The publication in 2015 (ed. Li) of Chap. 6 of the rediscovered Sanskrit text of Candrakīrti’s Madhyamakāvatāra (MA) allows us to witness more directly Candrakīrti’s careful and deliberate critique of the ‘chariot argument’ for the merely conventional existence of the self in Indian Abhidharmic thought. I argue that in MA 6.140–141, Candrakīrti alludes to the use of the chariot argument in the Milindapañha as negating only the view of a permanent self (compared to an elephant), rather than negating ego-identification (compared (...) to a snake in its hole). In contrast to this misuse of the chariot argument, in MA 6.150–165 Candrakīrti uses the chariot argument as an allegory to enable the meditator to refute the basis of ego-identification in seven ways. Candrakīrti’s use of the chariot argument does not establish any theory about the self or not-self, but acts as a guide to meditation as part of philosophy as a spiritual practice with the goal of liberation. (shrink)

A dilemma exists when a doctor is faced with a child or young person who refuses medically indicated treatment. The Gillick case has been interpreted by many to mean that a child of sufficient age and intelligence could validly consent or refuse consent to treatment. Recent decisions of the Court of Appeal on a child's refusal of medical treatment have clouded the issue and undermined the spirit of the Gillick decision and the Children Act 1989. It is now the case (...) that a child patient whose competence is in doubt will be found rational if he or she accepts the proposal to treat but may be found incompetent if he or she disagrees. Practitioners are alerted to the anomalies now exhibited by the law on the issue of children's consent and refusal. The impact of the decisions from the perspectives of medicine, ethics, and the law are examined. Practitioners should review each case of child care carefully and in cases of doubt seek legal advice. (shrink)

This article investigates the original meaning of dependent arising in the Buddha’s teaching, by focussing on the imasmi" sati formula. Modern scholars such as the Rhys Davidses, K.N. Jayatilleke and Paul Williams have interpreted it as a princi- ple of causation, comparable to a scientific conception of causation. I argue instead that this formula implies that the Buddha held that causation is nothing more than the correlation of causes and effects, and that it commits the Buddha to a Humean regularity (...) thesis about causation. I draw a distinction between the Buddhist and scientific concepts of causation, and then summarise an alternative approach made by more recent scholars such as Sue Hamilton, Noa Ronkin and Eviatar Shulman, who present dependent arising in terms of conditionality in the causal structure of subjective experience. I conclude by presenting the argument that the imasmi" sati formula does not express a principle of causation but is rather a formula for the method of discovering and presenting causation as conditionality in experience. (shrink)

The early Buddhist exegetical text, the Nettippakarana, apparently uniquely, describes the stages of the path as ‘transcendental dependent arising’ (lokuttara paticca-samuppada), in contrast with the twelve nidanas, called ‘worldly dependent arising’ (lokiya paticca-samuppada). A close reading of the Nettippakarana in relation to another, related, exegetical text, the Petakopadesa, reveals that the latter interprets the same stages of the path in a different way. More broadly, while the Petakopadesa takes paticca-samuppada to refer only to the twelve nidanas, the Nettippakarana’s exegetical strategy (...) takes paticca-samuppada to refer to an over-arching principle of conditionality, both ‘worldly’ and ‘transcendental’. This exegesis has proved popular with modern western Buddhist exegetes. (shrink)

In this article we explore the underpinnings of what we view as a recent "backlash" in English law, a judicial reaction against considering children's and young people's expressions of their own feelings about treatment as their "true" wishes. We use this case law as a springboard to conceptual discussion, rooted in (a) empirical psychological work on child development and (b) three key philosophical ideas: rationality, autonomy and identity. Using these three concepts, we explore different understandings of our central theme, true (...) wishes. These different conceptual interpretations, we argue, help to elucidate important clinical questions in the area of children's informed consent to treatment. For example, how much should a child's own wishes count in making medical decisions? Does it make a difference if the child or young person is undergoing psychiatric treatment?—if in some sense her wishes are abnormal, not "true" expressions of what she really wants? If the child's wishes do not count, why not? If they do matter but count for less, how much less? We conclude by advocating functional tests of a young person's true wishes, applicable on a case-by-case basis, rather than a black-and-white distinction between "incompetent" children and "competent" adults. (shrink)

The paper is written in response to those who fail to recognize the relation between a patient's mental competency and her state of pain. Some clinicians claim that a proper diagnosis can only be made in the absent of analgesia. Rather, the patient's state of pain directly affects her mental competency and thus her ability to give valid consent. Clinicians should rethink their approach to diagnosis when the patient is in pain.