This is a book of three philosophical chapters on aspects of terrorism, torture, and war. It relates issues in ethical theory to practical ethics. The chapter on torture considers views about what ...torture is and the various occasions on which it could occur in order to determine why it might be wrong to torture a wrongdoer held captive, even if this were necessary to save his victims. The discussion of terrorism examines whether it is the intention to harm civilians rather than harm to them being “collateral damage” that makes terrorism distinctively wrong, what else might make it wrong, and whether it is always wrong. The third chapter first discusses whether having a right reason, in the sense of a right intention, is necessary in order for starting war to be just. It then examines ways in which the harms of war can be proportional to the achievement of the just cause and other goods war can bring about, so as to make starting war permissible.
Background: The aim of this prospective study was to evaluate the value of F-18-fluorodeoxyglucose–positron emission tomography (FDG–PET) for early assessment of chemotherapy response in patients ...with advanced colorectal cancer. Methods: Dynamic FDG–PET was carried out before and at 2 (n = 50) and 6 months (n = 19) after the start of treatment. Quantitative Patlak analysis metabolic rate of glucose (MRGlu) and a simplified method to measure glucose metabolism standardized uptake value (SUV) were evaluated. The predictive value of changes in glucose metabolism was assessed with Cox proportional regression analysis. Overall survival (OS) and progression-free survival (PFS) were calculated using Kaplan–Meier estimates. Results: There was an increase in the rates of death (P = 0.049 for ΔMRGlu PET1–2; P = 0.017 for ΔSUV PET1–2; P = 0.032 for ΔMRGlu PET1–3; P = 0.048 for ΔSUV PET1–3) and progression (P = 0.026 for ΔMRGlu PET1–2; P = 0.035 for ΔSUV PET1–2; P = 0.041 for ΔMRGlu PET1–3; P = 0.081 for ΔSUV PET1–3) associated with worse response as assessed by PET on Cox proportional regression analysis. The OS and PFS analysis showed a significant predictive value at broad ranges of ΔMRGlu and ΔSUV cut-off levels. Conclusion: The degree of chemotherapy-induced changes in tumor glucose metabolism is highly predictive for patient outcome. The use of FDG–PET for therapy monitoring seems clinically feasible since simplified methods (SUV) are sufficiently reliable.
This article consider some clinical and population level approaches to advanced care of chronic conditions and end of life care. One approach aims to follow patient values and preferences about ...acceptable end of life (EOL) as elicited by questionnaires. The grounds for emphasising patients’ preferences and the adequacy of the questionnaires are examined. Other approaches involve additional aims such as meeting patient and family members needs, providing information, cost effectiveness and satisfying professionals' preferences for a certain type of EOL experience. Issues raised by adding these (and other) aims are examined.
Reflecting on the contribution by Rahul Kumar to the symposium, I consider the following topics in relation to risks in research: (1) treating someone as a mere means; (2) aggregation; (3) different ...conceptions of contractualism; (4) uncertainty; (5) paternalism and complicity.
Functional magnetic resonance imaging (fMRI) studies, run by Joshua Greene, are said to show that when people judge it permissible to turn a trolley headed toward five persons away from them, though ...it will then hit and kill another person, brain centers involved in cognitive processes (and associated with rational thought) are stimulated. By contrast, fMRI studies are said to show that when people judge it to be impermissible to throw someone over a bridge into the trolley's path, so that his body stops it from killing the five but he dies, brain centers associated with emotion are stimulated. Here, Kamm reviews the second (normative) claim and briefly presents an objection to it that has been raised by Selim Berker. He examines some criticisms that have been made of the view that deontological responses in fMRI studies are responses to a morally irrelevant personal factor and suggests that greater involvement of emotion centers in the brain may not align with the presence of this personal factor. Moreover, he raises new doubts about the possibility of deriving normative conclusions from neuroscientific data by considering what people would think if they were confronted with certain hypothetical experimental data.
This book comprises chapters that discuss aspects of war and other conflicts in the light of both nonconsequentialist ethical theory and the views of such theorists as Barbara Herman, Jeff McMahan, ...Avishai Margalit, and Michael Walzer. The first chapter deals with the relation between states of affairs whose termination justifies war and states of affairs that once achieved should put an end to war. The next few chapters deal with conduct in war. They first consider the implications of general moral principles (including the Doctrine of Double Effect and Principle of Permissible Harm) for the permissibility of harm to combatants and noncombatants, and then whether factors unique to war should alter what is permissible. In particular, if the context of war should affect the relative violability of different combatants and different noncombatants, if terror killing combatants and/or noncombatants should ever be permissible, and if there is liability to harm in virtue of belonging to a group. The fifth chapter examines how recent discussions by nonconsequentialists about redirection of threats (as in the famous Trolley Problem) may illuminate the moral status of collaboration that took place with Nazis during the Holocaust. What justice requires after conflict and how our ability to provide it affects the permissibility of starting war, is the question of the next topic. Truth and reconciliation commissions and retribution post-conflict are discussed, and whether harm to civilians stemming from such procedures (and how the harm arises) bear on the permissibility of instituting the procedures. The three concluding chapters deal with moral aspects of conflicts outside of standard war, including those involving the threat of terrorism, resistance to communal injustice (for example, in the case of the Taliban women), and the use of nuclear weapons for deterrence.
Background & Aims Inflammatory bowel diseases (IBD) are becoming more common in Asia, but epidemiologic data are lacking. The Asia-Pacific Crohn’s and Colitis Epidemiology Study aimed to determine ...the incidence and phenotype of IBD in 8 countries across Asia and in Australia. Methods We performed a prospective, population-based study of IBD incidence in predefined catchment areas, collecting data for 1 year, starting on April 1, 2011. New cases were ascertained from multiple overlapping sources and entered into a Web-based database. Cases were confirmed using standard criteria. Local endoscopy, pathology, and pharmacy records were searched to ensure completeness of case capture. Results We identified 419 new cases of IBD (232 of ulcerative colitis UC, 166 of Crohn’s disease CD, and 21 IBD-undetermined). The crude annual overall incidence values per 100,000 individuals were 1.37 for IBD in Asia (95% confidence interval: 1.25−1.51; 0.76 for UC, 0.54 for CD, and 0.07 for IBD-undetermined) and 23.67 in Australia (95% confidence interval: 18.46−29.85; 7.33 for UC, 14.00 for CD, and 2.33 for IBD-undetermined). China had the highest incidence of IBD in Asia (3.44 per 100,000 individuals). The ratios of UC to CD were 2.0 in Asia and 0.5 in Australia. Median time from symptom onset to diagnosis was 5.5 months (interquartile range, 1.4−15 months). Complicated CD (stricturing, penetrating, or perianal disease) was more common in Asia than Australia (52% vs 24%; P = .001), and a family history of IBD was less common in Asia (3% vs 17%; P < .001). Conclusions We performed a large-scale population-based study and found that although the incidence of IBD varies throughout Asia, it is still lower than in the West. IBD can be as severe or more severe in Asia than in the West. The emergence of IBD in Asia will result in the need for specific health care resources, and offers a unique opportunity to study etiologic factors in developing nations.
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