The question of whether there is justification for physicians to participate in state-sanctioned corporal punishment has prompted long and heated debates around the world. Several recent and high-profile sentences requiring physician assistance have brought the conversation to Saudi Arabia. Whether a physician is asked to participate actively or to assess prisoners’ ability to withstand this form of punishment, can there be an ethical justification for medical training and skills being put toward these purposes? The aim of this article is to examine aspects of Islamic law along with the different professional and religious obligations of Saudi Arabian physicians, and how these elements may inform the debate.

No single issue has dominated health practitioners’ ethical debates in 2014 in Australia, but a controversial decision on gene patenting and the media focus on “Dr. Death,” euthanasia campaigner Dr. Philip Nitschke, have given new life to these two familiar (and global) debates. Currently a dying with dignity bill, drafted by the Australian Green Party, is under examination. The Senate inquiry into the bill received more than 663 submissions, with 57% opposed and 43% in support of the bill, which has now been referred to a Senate committee. Will this be another of Australia’s failed attempts to legalize euthanasia? The trial of Dr. Nitschke begins on November 10, 2014.

The American College of Physicians in its ethics manual endorsed the idea that physicians ought to improve their ability to provide care to their patients more parsimoniously. This elicited a critical backlash; critics essentially claimed that what was being endorsed was a renamed form of rationing. In a recent article, Tilburt and Cassel argued that parsimonious care and rationing are ethically distinct practices. In this essay I critically assess that claim. I argue that in practice there is considerable overlap between what they term parsimonious care and what they define as rationing. The same is true of the Choosing Wisely campaign endorsed by the American Board of Internal Medicine. In both cases, if the goal is to control healthcare costs by reducing the use of marginally beneficial care that is not cost effective, then a public conversation about the justness of specific choices is essential.

This article takes up a game-theoretic perspective on California’s recently passed bill (SB 277) that closes all nonmedical exemptions for school-mandated vaccination. Such a perspective characterizes parental decisions to vaccinate their children as a collective action problem and reveals the presence of an incentive to free ride—to enjoy the benefits of others’ efforts to vaccinate their children without vaccinating one’s own. This article defends California’s legislation as a reasonable means of overcoming the free rider problem and of ensuring that the burdens of vaccination are shared equally.

Ethical issues in long-term care settings, although having received attention in the literature, have not in our opinion received the appropriate level they require. Thus, we applaud the Cambridge Quarterly for publishing this case. We can attest to the significance of ethical issues arising in long-term care facilities, as Mr. Hope’s case is all too familiar to those practicing in these settings. What is unique about this case is that an actual ethics consult was made in a long-term care setting. We have seen very little in the published literature on the use of ethics structures in long-term care populations. Our experience is that these healthcare settings are ripe for ethical concerns and that providers, patients, families, and staff need/desire ethics resources to actively and preventively address ethical concerns. The popular press has begun to recognize the ethical issues involved in long-term care settings and the need for ethics structures. Recently, in California a nurse refused to initiate CPR for an elderly patient in a senior residence. In that case, the nurse was quoted as saying that the facility had a policy that nurses were not to start CPR for elderly patients.1 Although this case is not exactly the same as that of Mr. Hope, it highlights the need for developing robust ethics program infrastructures in long-term care settings that work toward addressing ethical issues through policy, education, and active consultation.

This article examines current trends and prospects in Finnish healthcare literature and discussion. The Finnish healthcare system was long considered to manifest an equal, universal, and solidaristic welfare scheme. However, recent data reveals structural inequalities in access to healthcare that result in health differences among socioeconomic groups. The political will aims at tackling these inequalities, but the ideological trend toward responsibilization of the individual taking place across political spheres elsewhere in Europe creates potential challenges to this goal. The applications of this trend have a theoretical background in the responsibility-sensitive egalitarian—or luck egalitarian—tradition. The theory, which is unfit for real-life policy applications, has explicit appeal in considerations aiming at the responsibilization of the individual within the healthcare sector. It remains to be seen in which direction the Finnish welfare schemes will continue to develop.

Arctic ministers agreed at the latest 2015 Arctic Council ministerial meeting in Iqaluit to establish a ‘Task Force to assess future needs for a regional seas program or other mechanism, as appropriate, for increased cooperation in Arctic marine areas.’ Involving the Arctic Council in increased coordination of national marine management measures, and in drawing on experts from international organisations or treaty bodies to address related questions, is consistent with the longstanding advisory role of the Arctic Council. It also builds prudently on the council's emerging role as convener to accomplish discrete tasks critical to the health of the Arctic environment and the wellbeing of Arctic peoples. In order to strengthen Arctic marine cooperation and governance, the Arctic Council should adopt some instrument or arrangement through which it can more effectively coordinate among national management efforts affecting the Arctic marine environment and increase the effectiveness of the interplay with global governance mechanisms. The purpose of this commentary is to present World Wide Fund for Nature (WWF) perspectives on two important dimensions of this proposal. First, the commentary is to review the arguments as to why a strong regional seas program for the Arctic is required. Second, it is to address a series of questions that arise in considering the design of a framework mechanism necessary to create the program. The paper will provide WWF's views with regards to the mandate and scope of a future cooperative mechanism, its relationship to the Arctic Council and membership, and its legal form.

The preambles of the 1959 Antarctic Treaty and the 1991 Protocol on Environmental Protection to the Antarctic state that Antarctica is to be managed in the interest of all mankind. However, key phrases such as ‘interest of all mankind’ and ‘wilderness and aesthetic values’ are subject to interpretation. The objective of this study is to gain a better understanding of public perceptions of the Antarctic wilderness, proceeding from the assumption that public views should be incorporated into the consultative parties’ decision making process. The study expands on previous research by exploring whether perceptions of the Antarctic environment varied between students at two comparably sized public universities in Spain and the United States. Four hundred undergraduate students were asked about their values, beliefs and attitudes with respect to environmental management practices in Antarctica. After controlling for course type, responses showed little variation based on nationality. A large proportion of students valued Antarctica as a science laboratory for the benefit of mankind, as one of the world's last great wildernesses, and an important component of the climate system. Students did not support an increase in the number of people going to Antarctica, and favoured limitations on infrastructure development.

How should deontologists approach decision-making under uncertainty, for an iterated decision problem? In this article I explore the shortcomings of a simple expected value approach, using a novel example to raise questions about attitudes to risk, the moral significance of tiny probabilities, the independent moral reasons against imposing risks, the morality of sunk costs, and the role of agent-relativity in iterated decision problems.

Suppose someone (P1) does something that is wrongful only in virtue of the risk that it will enable another person (P2) to commit a wrongdoing. Suppose further that P1’s conduct does indeed turn out to enable P2’s wrongdoing. The resulting wrong is agentially mediated: P1 is an enabling agent and P2 is an intervening agent. Whereas the literature on intervening agency focuses on whether P2’s status as an intervening agent makes P1’s conduct less bad, I turn this issue on its head by investigating whether P1’s status as an enabling agent makes P2’s conduct more bad. I argue that it does: P2 wrongs not just the victims of φ but P1 as well, by acting in a way that wrongfully makes P1 accountable for φ. This has serious implications for compensatory and defensive liability in cases of agentially mediated wrongs.

Many scholars have argued that well-being is the satisfaction of preferences, or of fully informed preferences, or of fully informed preferences about one's own life. But none of those theories can be true if it is possible to prefer, with full information, to decrease one's own well-being. And because it is possible to have such a preference, those theories cannot be true.

Comparative valuation of different policy interventions often requires interpersonal comparability of benefit. In the field of health economics, the metric commonly used for such comparison, quality adjusted life years (QALYs) gained, has been criticized for failing to respect the equality of all persons’ intrinsic worth, including particularly those with disabilities. A methodology is proposed that interprets ‘full quality of life’ as the best health prospect that is achievable for the particular individual within the relevant budget constraint. This calibration is challenging both conceptually and operationally as it shifts dramatically when technology or budget developments alter what can be achieved for incapacitated individuals. The proposal nevertheless ensures that the maximal achievable satisfaction of one person's preferences can carry no more intrinsic value than that of another. This approach, which can be applied to other domains of social valuation, thus prevents implicit discrimination against the elderly and those with irremediable incapacities.

In this article we survey descriptions of Christmas celebrations contained in the diaries and narratives of polar explorers (mostly British) from 1818 to 1912. We find that Christmas was a time almost universally associated with the display of positive emotions, although this was in the context of increased amounts of stress associated with the challenges of over-wintering at high latitudes. Firstly, we argue that Christmas was crucial to the well-being of expedition participants because it opened emotional channels that enabled them to cope with stress. Secondly, we argue that Christmas revealed a play space in which certain types of normally deviant behaviour were welcomed. Thirdly, we argue that Christmas was a major nutritional event for over-wintering crew members, satisfying a need for calories that was rarely met in the everyday rations.

This article discusses il y a-clefts in spoken French. In the linguistic literature, only one function of il y a-clefts is widely acknowledged, namely presenting a new event in the discourse. By studying corpus examples in their wider context, we found however that many occurrences do not easily fit in the properties described in the literature. We make a distinction between presentational il y a-clefts, which can be event-presenting or entity-presenting, and specificational enumerative il y a-clefts, which give an example of a class that was implicitly or explicitly evoked in the context.

Death investigation and coronial practices have undergone significant social, political and legal scrutiny in recent years. A wave of coronial reform has occurred across jurisdictions, including in the United Kingdom (UK), Australia, Canada and New Zealand, with a concomitant focus on the adequacy of death investigation law and policy. Taking key coronial developments in the UK and Australia as its starting point, this paper explores a legal jurisdiction undergoing immense legal and policy reform to illustrate why coronial law and practice is of increasing scholarly interest. It begins by tracing the contentious landscape of UK coronial law reform, which has also resonated internationally, thereafter examining key controversies that refocused attention on the value of the jurisdiction, before discussing contemporary coronial issues including, publicity, human rights and death prevention.

This paper examines the role of coroners in investigating and reporting on cases of death after police contact (DAPC) in England and Wales. It considers how Article 2 (the right to life) of the European Convention on Human Rights (ECHR) has affected coronial processes and practices. It argues that the effects of Article 2 represent an evolutionary shift in accountability processes surrounding cases of DAPC in England and Wales, but that this shift has in turn been mediated by aspects of institutional structure in the coronial system. It discusses how this shift demonstrates the dynamic relationship between the coronial system, state and society and how this has continued to evolve as a result of external demands.