisted suicide in dementia cases, specifically Alzheimer's disease. It discusses the ethical and practical dilemmas created by euthanasia requests in advance directives and the related inconsistencies in the Dutch legal regulations regarding euthanasia/assisted suicide. After an initial focus on euthanasia in advanced dementia, the actual debate concentrates on making euthanasia/assisted suicide possible in the very early stages of dementia. A review of the few known cases of assisted suicide of people with (...) so-called early dementia raises the question why requests for euthanasia/assisted suicide from patients in the early stage of Alzheimer's disease are virtually non-existent. In response to this question two explanations are offered. It is concluded that, in addition to a moral discussion on the limits of anticipatory choices, there is an urgent need to develop research into the patient's perspective with regard to medical treatment and care-giving in dementia, including end-of-life care. (shrink)

Public participation is increasingly an aspect of policy development in many areas, and the governance of biomedical research is no exception. There are good reasons for this: biomedical research relies on public funding; it relies on biological samples and information from large numbers of patients and healthy individuals; and the outcomes of biomedical research are dramatically and irrevocably changing our society. There is thus arguably a democratic imperative for including public values in strategic decisions about the governance of biomedical research. (...) However, it is not immediately clear how this might best be achieved. While different approaches have been proposed and trialled, we focus here on the use of public deliberation as a mechanism to develop input for policy on biomedical research. We begin by explaining the rationale for conducting public deliberation in biomedical research. We focus, in particular, on the ELS (ethical, legal, social) aspects of human tissue biobanking. The last few years have seen the development of methods for conducting public deliberation on these issues in several jurisdictions, for the purpose of incorporating lay public voices in biobanking policy. We explain the theoretical foundation underlying the notion of deliberation, and outline the main lessons and capacities that have been developed in the area of conducting public deliberation on biobanks. We next provide an analysis of the theoretical and practical challenges that we feel still need to be addressed for the use of public deliberation to guide ethical norms and governance of biomedical research. We examine the issues of: (i) linking the outcomes of deliberation to tangible action; (ii) the mandate under which a deliberation is conducted; (iii) the relative weight that should be accorded to a public deliberative forum vs other relevant voices; (iv) evaluating the quality of deliberation; and (5) the problem of scalability of minipublics. (shrink)

Peter Stemmer advocates a new foundation of morality. He claims that any moral principle is justified only if every person to whom the principle applies consents to it on the basis of his or her own interests. But how can this ‘metanorm’ of unanimous consent be justified? Since Stemmer decisively rejects all objectivist foundations of morality, the only justification for his ‘metanorm’ can again be nothing but a unanimous consent. Through numerous examples I hope to have shown in my article (...) that the alleged connexion of all our moral demands with a general, unanimous consent is not realistic – no matter whether these demands are based on our spontaneous or on our well considered attitudes. And this holds no less for legal norms with their hard sanctions than for moral principles. (shrink)

"Law week soccer competition: 16-19 May 2005." Ethos: Official Publication of the Law Society of the Australian Capital Territory, (198), pp. 25.

Jahi McMath's case has raised challenging uncertainties about one of the most profound existential questions that we can ask: how do we know whether someone is alive or dead? The case is striking in at least two ways. First, how can it be that a person diagnosed as dead by qualified physicians continued to live, at least in a biological sense, more than four years after a death certificate was issued? Second, the diagnosis of brain death has been considered irreversible; (...) in fact, there has never been a case of a person correctly diagnosed as brain‐dead who improved to the point that the person no longer fulfilled the diagnostic criteria. If the neurologist Alan Shewmon is correct that, prior to her cardiac arrest in June 2018, McMath no longer met the criteria for brain death and was actually in a minimally conscious state, this case could have momentous implications for how we think about this diagnosis going forward. In this essay, I will offer a hypothesis that could, perhaps, explain both these aspects of the case. The hypothesis is based on differences in how we distinguish between biological and legal categories. The law tends to prefer to draw bright‐line distinctions between categories, whereas biological categories tend to fall along a spectrum, without sharp distinctions. (shrink)

The Last Gift is an observational HIV cure-related research study conducted with people with HIV at the end of life (EOL) at the University of California San Diego. Participants agree to voluntarily donate blood and other biospecimens while living and their bodies for a rapid research autopsy postmortem to better understand HIV reservoir dynamics throughout the entire body. The Last Gift study was initiated in 2017. Since then, 30 volunteers were enrolled who are either (1) terminally ill with a concomitant (...) condition and have a prognosis of 6 months or less or (2) chronically ill with multiple comorbidities and nearing the EOL.Multiple ethical and logistical challenges have been revealed during this time; here, we share our lessons learnt and ethical analysis. Issues relevant to healthcare research include surrogate informed consent, personal and professional boundaries, challenges posed conducting research in a pandemic, and clinician burnout and emotional support. Issues more specific to EOL and postmortem research include dual roles of clinical care and research teams, communication between research personnel and clinical teams, legally required versus rapid research autopsy, identification of next of kin/loved ones and issues of inclusion. Issues specific to the Last Gift include logistics of body donation and rapid research autopsy, and disposition of the body as a study benefit.We recommend EOL research teams to have clear provisions around surrogate informed consent, rotate personnel to maintain boundaries, limit direct contact with staff associated with clinical care and have a clear plan for legally required versus research autopsies, among other recommendations. (shrink)