Contemporary Philosophical Problems
Edited by Alexander N. Chumakov and William C. Gay
Akop P. Nazaretyan, Alexander N. Chumakov, Alexander V. Katsura, Anastasia V. Mitrofanova, Ilia V. Ilyin, Ivan A. Aleshkovskiy, Leonid E. Grinin, Olga G. Leonova, Pavel S. Seleznev, Sergey A. Nikolsky, Tatiana A. Alekseeva, Valentina G. Fedotova, Vladimir N. Porus, Vladimir V. Mironov, William C. Gay, Yakov A. Plyais
The Outrage (1964) is based on the Japanese Film Rashomon (1950) directed by Akira Kurosawa. Although setting the stage for a story in the American Southwest in the 1870s, The Outrage inherits the plot and some key elements of Rashomon. A married couple, the bandit and one witness tell their stories about a rape and murder. This incident is recounted differently by these four witnesses. The viewers are unable to decide what had actually occurred. This situation is called the ‘Rashomon effect’. Kurosawa’s Rashomon is not offering a collective truth but projecting its breathtaking transformation. On the one hand, The Outrage differs from the original in the remake because their narratives are different and each film inseparably combines its own culture and audiences. In particular, turning the spotlight on the narrative of violence, the difference between the two becomes more obvious. There are many forms of empathy, and human beings mirror the ubiquitous form of empathy within their actions, consciously or unconsciously. Even in a duel to the death, or killing people through violence, we can witness empathy. In Rashomon the duel scenes are given much time and a duel is shown as a symbolic representation of empathy, wherein each character’s true self is revealed and the two establish their world into which nobody can enter except viewers. In The Outrage the fight ends when the husband trips and accidentally falls on the knife. He rises, faces the camera, weakly declaring ‘I tripped’, and finally dies. The duel is supposed to be an empathetic interchange, but it ends as ‘an accident’, which spoils Kurosawa’s intention. Kurosawa rejects the intervention of the will of Heaven. Therefore, the remake of Kurosawa’s film does not resemble the original at all.
Considering end-of-life issues, does it make sense to distinguish between killing and letting die? Or should killing a patient (for example, by lethal injection) and letting him die (by withholding or withdrawing treatment) be considered morally equivalent actions? The killing/letting die distinction has a long tradition in the history of moral philosophy. Generally, killing is forbidden (except in cases of self-defence); nevertheless, sometimes it is morally legitimate to not prevent someone from dying (for example when one does not rescue a drowning victim so as not to endanger his own life). The distinction seems to be confirmed within medical ethics. Since the time of the Hippocratic school, the physician has the duty to “not directly kill” the patient; withholding treatment is permissible because in this case the doctor is not killing the patient but letting him die. This framework is criticized within the contemporary bioethical debate. For example, utilitarianism legitimates active euthanasia, arguing that killing and letting die are morally equivalent per se because both actions have the same consequences (the death of others) and intentions do not influence the moral assessment of an action, but only the agent’s character traits. Yet, should the killing/letting die distinction be totally rejected? By affirming that it is without moral significance, are there any implications in our attitudes toward death and care for the dying? To argue the moral relevance of the killing/letting die distinction, this chapter will analyse the types of letting die actions, distinguishing the guilty letting die (therapeutic abandonment) from the letting die for the patient’s good (withdrawing extraordinary or disproportionate medical treatments). The goal is twofold: to encourage the inclusion of suffering and dying experiences in our lives, and to call for the authentic commitment of health professionals and society to caring for the dying.
Manya Hendriks and Robert Pool
The notion of autonomy has increasingly influenced health care practice over the past several decades. The contrast between diverse theories of autonomy – in particular liberal autonomy and relational autonomy – has been carved out in literature. Each of these theories correlates with a peculiar attitude towards end-of-life decisions rooted in particular cultures and societies. From a historical point of view, autonomous decision-making has been prevalent in Western health care whereas shared decision-making is more prevalent in non-Western health systems. Yet, when the notion of autonomy is referred to in the qualitative research literature on the end-of-life, the contrast is hardly, if ever, mentioned. In this literature review we explore the use of the term autonomy in the qualitative research literature on end-of-life decisions and analyse how the concept is interpreted and used, whether implicitly or explicitly. We provide (1) a first account of the qualitative empirical literature on autonomy, and (2) a description of the conceptualization of the term based on philosophical literature. Two themes resulted from the analysis: unconstrained decision-making and shared decision-making. The first theme was predominant in the reviewed articles, and in most autonomy was explicitly defined from the one-sided theoretical perspective of liberal autonomy, whereas the theory of relational autonomy was more often implicitly assumed. However, there was a gradual development in which articles defined relational autonomy explicitly. This analysis is aimed at identifying the conceptual variety of the notion of autonomy as it is used in qualitative research on end-of-life decisions, at improving the operationalization of the concept as well as exploring the intimate relationship between end-of-life decisions and culture.
Suffering has always belonged to one of the major issues in both philosophical and theological reflection. Among many approaches to the problem, an interesting line of thought tries to shed light on a paradoxically positive potential present in this generally negative aspect of human experience. Many authors attempt to demonstrate a wide ambiguity of human experience: evil is often accompanied by good. An analysis of the more general structure of reality reveals that some negative aspects frequently contribute to the intensity of the positive ones. In human beings, this double effect can even foster personal maturity. One of the essential dimensions where suffering is experienced is existential anxiety. This paper focuses on Paul Tillich’s attempt to formulate a wider reflection regarding an aspect of suffering that also embraces its possible positive features. The author’s considerations in this regard are based on the use of his original idea of ‘the courage to be.’ The concept assumes in Tillich its own particular meaning which is neither strictly existential nor situational. For Tillich, all types of anxiety are expressions of non-being. The counterpart of non-being is ‘the courage to be.’ It can be described as the possibility of integrating the absurd of non-being. Therefore, it may be understood and developed only against the backdrop of its negation wherein lie the forces of non-being experienced as anxiety. ‘The courage to be’ represents a transcendent approach to life as a whole which permits one to look beyond suffering itself. It is a conviction of being accepted by a reality that infinitely exceeds the person and his experience of himself. This paper also contains certain developments of Tillich’s considerations. His reflection is an important contribution to theodicy and still actively shapes Christian thought although the conclusions do not have a strictly denominational character. Rather, representing a method of philosophical theology, they permit a wider discussion in the inter-religious area.