Some of the contemporary ethical debates have put in value the rational feature of feelings because of the estimative intentionality that is implied in them. In this context, some claim that the intentionality of emotions is a kind of value perception, as Phenomenology stressed at the beginning of the twentieth century, particularly Max Scheler, by analysing emotional Feeling [_Fühlen_] in the frame of emotional life. In order to extend the context of this philosophical debate, and after describing Scheler’s (...) phenomenology of feelings of the intentional and non-intentional emotional life, firstly, we defend _the_ _axiological_ _and_ _emotional_ _intentionality_ _as_ _double_ _intentionality_ that—in our understanding—Scheler analyses phenomenologically, while taking distance from Franz Brentano and Edmund Husserl’s intentional structure of estimative emotions. And, secondly, we propose a tentative interpretation of _the link_ between estimative and emotional double intentionality _as living_ _structure_ _of_ _ethical_ _life_, in the light of Martin Heidegger’s Hermeneutical Phenomenology. (shrink)

Hegel's account of ethical life can be shown to contradict Aristotle's in two main ways: first, Hegel follows Kant in emancipating virtue/duty from the particularity associated with the content of motivational drives and with Aristotle's eudaimonia. Hegel thus rejects Aristotelian happiness as the final end of rational action and prioritizes duty. However, against Kant, Hegel unites abstract duty and determined drives within a speculative notion of ethical duty: rational agents find happiness in heeding duty's call. Second, Hegel (...) follows Kant in emancipating agency's subjective dimension from the all-encompassing determinacy of Aristotelian substance metaphysics. At the same time and against Kant, Hegel unifies agency's undetermined, subjective dimension with the determinacy of objective norms and habitual praxis: ethical praxis must be animated by undetermined subjectivity whilst being determined. In both cases, Hegel goes beyond Aristotle by resting his argument on the speculative structure of ‘the concept of the will’. (shrink)

Role ethics, broadly speaking, is a normative ethical theory that has a prominent emphasis on roles. Although it was prominent in ancient cultures, such as in China and Greece, role ethics waned during the Enlightenment era. Not until very recently has role ethics been articulated in its own terms. Among current discussions on roles, the most systematic role ethics are Confucian role ethics, Epictetus’ role ethics, Sarah Harper’s rolecentered morality and Jeremy Evans’ role ethics. They are my primary interlocutors (...) as I develop and defend an alternative approach to understanding, examining and guiding our ethical life. By arguing that our ethical life is pervasively structured by roles, and drawing on the lights that my primary interlocutors have shed, I propose a role-structured ethics or role ethics that addresses some central issues regarding the nature of roles, the self, role identification, role fulfillment, role conflicts, and changing roles. Importantly, I emphasize the place of traditions in constructing a complete normative role ethics. So throughout the dissertation, I outline and defend the basic structure of any plausible specific role ethics, which is neutral among various traditions. I call such a structure “Role Ethics.” In particular, I investigate the nature of roles and its relation to the self, role fulfillment and its relation to the concept of duties, virtues and skills, as well as the nature of role conflicts and how to approach them. Along these lines of exploration, I also argue that they have important implications on the dignity of persons, moral education, and the notion of practical wisdom. Last but not the least, due to the universality of roles in various traditions, I propose that Role Ethics can serve as a platform to bring various traditions into meaningful dialogue. (shrink)

According to the received view, Kant and Hegel espouse diametrically opposed views of moral motivation. Kant holds that to act morally is to act out of reflective recognition that a proposed intention ought to be made into a universal law. Action of true moral worth can never be motivated by an immediate inclination. Hegel, in contrast, holds that the natural inclination of an agent, who has been successfully acculturated within a just society, is moral action. The received interpretation is right, (...) but it misses a critical part of Hegel's view and it is to this idea that the entire dissertation is devoted. Hegel does not reject Kant's claim that a necessary condition of morality is autonomous action, which is not determined immediately by natural inclinations or acquired habits. He thinks that precisely such action is the origin of any actual, shared form of ethical life. It is in his idea of a founding act of ethical life that Hegel claims Kant's inheritance. ;The founding act of ethical life does not, however, meet Kant's criterion of moral action. Modeled, in the Phenomenology of Spirit, on Antigone's tragedy, the founding agent acts without being conscious of the universal ethical significance of the act; nor does the community the act transforms acknowledge its significance. The lawmaker and the community are necessarily blind to each other. This tragic, mutual blindness is a condition of the most extreme violence. ;Are there, in reality, any such acts? Modern political life has its founding moment, according to Hegel, in the French Revolution, the Reign of Terror and the Napoleonic Wars. The old world and its political structures and institutions has collapsed, leaving action doomed to go unacknowledged. The violence of the Revolution and its aftermath is the condition of the foundation of a new shape of life. Though to be condemned absolutely, it is the necessary condition of the foundation of modern states. The concluding claim of the Philosophy of Right is that war, more generally, is the collapse of the actual life of states and the call to found a new shape of ethical life. (shrink)

Kant's formalism remains unreal if it cannot be concretized in a historical ethos. An ethos belongs—with texts, contexts, structures, processes, networks, etc.—to an economy of customs and opinions, which presupposes that participating individuals have been and are being initiated and acculturated to it. The analysis of education, transmission, and transition unveils the irreducible—noneconomic and non-textual— essence of addressing and interlocution, without which no culture could exist. The otherness that is involved implies, but is not confined to, "you." The third and (...) I myself are also other by imposing the same inescapable responsibility for them on me. (shrink)

The article attempts to show that Hegel’s concept of “civil society” is characterized by a deep ambivalence about the value of the new market economy. On the one side, Hegel believed that the economic system represented by “civil society” succeeded like no other in simultaneously giving free reign to the desires of individual subjects and integrating them into a stable structural framework. On the other side, Hegel’s reflections are growingly overtaken by doubts as to whether, in light of its self-destructive (...) tendencies, the market system can be as successful in guaranteeing individual freedom as he first envisaged it to be. In the course of this essay, it will ultimately become clear that Hegel’s attempt to redefine “civil society” reveals considerably more conceptual indecision and inner conflict than one might have suspected from the great system builder. (shrink)

Race is central to the construction and application of American criminal law and, in turn, criminal law significant to the American racial experience. Yet, there remains controversy about the very nature of the question of “race in criminal law.” This chapter takes up different possible views of race and racism in criminal law, scanning questions surrounding hate crimes and racist intent, before focusing on structural racism in legislation, policing, prosecution, sentencing, mass incarceration and collateral sanctioning as the most pressing facets (...) of race in criminal law. The endemic nature of this racism often prompts legal theorists to speculate about the obligations of oppressed racial minorities to obey the law. Ironically, less explored is the more pressing dilemma, how can privileged citizens find a way to live ethically under a system of criminal law that imposes racial injustice in their name. (shrink)

Since G.A. Cohen’s influential criticism, John Rawls’s focus on the basic structure of society has fallen out of favor in moral and political philosophy. The most prominent defenses of this focus has argued from particular conceptions of justice or from a moral division of labor. In this dissertation, I instead argue for the Rawlsian focus from the ways in which social institutions establish new obligations, rights and powers. I argue that full evaluation of individual conduct requires that we evaluate the (...) practices within which an individual’s actions occur. Likewise, full evaluation of practices often requires evaluating the systems within which actions occur. I argue that we should treat the basic structure of society as a moral subject because the full evaluation of the various institutions that constitute the basic structure requires that we evaluate the basic structure as a whole. This argument shows the advantages of the Rawlsian approach even when we do not accept contractualism, constructivism or the two principles of justice. We need only accept the view that the major social institutions establish obligations, rights, and powers for individuals as members of society. (shrink)

Part I: The representation of life -- Can life be given a real definition? -- The representation of the living individual -- The representation of the life-form itself -- Part II: Naive action theory -- Types of practical explanation -- Naive explanation of action -- Action and time -- Part III: Practical generality -- Two tendencies in practical philosophy -- Practices and dispositions as sources of the goodness of individual actions -- Practice and disposition as sources of (...) individual action. (shrink)

The book is divided into three parts. The first criticizes in some detail the various naturalistic theories as they appear in philosophy and the sciences. Thus Professor Vivas reckons with the interest theory of Santayana and R. B. Perry, the postulational theory of Charner Perry, the instrumentalist theory of Dewey, the linguistic theory of Stevenson, and again, the cultural relativity of the anthropologists and the genetic account of conscience in Freud. Once these are demolished, the second part looks for the (...) generic structure of the moral experience as focussed in the process of resolving a moral perplexity. Professor Vivas stresses the role of a hierarchically organized system of values espoused by the self which constitutes the person, and repeatedly insists on the objective or "ontic" status of the values. The person is regarded as an axiological not a psychological category; and it is only through resolving moral perplexities that a man finds out, by creating, what he is. The creative element prevents moral decision from being simply self-expression. In fact, the ethical stage, as distinguished from the moral, is characterized by the overthrow of a man's dominant values: "when we repudiate our constitutive values altogether and forge an entirely new personality, a naked, empty self must do the choosing, and how this process is possible is not at all obvious". The third part presents the rise of the ethical attitude in this second birth. Its essence lies in the absolute sanctity of the person, and Professor Vivas sees this as the answer to the conflict of values in our time. (shrink)

The article aims to base the presence of a reconceptualization of the political in Michel Foucault's thought, taking as the reading key ethhopolitics as a conceptual proposal. There, we can find a concept completely opposed to the way in which both modern governmentality and the tradition of political thought have understood the meaning of politics in the West. Following this purpose, the hypothesis is proposed and developed, according to which the analytical gesture that persists in Michel Foucault's thought is a (...) concept of the political that affirms life in its radical exuberance and unfoundedness. In this statement, we recognize the signatures of a triangular conceptual structure made up of the fold between life, ethics and power. After exposing the problem and clearing some methodological difficulties for its approach, we examine in detail the investigations that comprise the archeology of ethical life in the French philosopher. It is argued that the very textuality of ethhopolitics is formulated as politicity rather than as a specific policy, that is, it is presented as a politics of life, since it is implied as a singular modulation of existence. The article concludes with a scriptural threshold composed of five theses that attempt to expand and project the philosophical-political returns of the analysis developed towards a research program. (shrink)

Business ethics has been emphasized throughout the past decade and organizations are aware of the influence it has on the organization’s performance. As a result, ethical leadership is important as it influences the employees profoundly. This study aims to address this issue and explore the influence ethical leadership has on employees by examining job satisfaction, subjective well-being at work, and life satisfaction. Two groups of independent data were collected and a multi-group analysis was conducted before pooling together (...) for a two-step structural equation modeling test. The results revealed that ethical leadership has a negative direct effect on employee well-being which offers significant findings for the meaning of ethical leadership in the Chinese culture. Useful managerial implications are provided for managers and supervisors at the end of this study. (shrink)

The purpose of the study is to substantiate and develop the author's model of the structure of the life world of a modern person based on the analysis of fundamental sociophilosophical ideas about the structuring of the human life world. The scientific novelty consists in generalizing the views of various representatives of the phenomenological direction on the human life world and structuring the life world of a modern person, taking into account such factors as (...) the socio-biological nature of a person, the multidimensional nature of the human psyche and the peculiarities of the space of everyday life of a modern person. As a result, it is proved that the structure of the life world of a modern person is nothing more than a three-component system formed by the "objective world", reflecting the biological essence of a person and the experience of scientific research accumulated by mankind, the "social world", reflecting the social essence of a person and the moral and ethical norms developed by mankind, the" inner world", reflecting the peculiarities of the functioning of the human psyche in cognitive, emotional, evaluative and behavioral aspects. (shrink)

We live in a world in which ‘smart’ algorithmic tools are regularly used to structure and control our choice environments. They do so by affecting the options with which we are presented and the choices that we are encouraged or able to make. Many of us make use of these tools in our daily lives, using them to solve personal problems and fulfill goals and ambitions. What consequences does this have for individual autonomy and how should our legal and regulatory (...) systems respond? This chapter defends three claims by way of response. First, it argues that autonomy is indeed under threat in some new and interesting ways. Second, it evaluates and disputes the claim that we shouldn’t overestimate these new threats because the technology is just an old wolf in a new sheep’s clothing. Third, and finally, it looks at responses to these threats at both the individual and societal level and argues that although we shouldn’t encourage an attitude of ‘helplessness’ among the users of algorithmic tools there is an important role for legal and regulatory responses to these threats that go beyond what are currently on offer. (shrink)

This article will focus on issues concerning the provision of artificial nutrition and hydration to patients who are extremely old, completely bedridden, and totally dependent on others. These patients have no advance directives, no malignancy, suffer from persistent but unstable disturbance of consciousness as well as severe cognitive impairment, and cannot eat sufficient amounts of food to maintain their lives. Should ANH be provided? Some would agree while others would maintain otherwise. The underlying values and normative theory behind each argument (...) are quite different. In this paper, I will present opinions, comments, and arguments concerning the provision of PANH to such patients and examine each using the Takahashi‘s three levels structure analysis. Utilitarianism is a fitting ethical theory for the third level in arguments against the provision of PANH to patients in question, and the non-religious sanctity of life doctrine covers the opposite position. (shrink)

This is the first collection of essays devoted to the thought of Anselm W. Müller. It brings to the attention of the English-speaking world an influential and highly regarded philosopher who has made important contributions to a wide range of philosophical debates. The volume begins with a biographical sketch of Müller. Arguably, Müller's most important contributions are to the philosophy of action and virtue ethics. The contributors, which include friends, colleagues, and former students, engage with different aspects of Müller's thought (...) in these areas. Subjects include his interpretation of Aristotle and Wittgenstein, the teleology of thought and action, the Aristotelian distinction between poiesis and praxis and its application to ethical upbringing, and the possibility of practical knowledge and practical truth. Teleological Structures in Human Life will be of interest to researches and advanced students working on virtue ethics, philosophy of action, and practical reasoning. (shrink)

The last two decades have witnessed a crescendo of allegations that clinical translation is rife with waste and inefficiency. Patient advocates argue that excessively demanding regulations delay access to life‐saving drugs, research funders claim that too much basic science languishes in academic laboratories, journal editors allege that biased reporting squanders public investment in biomedical research, and drug companies (and their critics) argue that far too much is expended in pharmaceutical development.But how should stakeholders evaluate the efficiency of translation and (...) proposed reforms to drug development? Effective reforms require an accurate model of the systems they aspire to improve—their components, their proper functions, and their pathologies. However, there is currently no explicit and well‐developed model of translation for evaluating such criticisms.In what follows, we offer an explicit model of clinical translation. Many discussions of clinical translation and its pathologies presume that its main output is tangible: new drugs, vaccines, devices, and diagnostics. We disagree. We argue that the principal output of clinical translation is information—in particular, information about the coordinated set of materials, practices, and constraints needed to safely unlock the therapeutic or preventive activities of drugs, biologics, and diagnostics. To develop this information calls for a process far different from a simple linear progression of clinical trials; it requires exploratory sampling of many different elements in this set. Our model points to some limitations and liabilities of influential proposals for reforming research. It also reveals some underrecognized opportunities for improving the efficiency of clinical translation. (shrink)

Cheating is deeply embedded in everyday life. The costs of the most common forms of cheating total close to a trillion dollars annually. Part of the problem is that many individuals fail to see such behavior as a serious problem. "Everyone does it" is a common rationalization, and one that comes uncomfortably close to the truth. That perception is also self-perpetuating. The more that individuals believe that cheating is widespread, the easier it becomes to justify. Yet what is most (...) notable about analysis of the problem is how little there is of it. Whether or not Americans are cheating more, they appear to be worrying about it less. In Cheating, eminent legal scholar Deborah L. Rhode offers the only recent comprehensive account of cheating in everyday life and the strategies necessary to address it. Because cheating is highly situational, Rhode drills down on its most common forms in sports, organizations, taxes, academia, copyright infringement, marriage, and insurance and mortgages. Cheating also reviews strategies necessary to address the pervasiveness and persistence of cheating in these contexts. We clearly need more cultural reinforcement of ethical conduct. Efforts need to begin early, with values education by parents, teachers, and other role models who can display and reinforce moral behaviors. Organizations need to create ethical cultures, in which informal norms, formal policies, and reward structures all promote integrity. People also need more moral triggers that remind them of their own values. Equally important are more effective enforcement structures, including additional resources and stiffer sanctions. Finally, all of us need to take more responsibility for combatting cheating. We need not only to subject our own conduct to more demanding standards, but also to assume a greater obligation to prevent and report misconduct. Sustaining a culture that actively discourages cheating is a collective responsibility, and one in which we all have a substantial stake. (shrink)

Bioethical dilemmas can emerge in research and clinical settings, from end-of-life decision-making to experimental therapies. The COVID-19 pandemic raised serious ethical challenges for healthcare organizations, highlighting the need to conduct needs assessments of the bioethics infrastructures of healthcare organizations. Clinical ethics committees (CECs) also create equitable policies, train staff on ethics issues, and play a consultative role in resolving the difficulty of complex individual cases. The main objective of this project was to conduct a needs assessment of the (...) bioethics infrastructure within a comprehensive hospital system. A cross-sectional anonymous online survey, including quantitative and qualitative formatted questions. The survey was sent to five key leaders from the organization’s hospitals. Survey questions focused on the composition, structure, function, and effectiveness of their facilities’ bioethics infrastructure and ethics-related training and resources. Positive findings included that most facilities have active CECs with multidisciplinary membership; CECs address critical issues and encourage team members to express clinical ethics concerns. Areas of concern included uncertainty about how CECs function and the process for resolving clinical ethics dilemmas. Most reported no formal orientation process for CEC members, and many said there was no ongoing ethics education process. The authors conclude that if CECs are a critical institutional resource where the practice of medicine and mission intersect, having well-functioning ethics committees with trained and oriented members demonstrates an essential commitment to the mission. The survey revealed that more needs to be done to bolster the bioethics infrastructure of this institution. (shrink)

Contemporary architecture is increasingly grounded in science and mathematics. Architectural discourse has shifted radically from the sometimes disorienting Derridean deconstruction, to engaging scientific terms such as fractals, chaos, complexity, nonlinearity, and evolving systems. That's where the architectural action is -- at least for cutting-edge architects and thinkers -- and every practicing architect and student needs to become conversant with these terms and know what they mean. Unfortunately, the vast majority of architecture faculty are unprepared to explain them to students, not (...) having had a scientific education themselves. Here is an architecture book by an architect/scientist, just in time to help architects in the new millennium. Alexander discusses many of the scientific terms arising in cutting-edge architecture, and explains them to those who don't have scientific training or advanced mathematical knowledge. We find discussions of the evolution of forms; the importance of process in design; iteration; genetic algorithms; sequences of transformations; different levels of scale (i.e. fractals); etc. They are explained here by an architect who is also a scientist, because he wants to change the way architects think and build. Alexander is not merely popularizing other scientists' results and making them accessible to architects: he is in fact presenting new and original scientific work that ties many of these concepts together in a way that will be useful to architects. (shrink)

Introduction The act of caring in nursing requires previous deliberation and decision, however this perception only arises when an ethical problem emerges. Objective: Identify ethical problems of nurses action in the area of beginning of human life Method: Exploratory and descriptive method, with a qualitative approach. Semi-structured interviews were used to collect data, who were submitted to content analysis. The sample was constituted by 26 nurses. Results 18 categories of problem areas and 56 ethical problems in (...) early human life were identified. The results obtained are very diverse, including areas such as termination of pregnancy, informed consent or maintaining privacy. However, other problem areas also emerge and numerous new subcategories/ethical problems, including: dealing with miscarriage, extreme situations, minors’ pregnancy, serious malformations detected at birth, consent regarding care during childbirth, Non- identification of a ethical problem, nurse social recognition and non-involvement of the person in labour. Conclusion Nurses face different ethical problems that impact their lives. We intend to contribute in helping to make decisions in this field, which the outset is of hope and joy, but which hides, behind this evidence, countless situations of suffering for everyone involved. The identification of ethical problems in this field, it is the first step to reflect about theme and helping decision-making for nurses that are taking care in this area of beginning of human life, when confronted whit the same type of ethical problems. (shrink)

Christian ethics has from the beginning been concerned with moral agency and culture, and Christian social ethics has acknowledged the power of social structures for the last 150 years. But ethics has yet to employ extensively the resources of that discipline that specializes in understanding structure and culture: sociology. Out of a concern to defend human freedom, Catholic social teaching has employed an individualistic approach that misdescribes the characteristics of social evil as little more than the sum of individual choices (...) and proposes individual conversion as a remedy. This book presents a refined sociological understanding of social structures and culture: critical realist sociology. It briefly describes the roots of critical realism in the natural sciences, its understanding of social structure and culture, and how structure and culture have causal impact on human decisions - through freedom, not cancelling it. It makes clear how, in most cases, people "go along" with the restrictions and opportunities offered them but, when there is sufficient frustration with these, how decisions can transform both structure and culture. The analysis is then applied in more detail to provide needed illumination in three areas: the ecological crisis, economic life, and virtue ethics. The core claims of the volume, offering an explanatory account of moral-agency-amidst-structure-and-culture for use in social ethics, would be of great interest to all those working in the field, both Catholic and Protestant. (shrink)

This paper achieves two general objectives. It first analyses Bernard Hodgson's "Economic As Moral Science" as a path-breaking internal critique of neo-classical economic theory, and it then demonstrates that the underlying neo-classical paradigm he presupposes suffers from a deeper-structural myopia than his standpoint recognizes. EMS mainly exposes the a priori moral prescriptions underlying orthodox consumer choice theory - namely, its classical utilitarian ground and four or, as argued here, five hidden universal categorical-ought prescriptions which the theory presupposes as instrumental imperatives: (...) comparability evaluations by all consumer judgements; non-satiety of consumer desire; consistency and transitivity of consumer preferences; diminishing rate of marginal substitution by consumer choice; and an unlimited aggregate growth of commodity production, or "the liberal growth ethic". The article argues that Hodgson's refutation of the neo-classical claims of "value neutral scientific method" is sound, that his bridging of the Humean reason-desire divide by the "rational review" of wants is resonantly demonstrated, and that his argument for conversion of an "a priori-cum-normative-cum-idealized" neoclassical theory into scientific status is logically plausible but morally abhorrent. The principal objection to Hodgson's magisterial exposé of neo-classical doctrine's moral a priorism is that the latter's normative presuppositions are profoundly deranged at a level that he himself assumes as given. In consequence, there is theoretical closure at three levels: to the underlying "life economy" of non-priced and non-profit production and distribution of goods otherwise in short supply; to the "civil commons" infrastructure sustaining these non-commodity systems of social and ecological production and distribution; and to the systemic despoiling of both by monetized market mechanisms which are falsely assumed as the defining limits of "the economy". (shrink)

Originally published in 1949, this book covers both psychological and sociological aspects of moral life in Western society in the first half of the 20th Century and the historical influences on its thinking and way of behaviour. It discusses education, art, social structure, law and religion and ethical failure.

We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation’s first hospital ethics committees, this committee has primarily focused on the optimum use of life-sustaining treatments. We outline specific sociodemographic and clinical characteristics of consult patients during this period, demographic differences between the adult inpatient population and patients for whom the ethics committee (...) was consulted, and salient features of the consults themselves. We include three case studies that illustrate important consult themes during this period. Our findings expand knowledge about the structure and workings of hospital ethics committees and illustrate how one ethics committee has developed and utilized policies on end-of-life care. More generally, we model a sociological approach to the study of clinical ethics consultation that could be utilized to contextualize institutional practices over time. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision-making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real-life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we (...) attempt to capture a comprehensive overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement-based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

With disagreement, doubts, or ambiguous grounds in end–of-life decisions, doctors are advised to involve a clinical ethics committee. However, little has been published on doctors’ experiences with discussing an end-of-life decision in a CEC. As part of the quality assurance of this work, we wanted to find out if clinicians have benefited from discussing end-of-life decisions in CECs and why. We will disseminate some Norwegian doctors’ experiences when discussing end-of-life decisions in CECs, based on semi-structured interviews (...) with fifteen Norwegian physicians who had brought an end-of-life decision case to a CEC. Almost half of the cases involved conflicts with the patients’ relatives. In a majority of the cases, there was uncertainty about what would be the ethically preferable solution. Reasons for referring the case to the CEC were to get broader illumination of the case, to get perspective from people outside the team, to get advice, or to get moral backing on a decision already made. A great majority of the clinicians reported an overall positive experience with the CECs’ discussions. In cases where there was conflict, the clinicians reported less satisfaction with the CECs’ discussions. The study shows that most doctors who have used a CEC in an end-of-life decision find it useful to have ethical and/or legal aspects illuminated, and to have the dilemma scrutinized from a new perspective. A systematic discussion seems to be significant to the clinicians. (shrink)

Medical communication in Western-oriented countries is dominated by concepts of shared decision-making and patient autonomy. In interactions with Roma patients, these behavioral patterns rarely seem to be achieved because the culture and ethnicity have often been shown as barriers in establishing an effective and satisfying doctor–patient relationship. The study aims to explore the Roma’s beliefs and experiences related to autonomy and decision-making process in the case of a disease with poor prognosis. Forty-eight Roma people from two Romanian counties participated in (...) semi-structured interviews, conducted by a research team from the University of Medicine and Pharmacy of Iasi. Participants were recruited among the chronically ill patients and caregivers. The Roma community opposes informing the terminal patients about their condition, the “silence conspiracy” being widely practiced. The family fully undertakes the right of decision making, thus minimizing the patient’s autonomy. We identified ethical dilemmas concerning autonomy, lack of patients’ real decision-making power, and paternalistic attitudes exerted firstly by the family and, on demand, by the physician. Instead, the Roma patient benefits from a very active support network, being accompanied at the hospital by numerous relatives. The patient’s right to make autonomous decisions promoted in the Western countries and stipulated by the Romanian law has diminished value in the Roma community. For the Roma, the understanding of dignity is not simply individual and personal, but it is closely related to their cultural particularities. Ignoring their cultural values could create conflicts between healthcare providers and community. (shrink)

Clinical ethical support services (CESS) represent a multifaceted field of aims, consultancy models, and methodologies. Nevertheless, the overall aim of CESS can be summed up as contributing to healthcare of high ethical standards by improving ethically competent decision‐making in clinical healthcare. In order to support clinical care adequately, CESS must pay systematic attention to all real‐life ethical issues, including those which do not fall within the ‘favourite’ ethical issues of the day. In this paper we (...) attempt to capture a comprehensive overview of categories of ethical tensions in clinical care. We present an analytical exposition of ethical structural features in judgement‐based clinical care predicated on the assumption of the moral equality of human beings and the assessment of where healthcare contexts pose a challenge to achieving moral equality. The account and the emerging overview is worked out so that it can be easily contextualized with regards to national healthcare systems and specific branches of healthcare, as well as local healthcare institutions. By considering how the account and the overview can be applied to i) improve the ethical competence of healthcare personnel and consultants by broadening their sensitivity to ethical tensions, ii) identify neglected areas for ethical research, and iii) clarify the ethical responsibility of healthcare institutions' leadership, as well as specifying required institutionalized administration, we conclude that the proposed account should be considered useful for CESS. (shrink)

Not a philosophical analysis or explication, this compact, lyrical study remains deliberately within the "organic" categories of biblical speech--which it is part of its purpose to exemplify--and with considerable success communicates the Christian conception of ethical life as man's response to God's self-revealing activity in history, to be understood only in terms of "the living continuity between man-in-God and man-in-man."--L. K. B.

Society and social structures play an important role in the formation and evaluation of concepts and practices in clinical ethics. This is evident in the ways the authors in this issue explore a wide range of arguments and concepts in clinical ethics including moral distress and conscience based practice, phenomenological interview techniques and gender dysphoria, continuous deep sedation (CDS) at the end of life, the notion of patient expertise, ethically permissible medical billing practices, the notion of selfhood and patient (...) centered care in dementia patients, and the definition of minimal risk as used in research regulations. (shrink)

The model of the successful manager was based on the 1950's family. Thus career demands assumed the presence of a spouse at home to handle family responsibilities. This study seeks to determine whether women and men in alternate family structures will be able to succeed in managerial careers. Data were analyzed from two MBA alumni cohorts: one older cohort with three waves of data collected over a thirteen-year period and a second younger cohort with data collected in the most recent (...) wave. A typology of family structure was utilized to categorize the managers into one of twelve family structures based on marital status, parental status, and spousal employment status. The post-traditional family where both parents are employed was found to be most prevalent for both men and women. A small percent of the MBAs were in the traditional family where the father is employed and the mother is not employed. Family structure in early career appears to be stable over the thirteen-year study period. Analyses reveal that for men, those in traditional families are most rewarded in their careers in terms of income and salary progression. Women had no family structure that achieved career success comparable to traditional family men. Despite increased acknowledgement of the varied family structures of managers and the adoption of family friendly policies by companies, rewards are not distributed equally. This has implications for managers, organizations, and society. (shrink)

This is a broad based introductory text suitable, I suggest, for diploma level or first year degree level courses. The fourth edition retains some of the best elements of the third and updates much of the remaining text. The structure of the chapters is useful, providing a list of learning outcomes for the reader and flagging up the material to follow. The summary at the end of each chapter is also very useful for reviewing the key points, as are the (...) discussion questions posed at the end of each chapter. Dealing with a number of the questions posed, …. (shrink)

Recent advances in life-sustaining treatments and technologies, have given rise to newly-emerged, critical and sometimes, controversial questions regarding different aspects of end-of-life decision-making and care. Since religious values are among the most influential factors in these decisions, the present study aimed to examine the Islamic scholars' views on end-of-life care. A structured interview based on six main questions on ethical decision-making in end-of-life care was conducted with eight Shiite experts in Islamic studies, and was analyzed (...) through deductive content analysis. Analysis revealed certain points in Islamic views on the definition of death and the persons making decisions about end-of-life care. According to the participants, in addition to conventional criteria such as absence of heartbeat and respiration, the irreversible cessation of human voluntary acts are considered to be the criteria in establishing death. The participants also recognized physicians as the main authorities in verifying signs of death. Furthermore, it was emphasized that life preservation and continuation of care must be sensible, and the patient can request not to have death-prolonging procedures started or continued. In the view of participants, patient's autonomy cannot be the sole basis for all measures, but Islamic ethical and jurisprudential principles should be relied upon to make correct and sensible decisions whether to continue or stop terminal patients' care. Final decisions should be made by a team of experts, and physicians must be at the center of such a team. Finally, we suggest that a guideline in keeping with Islamic norms on human life and death, purpose of life, God's will, boundaries of man's authority, and the physician's ethical duties and obligations should be developed. (shrink)

Insofar as living well is, for Aristotle, the ultimate end of human life, and insofar as our life comprises different activities (energeiai), the key prerequisite for living well is to rank and choose different activities according to their value. The objective of this article is to identify and discuss different considerations that determine the value of an activity in Aristotle's ethics. Focusing on selected passages from Nicomachean Ethics X, I argue that the structure of an activity's value displays (...) considerable heterogeneity. An activity can be good on account of its excellence, excellence-independent worthwhileness, as well as its continuity; these kinds of value do not necessarily entail each other, and they can even occur at each other's expense. This interpretation shifts the focus from the notion of virtue to the notion of activity, and thus opens up a fresh angle on Aristotle's: virtue or excellence is just one source of activity's value, alongside its worthwhileness and continuity. (shrink)

Here moral problems created by the use of constructive imaging technologies within the life sciences are discussed. It specifically deals with the creation of dichotomies, such as gender, race and other differences, created and manifested through the contingent use of scientific and computational models and methods, channelling the production process of scientific results and images. Gender in technology studies has been concerned with destabilizing essentialist and dichotomous co-constructions of gender and technology. In the technological construction process gendered social constructions (...) of stereotypes and inequalities both of the technological models and of the presumptions in life sciences become structural properties of the artefacts, again flowing back into the seemingly objective results and knowledge of the life sciences. Here we will deal with the construction of gender differences via biomedical imaging and the creation of norms in atlases. Additionally, the de-contextualized images, showing idiosyncratic selections and reducing complexity are used to popularize gendered assumptions about biological facts. (shrink)

This article addresses the problematic relation between Michel Henry’s phenomenology of life and ethics. More specifically, it asks whether Henry’s account of the self’s transcendental birth in the immanent self-generation of life allows for a sense of individual responsibility. I begin by discussing Henry’s generation of the self and show how the historical essence of the self is structured according to the antinomy of affectivity. I then show how, for Henry, this history of life is full and (...) yet incomplete. Accordingly, life is attracted to growth and this growth happens insofar as living beings proceed through a series of stages of despair. I develop these stages by looking at Henry’s analyses of anxiety, desire, and humility in relation to Kierkegaard. I argue that even though there is already an initial sense of responsibility at work in the earliest stirrings of anxiety, it is only in humility that the self comes to know who it truly is and how it ought to relate to others. Cet article se penche sur la relation problématique entre la phéno-ménologie de la vie et l’éthique de Michel Henry. Plus spécifiquement, nous nous demandons si l’explication de la naissance trans-cendantale du soi dans l’auto-génération immanente de la vie que propose Henry permet de rendre compte d’un sens de la responsabilité personnelle. Nous débutons avec une analyse de la génération du soi chez Henry et montrons comment l’essence historique du soi est structurée selon l’antinomie de l’affectivité. Nous montrons en-suite comment, pour Henry, cette histoire du soi est pleine bien qu’incomplète. En conséquence, la vie est attirée par la croissance, et cette croissance se produit dans la mesure où les êtres vivants passent à travers une série de stades du désespoir. Nous dévelop-pons ces divers stades en nous tournant vers les analyses que fait Henry de l’angoisse, du désir, et de l’humilité en relation avec Kierkegaard. Nous soutenons que même s’il y a déjà un sens initial de la responsabilité à l’oeuvre dans le premier éveil de l’angoisse, c’est seulement en atteignant le stade de l’humilité que le soi en vient à savoir qui il est vraiment et comment il doit se rapporter aux autres. (shrink)

John Cottingham identifies “the grand traditional project of synoptic ethics” as an attempt to define the essential features of a good human life within a rational understanding of the world, and of man’s place within it. That the project now seems dated he explains in two ways. First, he notes the recent specialization and professionalization of philosophy, its preference of technical topics to grand questions. Second, he adduces a skepticism that doubts the objectivity, and a liberalism that accepts a (...) plurality, of values. The upshot of both trends is a “committee ethics” that takes on “the task of articulating the structure of an optimal political system in which maximum scope is given for the pursuit of whatever values are in fact chosen by the citizens” —a grandish issue, surely, but neither a personal nor a metaphysical one. Cottingham’s main aim is to cast further doubt on the practicability of the traditional project so long as it is pursued in the traditional “ratiocentric” style. What that is he conveys through discussions of Plato, Aristotle, and Descartes. (shrink)

This essay outlines a new preface for ethics demanded by the massive developments of the global age. It does so in and through the comparative use of "myths" to explicate the lived structure of experience. The essay begins by isolating main features of global dynamics, including proximity, the compression of the world and the expansion of consciousness, and also global, cultural reflexivity. In the second step of the "preface," it is argued that globality itself is a moral space in which (...) peoples must orient their lives. It is a moral space defined by the massive extension of human power in the modern world. In light of the challenge that global dynamics and the extension of human power now pose, the essay then isolates, methodologically, options for developing a global ethics, and advocates a distinctly hermeneutical approach. This approach is practiced in the last section of the "preface" by engaging ethically the biblical "myth" of creation and its reinterpretation in an epitome of Jesus's Torah teaching. The intention is to show how current religious thought can speak to massive challenges in a distinctive way. It is, again, to offer a preface to ethics. (shrink)