John Hardwig

The most common approach to the problem of requests for futile treatment – the hospital futility policy – rests on the assumption that demands for futile treatment are both intractable and irrational. But there is another approach to the futility problem, an approach that would be dialogic, piecemeal, and case-by-case. This is the only approach that attempts to deal with both the hospital’s problem and the patient’s or family’s problem that motivates the request/demand for futile treatments. As such, it holds the promise of resolving the problem of demands for futile treatment in a way that does not generate anger and ill will at the hospital staff for what will inevitably strike patients and their families as a blatant assertion of the hospital’s power.

Abstract:Respect for persons protects patients regarding their own healthcare decisions. Patient informed choice for altruism (PICA) is a proposed means for a fully autonomous patient with decisionmaking capacity to limit his or her own treatment for altruistic reasons. An altruistic decision could bond the patient with others at the end of life. We contend that PICA can also be an advance directive option. The proxy, family, and physicians must be reminded that a patient’s altruistic treatment refusal should be respected.

Most traditional epistemologists see trust and knowledge as deeply antithetical: we cannot know by trusting in the opinions of others; knowledge must be based on evidence, not mere trust. I argue that this is badly mistaken. Modern knowers cannot be independent and self-reliant. In most disciplines, those who do not trust cannot know. Trust is thus often more epistemically basic than empirical evidence or logical argument, for the evidence and the argument are available only through trust. Finally, since the reliability of testimonial evidence depends on the trustworthiness of the testifier, this implies that knowledge often rests on a foundation of ethics. The rationality of many of our beliefs depends not only on our own character, but on the character of others.

For Socrates, philosophy is self-examination. If the Euthyphro is still to be philosophy in this sense, it must challenge people living now. This paper offers a reading that does this. First, a better case is made for something like the kind of expertise Euthyphro claims and for his position about piety. Second, Socrates and Euthyphro embody different views about the kind of expertise that would be relevant to discovering and engendering piety. Finally, Socrates’ unorthodox conception of piety is made explicit. With these features highlighted, the Euthyphro still possesses the power to provoke and challenge.