Parental decision making is necessary for contracting medical interventions that require personal risk–benefit evaluation, and for overseeing matters of education. In the nineteenth century, exemptions from obligatory vaccination were granted for religious and conscientious reasons. Then and today, religion and moral values play marginal roles in vaccine hesitancy and denialism. Rather, the key values invoked by vaccine hesitants and denialists are liberty and pluralism. Neither is compatible with limiting adolescents’ choice. Because vaccination does not require assessment of personal medical risks, (...) because it does not need to occur within the sphere of the doctor–patient relationship, and because the risk involved is within the range of their daily activities, adolescents have the right to free access to vaccination without legal requirement of parental involvement. Drawing on the development of Common Law, and on the development of respect for personal conscience in the history of ideas, this paper does not promote an argument that grants public health an overriding moral power. Rather, this paper rejects the presumption that vaccination of adolescents might involve a conflict between parental authority and public health. Free access to vaccination is compatible with the law and ethics of adolescents’ evolving autonomy in relation to healthcare. (shrink)

This paper explores the value of respect for personal autonomy in relation to clearly immoral and irrational acts committed freely and intentionally by competent people. Following Berlin's distinction between two kinds of liberty and Darwall's two kinds of respect, it is argued that coercive suppression of nonautonomous, irrational, and self-harming acts of competent persons is offensive to their human dignity, but not disrespectful of personal autonomy. Irrational and immoral choices made by competent people may claim only the negative liberty to (...) be left alone. Lives disposed to autonomy are worthy of solidarity and active support in addition to the right of free choice and action. Autonomous premeditated desires (distinguished from mere consent) may embody transcendental choices, which transcend consideration of physical and psychological well-being. Choices made by incompetent persons (e.g., children and the mentally disabled) are not related to autonomy, but to self-directedness. The value of human dignity confers protection to self-directedness, but not at the expense of other vital interests. (shrink)

The article examines the new discourse on medical professionalism and responsibility through the prism of conflicts among moral values, especially with regard to truth-telling. The discussion is anchored in the renaissance of English-language writing on medical ethics in the 18th century, which paralleled the rise of humanitarianism and the advent of the word “responsibility”. Following an analysis of the meanings of the value of responsibility in general and in medical practice in particular, it is argued that, similarly to the Aristotelian (...) notion of equity, responsibility of care is a second-order value, which corrects virtues, laws and norms in exceptional circumstances. Virtues and practices of the second order, such as responsibility and deliberation, bear especially on professional doctoring, which includes a commitment to give priority to the good of the patient over one’s own good. It is argued that, in situations of conflict, and particularly conflicts between personal moral identity and the good of patients, the fundamental professional commitment is to critical and rational deliberation and to the cultivation of psycho-moral flexibility. This leads indirectly to moral growth and strengthening of professional character. (shrink)

The article surveys the history of “terror” vis a vis the development of international humanitarian and human rights law. During the French Revolution, the word “terror” was coined to describe a deviation from the laws of war. Justified by a mixture of ideology and necessity. People who resort to terrorism either suspends or rejects the laws of war (jus in bellum) in the name of an alternative and heightened sense of truth. However, the terrorists’ strong sense of probity and mission (...) is also an opening for re-establishing communication, arbitration and mitigation of cruelty and destruction. This paper represents International Humanitarian Law (IHL) as an “abstract Leviathan”, submission to which is the contemporary norm of pacification. From the perspective of radical terrorism, it is tyrannical. From other perspectives, it is open to criticism and change. Most importantly, it is on the side of rational arbitration rather than arbitrary ordeal. Even radical terrorism, which refuses to recognize the legitimacy of the abstract Leviathan, seeks to communicate its radical messages rather than to seek victory my means of physical annihilation of its opponents. (shrink)

The American Journal of Bioethics, Volume 12, Issue 3, Page 37-39, March 2012.

:This article examines the concept of moral enhancement from two different perspectives. The first is a bottom-up approach, which aims at identifying fundamental moral traits and subcapacities as targets for enhancement. The second perspective, a top-down approach, is holistic and in line with virtue ethics. Both perspectives lead to the observation that alterations of material and social conditions are the most reliable means to improve prosocial behavior overall.Moral enhancement as a preventive measure invokes Gnostic narratives on the allegedly fallen status (...) of human nature, its search for salvation, and the dependence of the laity on heteronomous salvific interventions. The allure of the preventive kind of enhancement is attributable to its religious hues.Owing to the absence of clarity regarding moral enhancement and of metrics to evaluate its progress, humanity is at risk of prioritizing unclear and unsubstantiated measures of preventive diminishment at the expense of celebrating human capacities and joys. (shrink)

This paper presents and discusses a recent Israeli proposal to legislate on the rights of the dying patient. A gap exists between elitist biases of the committee proposing the law, and popular values and sentiments. The proposed law divides the dying patients into two groups: “those who wish to go on living” and “those who wish to die”. The former will have a right to life prolonging extraordinary care. It is not clear who would foot the bill for this care. (...) Also it is hard to see how this munificence could fail to discriminate against all other patients. Both the secular ethicists and the rabbis involved in drawing up the proposal accepted the assumption that it is good for some terminal patients to die. The rabbis objected, however, to direct and active interventions that shorten life. The solution arrived at was to install timers in the ventilators so as to allow them to expire automatically unless the patient wishes for their resetting. (shrink)

In the first part of this article we survey the concept of human rights from a philosophical perspective and especially in relation to the “right to healthcare”. It is argued that regardless of meta-ethical debates on the nature of rights, the ethos and language of moral deliberation associated with human rights is indispensable to any ethics that places the victim and the sufferer in its centre. In the second part we discuss the rise of the “right to privacy”, particularly in (...) the USA, as an attempt to make the element of personal free will dominate over the element of basic human interest within the structure of rights and when different rights seem to conflict. We conclude by discussing the relationship of human rights with moral values beyond the realm of rights, mainly human dignity, free will, human rationality and response to basic human needs. (shrink)

In dieser Arbeit werden drei Gedankenexperimente geprüft, die im Diskurs zur Moralität der Abtreibung vorgebracht wurden: der Geiger von Judith J. Thomson und zwei Erwiderungen darauf von Kenneth Himma und Christopher H. Conn. Sie sind dadurch charakterisiert, dass sie von Rechten sprechen, eine besondere Betonung auf Verkörperung legen und an die moralische Intuition appellieren. Ich behaupte, dass nur menschliche Individuen Menschenrechte haben können und dass Individuation nicht auf der Verletzung der moralischen Rechte anderer basieren kann. Deshalb kann der Fetus weder (...) Träger von moralischen Rechten noch ein Aggressor gegen die Rechte seiner Mutter sein. Die Paradigmen der Umweltethik scheinen für moralische Überlegungen über Abtreibung besser geeignet zu sein als das Paradigma der Rechte. Im Zentrum der Umweltethik stehen eher Fürsorge und Achtung vor dem Leben als Rechte; sie ist auf Verkörperung und natürliche Prozesse abgestimmt und beruft sich mehr auf Gefühle der Fürsorge und Tugend als auf ein Gerechtigkeitsgefühl. (shrink)

Although both codes of practice and virtue ethics are integral to the ethos and history of “medical professionalism”, the two trends appear mutually incompatible. Hence, in the first part of the paper we explore and explicate this apparent conflict and seek a direction for medical education. The theoretical and empirical literature indicates that moral deliberation may transcend the incompatibilities between the formal and the virtuous, may enhance moral and other aspects of personal sensitivity, may help design and improve other parts (...) of the curricula, and may foster self-awareness and clarification of the professional role. Not only are these goals essential for good and conscientious doctoring, but they may also reduce physicians’ “burn-out”. We argue that medical education should focus on the ubiquitous practice of deliberation in contemporary medicine, and especially the practice of moral deliberation. (shrink)