Sean Murphy

In Carter v. CanadaCanada(Attorney General), the Supreme CourtSupreme Court of Canada emphasized that a physician’s decision to participate in assisted dying is a matter of conscience or religious belief, and that nothing in Carter would compel physicians to provide assistance in dying. Legislators and regulators of medical practice have responded by affirming, in principle, the importance of upholding the freedom of conscience of physicians. In practice, however, varying policies have been implemented across Canada, with some regulators compelling physicians to refer patients to available providers who would be willing to administer medical assistance in dying (MAID). We begin this chapter by defining ‘conscience’ and discussing how it operates in the context of medical practice vis-à-vis the goals of medicine and its supporting virtues; we argue that professional obligations can sometimes necessitate conscientious objection. We proceed to explain how reasonable disagreement can exist regarding the consistency of MAID with the goals and virtues of medicine. We then discuss and critique the concept of the ‘conventional compromise’—a proposed justification for mandating referrals from conscientiously objecting physicians. Finally, we argue that referrals are not morally neutral acts and that long-standing professional obligations can prevent physicians from providing them for MAID.

Abelard’s most famous spokesman for the ancient and abiding moral and religious worth of the Law of Moses is probably the character of the Jew, inventedfor one of two fictional dialogues in the Collationes. The equally fictive Philosopher, a rationalist theist who gets the last word in his exchange with the Jew, condemns the Law as a useless addition to the natural law, a threat to genuine morality with a highly dubious claim to divine origin. The Philosopher’s condemnation, however, does not go unanswered. Abelard himself, writing in his own voice in two major treatments of the Law (the Sermon for the Feast of the Circumcision and the Commentary on the Letter of Paul to the Romans), defends the ancient worth of the Law as a revolution in moral understanding and a potential guarantor of salvation. The Law is just and rational, he argues, in every one of its precepts, even when interpreted according to the letter. As such, the letter of the Law has been and ought to be retained in Christianity: its moral precepts are binding everywhere and always; its non-moral precepts are binding, when, in the changing circumstances of the Church, they are found to be useful and not conducive to scandal.

The widespread emergence of innumerable technologies within health care has complicated the choices facing caregivers and their patients. The escalation of knowledge and technical innovation has been accompanied by an erosion of moral and ethical consensus among health providers that is reflected in the abandonment of the Hippocratic Oath as the immutable bedrock of medical ethics. Ethical conflicts arise when the values of health professionals collide with the expressed wishes of patients or the dictates of regulatory bodies and administrators. Increasing attempts by groups outside of the medical profession to limit freedom of conscience for health providers has raised concern and consternation among some health professionals. The personal and professional impact of health professionals surrendering freedom of conscience and participating in actions they deem malevolent or unethical has not been adequately studied and may not be inconsequential when considering the recognized impact of other circumstances of coerced complicity. We argue that the distinction between the two ways that freedom of conscience is exercised (avoiding a perceived evil and seeking a perceived good) provides a rational basis for a principled limitation of this fundamental freedom

This paper outlines the process of verbal communication of emotion as this occurs through the phases of the referential process, including arousal of an emotion schema; detailed and specific descriptions of images and episodes that are exemplars of emotion schemas; and reflection and reorganization, which may include emotion labels and other types of categorical terms. The concepts of emotion schemas and the referential process are defined in the theoretical framework of multiple code theory which includes subsymbolic sensory, visceral and motoric processes, symbolic images and words. Emotion schemas are defined as clusters of representations of events incorporating similar bodily, sensory and motoric processes activated in relation to different people in different contexts. Through the referential process subsymbolic components of a schema that have been activated in a speaker or writer and that may be connected only partially to words may be evoked in a listener or reader. The concept of the emotion schemas is examined in relation to current work in emotion theory and neuroscience. The unique effects of detailed descriptions of episodes in conveying complex aspects of emotional experience are discussed, as recognized by writers, and as demonstrated in empirical research. Computerized measures of the phases of the referential process are presented, focusing particularly on the central measure, the Weighted Referential Activity Dictionary which identifies points of narrative and imagery. The operation of the function words that dominate the WRAD are examined in relation to the structure of narrative expression underlying the verbal representation of emotion schemas.

Using the quasi-experimental setting of the Michael Vick dogfighting case, the researchers employed rich interview content to explore the question, “When a critical event occurs in the animal advocacy field, what motivates advocacy groups to respond?” The investigation reveals that what was thought to be one critical event was in actuality three unique yet interrelated critical events—(1) the revelation of the transgressions; (2) the punishment of the perpetrator; and (3) the decision about whether to ally with the perpetrator in advocacy. The study shows that legitimacy concerns, occasionally paired with reflections on organizational identity, influenced the decision-making of advocacy organizations across all three critical events, as each held the potential either to legitimize or to delegitimize the advocacy organizations and/or the perpetrator (i.e., Vick).