The intersection of ethics, computing, and genetics plots a space not yet adequately mapped, despite its importance, indeed, its rapidly growing importance. Its subdomains are well-enough known: or the study of ethical issues in genetics and genomics, is part of core curricula everywhere. Ethics and computing is an established subfield. Computing and geneticshas in little more than a decade progressed from subsubspecialty to the sine qua non of contemporary biomedical research, and it bids fair to transform clinical practice. We must (...) prepare for the complete digitization of the genomes of individual patients and the storage of millions of these genomes in very large databases. (shrink)

Increasingly widespread adoption of health information technology tools in clinical care increases interest in ethical and legal issues related to the use of these tools for public health and the effects of these uses on the clinician-patient relationship. It is argued that patients, clinicians, and society have generally uncontroversial duties to support civil society's public health mission, information technology supports this mission, and the effects of automated and computerized public health surveillance are likely to have little if any effect on (...) the clinician-patient relationship. It is also suggested, nevertheless, that electronic public health surveillance raises interesting and important ethical issues, some of which can be addressed if not resolved by empirical research, especially regarding patient preferences about secondary use of health data and their moral obligation to contribute to population- based health. (shrink)

One of the largest, oldest, and most interesting challenges in health care is the balancing act in which clinicians have generally uncontroversial duties both to individual patients and to communities. Physicians and nurses must — so we teach them — put patients first, and at the same time recognize that individuals are members of communities. Individuals affect the health of communities, and communities affect the health of individuals. Thus, the moral and professional duties that result are sometimes in conflict.Moreover, the (...) traditional, prosaic clinical encounter is evolving in an environment increasingly shaped by electronic health records, personal health records, pharmacogenomics and vast networks of data collection and storage for public health surveillance, human subjects research, health services evaluation, and comparative effectiveness research. Health information technology is changing everything. It would be perverse otherwise: imagine large amounts of data and information either ignored, missed, or collected and then ignored. (shrink)

To ask whether and to what extent there is an obligation to treat illegal immigrants impliesthat any duty to treat an illegal resident is different from or lesser than the duty to treat a citizen. What could be the reason for thinking that morality affords fewer benefits or rights to illegal residents?

The case of Terri Schiavo, a young woman who spent 15 years in a persistent vegetative state, has emerged as a watershed in debates over end-of-life care. While many observers had thought the right to refuse medical treatment was well established, this case split a family, divided a nation, and counfounded physicians, legislators, and many of the people they treated or represented. In renewing debates over the importance of advance directives, the appropriate role of artificial hydration and nutrition, and the (...) responsibilities of family members, the case also became one of history's most extensively litigated health care disputes. The Case of Terri Schiavo assembles a team of first-hand participants and content experts to provide thoughtful and nuanced analyses. In addition to a comprehensive overview, the book includes contributions by Ms. Schiavo's guardian ad litem, a neurologist and lawyer who participated in the case, and scholars who examine issues related to litigation, faith, gender, and disability. The volume also includes a powerful dissent from the views of many scholars in the bioethics community. The book is intended for students, health care professionals, policy makers, and other in search of carefully reasoned analyses of the case that will shape our view of death and end-of-life medical care for decades. (shrink)

The American Journal of Bioethics, Volume 12, Issue 5, Page 20-22, May 2012.

Point-of-care evidence-based medicine websites allow physicians to answer clinical queries using recent evidence at the bedside. Despite significant research into the function, usability and effectiveness of these programmes, little attention has been paid to their ethical issues. As many of these sites summarise the literature and provide recommendations, we sought to assess the role of conflicts of interest in two widely used websites: UpToDate and Dynamed. We recorded all conflicts of interest for six articles detailing treatment for the following conditions: (...) erectile dysfunction, fibromyalgia, hypogonadism, psoriasis, rheumatoid arthritis and Crohn's disease. These diseases were chosen as their medical management is either controversial, or they are treated using biological drugs which are mostly available by brand name only. Thus, we hypothesised that the role of conflict of interest would be more significant in these conditions than in an illness treated with generic medications or by strict guidelines. All articles from the UpToDate articles demonstrated a conflict of interest. At times, the editor and author would have a financial relationship with a company whose drug was mentioned within the article. This is in contrast with articles on the Dynamed website, in which no author or editor had a documented conflict. We offer recommendations regarding the role of conflict of interest disclosure in these point-of-care evidence-based medicine websites. (shrink)

Radio Frequency Identification (RFID) systems identify and track objects, animals and, in principle, people. The ability to gather information obtained by tracking consumer goods, government documents, monetary transactions and human beings raises a number of interesting and important privacy issues. Moreover, RFID systems pose an ensemble of other ethical challenges related to appropriate uses and users of such systems. This paper reviews a number of RFID applications with the intention of identifying the technology’s benefits and possible misuses. We offer an (...) overview and discussion of the most important ethical issues concerning RFID, and describes and examine some methods of protecting privacy. (shrink)

Advanced Cell Technology's Ethics Advisory Board has been called window dressing for a corporate marketing plan. But the scientists and managers have paid attention, and the lawyers have gone along.

News media accounts of issues in bioethics gain significance to the extent that the media influence public policy and inform personal decision making. The increasingly frequent appearance of bioethics in the news thus imposes responsibilities on journalists and their sources. These responsibilities are identified and discussed, as is (i) the concept of "newsworthiness" as applied to bioethics, (ii) the variable quality of bioethics reportage and (iii) journalists' reliance on ethicists to pass judgment. Because of the potential social and other benefits (...) of high quality reporting on ethical issues, it is argued that journalists and their bioethics sources should explore and accommodate more productive relationships. An optimal journalism-ethics relationship will be one characterized by "para-ethics," in which journalistic constraints are noted but also in which issues and arguments are presented without oversimplification and credible disagreement is given appropriate attention. (shrink)

In this engaging study, the authors put casuistry into its historical context, tracing the origin of moral reasoning in antiquity, its peak during the sixteenth and early seventeenth century, and its subsequent fall into disrepute from the mid-seventeenth century.

Francisco Ayala and others have argued that recent genetic evidence shows that the origins of the human race cannot be monogenetic, as the Church hastraditionally taught. This paper replies to that objection, developing a distinction between biological and theological species first proposed by Andrew Alexanderin 1964.

Catholic evolutionists have proposed to reconcile evolutionary anthropogenesis with Catholic doctrine by suggesting that a created soul could be infused into a body produced by evolution from an animal body. Could such an infusion yield not just a Platonic composite but a being with the unity of substance required by a Thomistic philosophy of nature? How could such a soul be the form of the body into which it was infused? This paper suggests that animals seem to have sense-powers with (...) a level of complexity, if not sufficient to underlie the abstraction of concepts in a being that also has a rational soul, then at least nearly so. The burden of proof lies rather on those who think that evolutionary development of such powers is not possible. In its final section, the paper argues that the existence of Eve as a second, and the only additional, initial rational being does not create special problems for the view here articulated. (shrink)

In 300 BCE, the tutor of the heir-apparent to the Chu throne was laid to rest in a tomb at Jingmen, Hubei province in central China. A corpus of bamboo-strip texts that recorded the philosophical teachings of an era was buried with him. The tomb was sealed, and China quickly became the theater of the Qin conquest, an event that proved to be one of the most significant in ancient history. For over two millennia, the texts were forgotten. But in (...) October 1993, they were unearthed. The discovery of the Guodian texts, together with other recently discovered Warring States manuscripts, has revolutionized the study of early Chinese intellectual history. Kenneth Holloway argues that the Guodian corpus puts forth a political philosophy based on the harmonious interconnection of individuals engaged in moral self-cultivation. This unique worldview, says Holloway, cannot meaningfully be categorized as "Confucian" or "Daoist," because it shares important concepts and vocabulary with a number of different textual traditions that have anachronistically been characterized as competing or incompatible "schools" of thought. He finds that within the Guodian corpus familiar philosophical concepts and texts are applied in distinctive ways, presenting a worldview that is quite different from the received textual traditions. In the corpus, the most important function of government is to assist in the harmonization of state and family relations. It sees the relationship between these two entities - the family and the collection of families that ultimately constitute the state - as being inherently conflicting social groupings. The texts posit an interesting solution: State and family disharmony can be overcome by developing a hybrid government that employs both meritocratic and aristocratic methods. Without knowledge of the emphasis on hybridization found in the Guodian texts, however, scholars were unable to understand the interrelationships between these two methods of government. This new understanding illuminates central issues of government, religion, and philosophy in early China that were overlooked in received texts. As part of the contribution to our understanding of this particular body of texts, Holloway proposes a methodology for assessing a corpus of texts without relying on assumptions and definitions that derive from two thousand years of scholarship. The Guodian corpus, and Holloway's analysis of it, are now absolutely indispensable to any student or scholar of ancient Chinese intellectual history. (shrink)

In Schools of Thought in International Relations, renowned foreign-affairs scholar Kenneth W. Thompson seeks to clarify the study of international relations theory by succinctly addressing salient issues in its intellectual history.

In this informed and comprehensive assessment of current issues in international policies, Kenneth W. Thompson addresses the role that traditions and values play in shaping change and in helping us to understand its implications. He challenges the idea that the enormous changes in contemporary national and international life have rendered the consideration of traditions and values obsolete. Thompson’s purpose is to illuminate the problems we face and to set forth general principles directed toward an informing theory on traditions and (...) values as they affect politics and diplomacy, while at the same time warning of the pitfalls and limitations of theory. In the first section of this book, Thompson draws on classical and Judaeo-Christian traditions in defining the relationship between philosophy, religion, and politics. He then examines the application of abstract values to such political realities as national interest, and goes on to consider the question of moral values in international diplomacy and politics. In a series of case studies, Thompson reflects on human rights, disarmament and arms control, and human survival. Maintaining that the implementation of traditions and values is sometimes uniquely the task of the American presidency, he studies the administrations of four postwar presidents—Dwight D. Eisenhower, John F. Kennedy, Lyndon B. Johnson, and Richard M. Nixon—in the light of the executives’ attitudes toward ethics and politics. Finally, Thompson considers the implications of national decline and the breakdown of international order for the future of the United States. The vast knowledge of international affairs and the literature of politics that Kenneth W. Thompson brings to this timely and reflective books makes it exceptionally readable as well as intellectually challenging. (shrink)

What is the proper role of cost-benefit analysis in understanding the tort concept of negligence or reasonable care? A straightforward question, you might think. But it is a question that manages to elicit groans of exasperation from those on both sides of the controversy. For most utilitarians and adherents to law and economics, the answer is obvious: to say that people should not be negligent is to say that they should minimize the sum of the costs of accidents and the (...) costs of preventing accidents. Under the economic formulation of the famous Learned Hand test, they should take a precaution if but only if the marginal costs (or burden, B) of that precaution are less than its marginal benefits (in the form of reduced risks of injury, measured by multiplying the probability (P) of the injury times the magnitude (L) of the injury if it occurs). If B>PxL, it would be absurd to require the greater expenditure, B. For many advocates of a fairness, corrective justice, rights-based, or contractualist perspective, the opposite answer is equally obvious. Permitting a person to impose risks of harm on others merely because he would thereby obtain a benefit (or would otherwise incur a burden) greater than the discounted value of the harm he might inflict, amounts to authorizing him to dump the costs of his risky activities on innocent victims. To permit this type of sacrifice of individuals on the altar of aggregate social welfare is morally abhorrent. Both sets of criticism have important elements of truth. Neither an unqualified cost-benefit analysis nor an unqualified rights-based rejection of tradeoffs is defensible - either as a description of tort doctrine and practice or as a normative prescription. However, a qualified (sensitive) consequentialist approach can accommodate legitimate criticisms of cost-benefit analysis: the consequentialist can launder preferences, and can consider the distribution of risk both in the social welfare calculus and in determining whether to compensate. At the same time, a qualified (tough-minded) deontological approach can accommodate the legitimate need to recognize tradeoffs: the deontologist can permit intrapersonal but not interpersonal aggregation of risks and benefits, can apply the concept of threshold deontology to risky activity, and can consider individual rather than population risk. I conclude that the formulation of the Learned Hand test found in the Restatement Third of Torts is broad enough to encompass each of these qualified approaches. (shrink)

With the world looking to the U.S. for strategic leadership in ethics and power, Americans cannot afford to deny American youth a strong foundation and education in international studies.

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Focuses on the theory and practice of presidentialism and constitutionalism.

Focuses on the theory and practice of presidentialism and constitutionalism.

from my first courses as an undergraduate in African American studies, I have been concerned about the dynamics by which white and Black1 people discuss race. For one, I was troubled in my undergraduate African American studies courses by the ease with which white students would insert themselves into conversations where, it seemed to me, they simply did not belong, for example, conversations concerning visions for the future of the Black community and strategies for achieving such visions. Shannon Sullivan speaks (...) of this phenomenon, accurately I believe, as “ontological expansiveness”: one central feature of privilege is a sense of entitlement to enter every room without first considering whether or not one is .. (shrink)

Doug Husak suggests that sometimes an actor should be deemed reckless, and not merely negligent, with respect to the risks that she knowingly created but has forgotten at the moment of action. The validity of this conclusion, he points out, depends crucially on what it means to be aware of a risk. Husak’s neutral prompt and counterfactual actual belief criteria are problematic, however. More persuasive is his suggestion that we understand belief, in this moral and criminal law context, as a (...) concept whose meaning is determined by its function as a culpability standard. Husak concludes that inadvertent actors are often less culpable than knowing-but-later-forgetful actors; this is plausible, but there are also numerous counterexamples. Holly Smith focuses on negligence cases in which an agent’s failure to notice a risk stems, not from a prior culpable choice, but from an objectionable attitude or set of attitudes. She is right to emphasize that genuine moral culpability does not depend on conscious choice. However, Smith also asserts that decisions that flow from an actor’s objectionable attitudes are only rarely culpable, because they often do not arise from a reasonably full configuration of the actor’s motives. This last requirement is, I fear, an unrealistic and unnecessarily demanding criterion of culpability. Even when many of the actor’s evaluative attitudes are inactive in Smith’s sense, the actor might deserve blame for not bringing them to bear on his decision. Michael Moore and Heidi Hurd thoroughly explore, and find deficient, H.L.A. Hart’s unexercised capacity theory of negligence. They are correct that that theory requires a further judgment: an actor’s inadvertence is culpable only if he had the capacity to have adverted if X where X is the source of the actor’s moral desert. They overstate, however, in suggesting that the capacity issue falls out of the picture once we identify that underlying desert basis. The authors also worry that if desert is grounded on an underlying vice, we lack a reliable way of ranking the different vices that might explain the actor’s inadvertence; this is not a fatal objection, however, because negligence determinations are quite feasible even in the absence of clear rankings. Moore and Hurd conclude by identifying eight distinct categories in which criminal liability for negligence is justifiable. Negligence is indeed a surprisingly complex and pluralist concept. The three articles in this symposium brightly illuminate some of the most fundamental conceptual and normative issues in the debate over whether it is just to blame and punish the negligently inadvertent. (shrink)

This article explores different dimensions of the concept of negligence in the law. The first sections focus on the fundamental distinction between conduct negligence, a conception that dominates tort law; and cognitive negligence, a conception that is much more important in criminal law. The last major section identifies five significant institutional functions served by a legal negligence standard: expressing a legal norm in the form of a standard rather than a rule; personifying fault; empowering the trier of fact to give (...) content to the standard; creating a secondary legal norm parasitic on a primary legal norm; and distinguishing grades of fault. These functions reveal the distinctive significance of negligence, but also disclose numerous problems that the use of such a legal standard can pose. Careful analysis of these different dimensions of negligence clarifies certain misconceptions and has important implications. For example, the question whether "negligence" is an appropriate minimum standard of liability is unanswerable until we identify the type of negligence at issue and its role in norm-definition. Similarly, comparing negligenceto supposedly "more serious" forms of fault, such as recklessness, knowledge, and purpose, is treacherous and sometimes amounts to comparing apples and oranges. A better understanding of the different conceptions of negligence and of the distinctive institutional functions of a legal negligence standard can facilitate the development of more coherent, and more justifiable, fault criteria in criminal law, torts, and other legal domains. (shrink)