The Journal of medicine and philosophy
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This article discusses the practice and development of organ donation by capital prisoners in China. It analyzes the issue of informed consent regarding organ donation from capital prisoners in light of Confucian ethics and expounds the point that under the influence of Confucianism, China is a country that attaches great importance to the role of the family in practicing informed consent in various areas, the area of organ donation from capital prisoners included. It argues that a proper form of organ donation from capital prisoners can be justified within the Confucian moral context in which the proper interests of capital prisoners and their families, the benefit of organ receptors, and a rightful order of society should all be appropriately considered. From the Confucian perspective, the act of donating organs from a capital prisoner must be decided by both the prisoner and his/her family (i.e., each side should hold a veto power), whereas such donation, in the proper circumstance protected by a rightful procedure, should be appreciated as a morally praiseworthy act of the prisoner who is willing to make the final effort to repent and correct his/her evil conduct and to leave something good to the world.
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Proponents of evidence-based medicine (EBM) provide the "hierarchy of evidence" as a criterion for judging the reliability of therapeutic decisions. EBM's hierarchy places randomized interventional studies (and systematic reviews of such studies) higher in the hierarchy than observational studies, unsystematic clinical experience, and basic science. Recent philosophical work has questioned whether EBM's special emphasis on evidence from randomized interventional studies can be justified. ⋯ However, in contrast to the recent philosophical work, I argue that a justification for EBM's hierarchy of evidence can be provided. The hierarchy should be viewed as a hierarchy of comparative internal validity. Although this justification is defensible, the claims that EBM's hierarchy substantiates when viewed in this way are considerably more circumscribed than some claims found in the EBM literature.
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This essay places Foucault's work into a philosophical context, recognizing that Foucault is difficult to place and demonstrates that Foucault remains in the Kantian tradition of philosophy, even if he sits at the margins of that tradition. For Kant, the forms of intuition-space and time-are the a priori conditions of the possibility of human experience and knowledge. ⋯ Foucault sees political space as central to understanding both the subject and objects of medicine, psychiatry, and the social sciences. Through this analysis one can see that medicine's metaphysics is a metaphysics of efficient causation, where medicine's objects are subjected to mechanisms of efficient control.