Knowledge about human wellbeing is a central part of ethical knowledge. But it is a neglected topic not only in ethics in general, but also in wellbeing theorizing, which has focused on enumerating the basic elements of wellbeing rather than on how to gauge, foster and maintain wellbeing in actual human lives. I consider the prospects for a procedural approach to wellbeing that sees it as depending on a process of continual adjustment between values, preferences, actions and (...) emotions. The value-fulfilment theory of Valerie Tiberius provides a model for such an approach, but needs to be corrected and supplemented in certain respects. I propose a version of the approach that is only partly, but still significantly procedural, and which does not privilege higher-order mental states. Considering the relevance of such an approach for ethics, I finally suggest that (certain forms of) moral agency may be best analyzed as an intersubjective process of adjustment and fulfilment of values and desires (etc.), and as a process of acquiring and exercising collective moral knowing how. (shrink)

The author begins with an outline of Bernard William's moral philosophy, within which he locates William's notorious doctrine that reflection can destroy ethical knowledge. He then gives a partial defence of this doctrine, exploiting an analogy between ethical judgements and tensed judgements. The basic idea is that what the passage of time does for the latter, reflection can do for the former: namely, prevent the re-adoption of an abandoned point of view (an ethical point of view in the one (...) case, a temporal point of view in the other). In the final section the author says a little about how reflection might do this. Footnotes1 This essay is derived from a lecture entitled ‘Bernard Williams’, delivered at Oxford University in 2000, in the series ‘Oxford Philosophers on Oxford Philosophers’, organized by Peter Hacker and David Wiggins. I am grateful to those who attended the lecture, and to Bernard Williams, for helpful comments. (shrink)

The study of sport is characterised by its inter-disciplinarity, with researchers drawing on apparently incompatible research traditions and ethical benchmarks in the natural sciences and the social sciences, depending on their area of specialisation. In this groundbreaking study, Graham McFee argues that sound high-level research into sport requires a sound rationale for one’s methodological choices, and that such a rationale requires an understanding of the connection between the practicalities of researching sport and the philosophical assumptions which underpin them. By examining (...) touchstone principles in research methodology, such as the contested ‘gold standard’ of voluntary informed consent in the natural sciences and the postmodern denial of ‘truth’ in the social sciences, McFee demonstrates that epistemology and ethics are inextricably linked. Drawing on a wide range of examples, from the laboratory to the sports field, McFee explores the concepts of ‘knowledge’ and ‘truth’ in sports research and makes a powerful case for a philosophical deepening of our approach to method and methodology in sport. This book is important reading for all advanced students and researchers working in sport, exercise and related disciplines. (shrink)

Background Medical ethics deals with the ethical obligations of doctors to their patients, colleagues and society. The annual reports of Sri Lanka Medical Council indicate that the number of complaints against doctors has increased over the years. We aimed to assess the level of knowledge, attitude and practice regarding medical ethics among doctors in three teaching hospitals in Sri Lanka. Methods A hospital-based cross-sectional study was conducted among doctors using a pre-tested self-administered, anonymous questionnaire. Chi Squared test, (...) and ANOVA test were used to identify the significance of association between level of knowledge and selected factors. Results Most doctors had a poor level of knowledge on medical ethics, with postgraduate trainees showing significantly higher level of knowledge. The average knowledge on medical ethics among doctors was significantly different between the three hospitals. Over 95% had a favourable attitude towards gaining knowledge and advocated the need for training. The majority indicated awareness of unethical practices. 24.6% of respondents stated that they get a chaperone ‘sometimes’ during patient examination while 3.5% never do. The majority responded that they never accept gifts from pharmaceutical companies in recognition of their prescribing pattern. 12–41% of doctors participated in the study acknowledged that they ‘sometime’ engaged in unethical practices related to prescribing drugs, accepting gifts from pharmaceutical companies and when obtaining leave. Conclusion Most doctors had a poor level of knowledge of medical ethics. Postgraduate trainees had a higher level of knowledge than other doctors. The majority showed a favourable attitude towards gaining knowledge and the need of training. Regular in-service training on medical ethics for doctors would help to improve their knowledge on medical ethics, as well as attitudes and ethical conduct. (shrink)

This volume is a comprehensive collection of critical essays on The Taming of the Shrew, and includes extensive discussions of the play's various printed versions and its theatrical productions. Aspinall has included only those essays that offer the most influential and controversial arguments surrounding the play. The issues discussed include gender, authority, female autonomy and unruliness, courtship and marriage, language and speech, and performance and theatricality.

BackgroundPediatricians in developing countries face different ethical dilemmas than do doctors working in settings with more resources. There are very few studies from developing countries analyzing pediatricians’ knowledge and attitudes regarding the ethical dilemmas that arise in such settings. To address this gap, we explored the clinical ethical knowledge, attitude and experience of physicians who are working in the Department of Pediatrics and Child Health of St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.Study populationAll pediatric resident doctors (...) and pediatric consultants who were working in the DPCH of SPHMMC in December, 2020.MethodA structured pretested self-administered questionnaire was distributed to all 79 of the residents and consultants in the department during the period December 15–27, 2020. The questionnaire assessed the knowledge, attitude and experiences of the study participants regarding a variety of bioethical issues. Data were analyzed using SPSS version 20.0 for windows. The mean, median, standard deviation, and interquartile range of respondents’ scores were determined and compared using Fisher’s exact test.ResultA total of 59/79 physicians completed the questionnaire. The mean age of the participants was 30.7 ± 4.1 years. Thirty six were female. At the time of data collection, more than half served < 5 years as a physician. The mean ethics knowledge score of the respondents was 12.3 ± 2.34 out of 23 knowledge questions. The lowest and highest knowledge scores were 8 and 19 respectively. Scores were highest on questions about confidentiality and lowest on questions about genetic testing and diagnosis. Only 13 physicians agreed with the practice of children should never be treated without consent of the parent. ConclusionTertiary care pediatricians at one hospital in Ethiopia lack knowledge about current standards in bioethics. There is a need for more ethics education in this setting. (shrink)

In the contemporary metaethical debate, expressivist (Blackburn, Gibbard) and constructivist (Korsgaard, Street) views can be viewed as inspired by irrealist ideas from Hume and Kant respectively. One realist response to these contemporary irrealist views is to argue that they are inconsistent with obvious surface-level appearances of ordinary ethical thought and discourse, especially the fact that we talk and act as if there is ethical knowledge . In this paper, I explore some constructivist and expressivist options for responding to this (...) objection. My conclusion is that, although both constructivists and expressivists can capture other surface-level features of ethical thought and discourse, the possibility of ethical knowledge causes special problems for these versions of irrealism. I end with some comments about where I think irrealists should begin to look for a response to these special problems, which points, somewhat surprisingly, towards an alternative inferentialist form of irrealism about epistemic and ethical thought and discourse, which is inspired by Sellars. (shrink)

How is ethical knowledge possible? One of the most promising answers is the moral sense view: we can acquire ethical knowledge through emotional experience. But this view faces a serious problem. Emotions are unreliable guides to ethical truth, frequently failing to fit the ethical status of their objects. This threatens to render the habit of basing ethical beliefs on emotions too unreliable to yield knowledge. I offer a new solution to this problem, with practical implications for how (...) we approach ethical decision-making. I argue that an agent can have a reliable belief-forming habit despite having unreliable emotions, so long as she is suitably attentive to defeaters. In moderately virtuous agents, unfitting ethical emotions are frequently accompanied by warning signs, such as negative metaemotions, epistemic feelings, moods, and social cues. An agent who cultivates the attentional skill of noticing these signs can prevent many of her unfitting emotions from translating into false beliefs. For a moderately virtuous agent with this skill, the habit of basing ethical beliefs on emotions will be reliable. The upshot is that emotion-based ethical knowledge is possible even for people whose emotions are unreliable, but only if we cultivate the skill of spotting defeaters. (shrink)

ObjectiveTo evaluate the relationship between recently trained paediatricians' ethics knowledge and exposure to a formal ethics or professionalism curriculum during residency.MethodsWe conducted a cross-sectional survey of recently trained paediatricians which included a validated 23-item instrument called the Test of Residents' Ethics Knowledge for Pediatrics. The sample included paediatricians who completed medical school in 2006–2008, whose primary specialty was paediatrics or a paediatric subspecialty, and who completed paediatric residency training in 2010–2011. This sample was stratified based (...) on residency programme variables: presence of a formal curriculum in ethics or professionalism, programme size and American Board of Pediatrics certifying exam passage rate. Paediatricians were randomly selected from each stratum for survey participation.ResultsAmong the 370 responding paediatricians (55%), the mean knowledge score was 17.3 (SD 2.2) out of a possible 23. Presence of a formal curriculum in ethics and/or professionalism was not significantly associated with knowledge. Knowledge was lowest on items about parental requests for a child to undergo genetic testing (2 items, 44% and 85% incorrect), preserving patient confidentiality over email (55% incorrect), decision-making regarding life-sustaining technologies (61% incorrect), and decision-making principles such as assent and parental permission (2 items, 47% and 49% incorrect).ConclusionsThis study highlights several areas in which paediatricians' knowledge may be low and that are amenable to targeted educational interventions. These findings should prompt discussion and research among ethicists and educators about how ethics and professionalism curricula can more consistently influence paediatricians' knowledge. (shrink)

This article analyses reflective practice by exploring ethical knowledge-in-use and the influence of context on professional nursing practice. Is ethical knowledge used in an appropriate context? The author identifies and discusses the theoretical underpinnings of reflective practice and offers an alternative paradigm to the generation and use of ethical knowledge in practice. The message to teachers and practitioners is decoded to facilitate teaching and learning.

An old question, still much discussed in moral philosophy, is whether there is any ethical knowledge. It is closely related, by simple etymology, to the question of cognitivism in ethics. Despite the fact that the terms ‘cognitivism’ and ‘objectivism’ seem sometimes to be used interchangeably, I take it that the question whether there can be ethical knowledge is not the same as the question whether ethical outlooks can be objective. A sufficient reason for this is that an (...) ethical outlook might be taken to consist of rules or principles, which do not admit of truth or falsehood and so cannot be objects of knowledge, but which can be seen as having an objective basis. (shrink)

This article analyses reflective practice by exploring ethical knowledge-in-use and the influence of context on professional nursing practice. Is ethical knowledge used in an appropriate context? The author identifies and discusses the theoretical underpinnings of reflective practice and offers an alternative paradigm to the generation and use of ethical knowledge in practice. The message to teachers and practitioners is decoded to facilitate teaching and learning.

Starting from a pragmatist point of view the paper dismisses the argument that ethical conduct is always based on knowledge of justifying and applying rules. In a first section I show that Plato and Kant already claimed that the originality of the ethical can’t be represented as either propositional knowledge or a norm, but is instead given to us in a way that is never fully available for our rational grasp. In a second section, I will address the (...) ethical conclusions James and Dewey draw from the fact that ethical demands can’t be translated into forms of knowledge. In a third section, I conclude with an argument for the originality of the ethical based on the thoughts of Stanley Cavell, stating that it is always something more than a mere competence in the sense of a knowledge of rules. (shrink)

Die Wissensvermittlung in Gesundheitsethik ermöglicht es Auszubildenden der Pflege, sich in ihrer zukünftigen Tätigkeit bei Entscheidungsprozessen des Behandlungsteams hinsichtlich pflegeethischer Fragestellungen einzubringen. Vor diesem Hintergrund wurde anhand der vorliegenden Studie die Entwicklung moralischer Positionen sowie pflegeethischer Kenntnisse von Pflegeauszubildenden sichtbar gemacht. An zwei Krankenpflegeschulen (Berlin und Fürth) wurden im Rahmen einer Panelstudie von August 2010 bis März 2011 Daten einer ersten Querschnittserhebung von Auszubildenden in der Pflege erhoben. Für die Studie wurde ein strukturierter Fragebogen verwendet. Die Studienteilnahme erfolgte freiwillig. Alle (...) Auszubildenden hatten vor der Befragung in unterschiedlichem Umfang Unterricht in Gesundheitsethik erhalten. An beiden Standorten zeigten die Teilnehmenden einen Zuwachs an pflegeethischen Kenntnissen. Auszubildende, die bislang keine praktische Erfahrung mit Sterbehilfe gemacht hatten, zeigten Schwierigkeiten in der theoretischen Handhabung dieser Maßnahmen. Für alle Auszubildenden zeigte sich ein allgemeiner Trend zu einer Befürwortung des partizipativen Interaktionsmodells und damit zu einer Förderung der Patientenselbstbestimmung. Zugleich schätzten die Studienteilnehmenden die Fähigkeiten von Patienten, medizinisch richtige Therapieentscheidungen zu treffen, als gering ein. Die Ausbildung in Gesundheitsethik besitzt ein großes Potential, Kenntnisse zu vermitteln und dadurch die ethische Kompetenzentwicklung zu befördern. Unsere Ergebnisse werfen die Frage auf, inwieweit es einer Integration praktischer Erfahrungen mit Fragestellungen der Gesundheitsethik bedarf, um eine praxisrelevante und wissenschaftlich fundierte Wissensvermittlung zu gewährleisten. (shrink)

This essay is concerned with Bernard Williams’ contention in Ethics and the Limits of Philosophy that, in ethics, reflection can destroy knowledge. I attempt to defend this contention from the charge of incoherence. I do this by taking seriously the idea that ethical knowledge is knowledge from an ethical point of view. There nevertheless remains an issue about whether the contention is consistent with ideas elsewhere in Williams’ own work, in particular with what he says (...) about knowledge in Descartes. In an earlier essay I argued that it is not. In a subsequent essay I indicated that I had changed my mind and gave a more sympathetic account of Williams’ contention. In this essay I set out the issues and say some more about my change of mind. (shrink)

Introduction The goal of this project was to develop and validate a new tool to evaluate learners' knowledge and skills related to research ethics. Methods A core set of 50 questions from existing computer-based online teaching modules were identified, refined and supplemented to create a set of 74 multiple-choice, true/false and short answer questions. The questions were pilot-tested and item discrimination was calculated for each question. Poorly performing items were eliminated or refined. Two comparable assessment tools were created. (...) These assessment tools were administered as a pre-test and post-test to a cohort of 58 Indian junior health research investigators before and after exposure to a new course on research ethics. Half of the investigators were exposed to the course online, the other half in person. Item discrimination was calculated for each question and Cronbach's α for each assessment tool. A final version of the assessment tool that incorporated the best questions from the pre-/post-test phase was used to assess retention of research ethics knowledge and skills 3 months after course delivery. Results The final version of the REKASA includes 41 items and had a Cronbach's α of 0.837. Conclusion The results illustrate, in one sample of learners, the successful, systematic development and use of a knowledge and skills assessment tool in research ethics capable of not only measuring basic knowledge in research ethics and oversight but also assessing learners' ability to apply ethics knowledge to the analytical task of reasoning through research ethics cases, without reliance on essay or discussion-based examination. These promising preliminary findings should be confirmed with additional groups of learners. (shrink)

The author draws on considerable research in this area to provide an overdue critical evaluation of the limits of the market, and future prospects for non-market socialism.

Background:Neonatal nurse practitioners have become the frontline staff exposed to a myriad of ethical issues that arise in the day-to-day environment of the neonatal intensive care unit. However, ethics competency at the time of graduation and after years of practice has not been described.Research aim:To examine the ethics knowledge base of neonatal nurse practitioners as this knowledge relates to decision making in the neonatal intensive care unit and to determine whether this knowledge is reflected in (...) attitudes toward ethical dilemmas in the neonatal intensive care unit.Research design:This was a prospective cohort study that examined decision making at the threshold of viability, life-sustaining therapies for sick neonates, and a ranking of the five most impactful ethical issues.Participants and research context:All 47 neonatal nurse practitioners who had an active license in the State of Mississippi were contacted via e-mail. Surveys were completed online using Survey Monkey software.Ethical considerations:The study was approved by the University of Mississippi Medical Center Institutional Review Board (IRB; #2015-0189).Findings:Of the neonatal nurse practitioners who completed the survey, 87.5% stated that their religious practices affected their ethical decision making and 76% felt that decisions regarding life-sustaining treatment for a neonate should not involve consultation with the hospital’s legal team or risk management. Only 11% indicated that the consent process involved patient understanding of possible procedures. Participating in the continuation or escalation of care for infants at the threshold of viability was the top ethical issue encountered by neonatal nurse practitioners.Discussion:Our findings reflect deficiencies in the neonatal nurse practitioner knowledge base concerning ethical decision making, informed consent/permission, and the continuation/escalation of care.Conclusion:In addition to continuing education highlighting ethics concepts, exploring the influence of religion in making decisions and knowing the most prominent dilemmas faced by neonatal nurse practitioners in the neonatal intensive care unit may lead to insights into potential solutions. (shrink)

The idea of dignity seems indissociable from that of humanity, whether in its universal dimension of ‘human dignity’, or in the individual ‘dignity of the person’. This paper provides an outlook on the ethics governing the sciences and technology, in particular the biological sciences and biotechnology, and recalls the notion of ‘glory’, both human and divine, as it infuses a great part of the Middle Ages and the Renaissance cultures, just before the scientific revolution in Europe.

Its preoccupation with ontology presents radical democracy with a thorny dilemma: how to combine commitment and affirmation with a distinctive emphasis on contingency and contestability. The article addresses this dilemma by engaging with three different perspectives. Ernesto Laclau’s work shows the intrinsic constraints of ontology and the inadequacy of a simple distinction between ontology and ethico-political decision. Simon Critchley opposes tying radical politics to ontological prefiguration and argues for a particular ethico-political orientation. But ethics and politics come entwined with (...) ontological assumptions, and the ethical direction of politics can be as restrictive as its ontological framing. William Connolly weds ontology and ethics to a sharp awareness of their contestability. But his approach does not reach deep enough. It is not alive to the contestability of the very recognition of contestability. To enhance openness and reflexivity, projects of radical democracy should combine a dimension of substantive, detailed accounts with a reflexive commitment to contestability, which disrupts, questions and renews the thicker descriptions in the name of democracy and truth. (shrink)

Open peer commentary on the article “Ethics: A Radical-constructivist Approach” by Andreas Quale. Upshot: The first of my two main goals in this commentary is to establish thinking of ethics as concepts rather than as non-cognitive knowledge. The second is to argue that establishing models of individuals’ ethical concepts is a scientific enterprise that is quite similar to establishing models of individuals’ mathematical concepts. To accomplish these two primary goals, I draw from my experience of working scientifically (...) with von Glasersfeld for 25 years while he was developing radical constructivism as a coherent model of knowing, and appeal to several of his basic insights to establish constructing models of ethical concepts as a scientific enterprise. (shrink)

This multidisciplinary book brings together a series of critical engagements regarding the notion of ethical practice. As a whole, the book explores the question of how the current neo-liberal socio-political moment, and its relationship to the historical legacies of colonialism, white settlement, and racism, informs and shapes our practices, pedagogies, and understanding of encounters in diverse settings. Drawing largely on the work of Sara Ahmed’s Strange Encounters: Embodied Others in Post-Coloniality, each chapter in this book takes up a particular encounter (...) and unravels the elements that created these meetings in specific times and spaces. Sites of encounters included in this volume range from the classroom to social work practice and from literary to media interactions, and take place both within Canada and internationally. Paramount to the discussions is a consideration of how relations of power and legacies of oppression shape self and others, and draw boundaries between bodies within an encounter. From a social justice perspective, Unravelling Encounters exposes the political conditions that configure our meetings with one another, and inquires into what it means to care, to respond, and to imagine oneself as an ethical subject. (shrink)

This article reflects one scholar's attempt to locate herself within emerging ethical methodologies given a specific concern with cross-cultural women's moral praxis. The field of comparative ethics's debt to past debates over methodology is considered through a typology of three waves of methodological invention. The article goes on to describe a specific research focus on U.S. Catholic and Iranian Shii women that initiated a search for a distinct method. This method of comparative ethics, which focuses on the production (...) of ethical knowledge through the interaction of discursive logics of various moral agents, is described. The conclusion turns to how methodological invention can itself become a constructive project through the way it (1) locates the scholar in relation to her subject of study and (2) allows for isolation of tactics within specific moral discourses. (shrink)

Der Unterricht in Medizinethik soll Medizinstudierenden die Grundlagen dafür vermitteln, in ihrer zukünftigen ärztlichen Tätigkeit gute Entscheidungen treffen zu können. Im Rahmen einer Panelstudie wird derzeit die Entwicklung moralischer Positionen, medizinethischer Kenntnisse und Motivationen von Medizinstudierenden der Ludwig-Maximilians-Universität München über den Verlauf des Studiums untersucht. Für die Datenerhebung wurde ein Fragebogen entwickelt, der medizinethische Positionen und Kenntnisse sowie Motivationen erfasst. Im Wintersemester 2009/10 wurde die erste Querschnittsuntersuchung mit Studierenden im 1., 3. und 8. Semester sowie im Praktischen Jahr durchgeführt. Die (...) Mehrzahl der Befragten verfügte über einen geringen Kenntnisstand in verschiedenen Themenbereichen des Unterrichtsfachs GTE. Rechtliche Grundlagen und praktische Umsetzung von Therapiebegrenzungsmaßnahmen waren bis ins PJ-Semester vielen Studierenden nicht bekannt. Im Verlauf des Studiums veränderten sich die Motivationen weg von der Motivation, Menschen helfen zu wollen, hin zu Wissenserwerb und dem Ergreifen eines sicheren Berufs. Obwohl viele Befragte ein hohes Interesse an medizinethischen Fragestellungen und Unterricht im Bereich GTE angaben, zeigte sich kein nachhaltiger Zuwachs an medizinethischen Kenntnissen im Laufe des Studiums. In der Zusammenschau werfen die Ergebnisse die Frage auf, inwieweit verschiedene Ausbildungskonzepte Einfluss auf die individuelle ethische Entwicklung Medizinstudierender nehmen können. Eine Untersuchung dieser Fragestellung bleibt Gegenstand weitergehender Forschung. (shrink)

In this essay, I consider whether the alleged demise of metaphysical realism does actually provide a better way for defending the cognitive status of ethical judgments. I argue that the rejection of a realist ontology and epistemology does not help to establish the claim that ethical knowledge is possible. More specifically, I argue that Hilary Putnam's argument does not succeed in making a case for ethical knowledge. In fact, his account of the procedures by which our valuations are (...) warranted—the criteria of idealized inquiry—ultimately begs the question in a number of crucial ways. Moreover, it prejudices the moral and political discussion in certain ideological respects. Finally, though Putnam has apparently modified to some extent his approach to the issue of realism in recent years, I will point out that these modifications are not fundamental and do not help to advance the case for ethical knowledge. I note also that Martha C. Nussbaum's appeal to Putnam’s argument actually works against her attempt to make a case for an Aristotelian conception of human flourishing. Ultimately, I conclude that metaphysical realism is vital for ethical knowledge. (shrink)

We examined the direct and indirect (via relational social capital) relationship between ethical leadership and knowledge hiding. We also tested the moderating role of instrumental thinking in the relationship between ethical leadership and knowledge hiding and the relationship between ethical leadership and relational social capital. Data were collected from 245 employees in different firms spanning different manufacturing and service sectors. The results showed that ethical leadership was negatively related to knowledge hiding, both directly and via relational social (...) capital. The results revealed that instrumental thinking moderated the positive relationship between ethical leadership and relational social capital, such that the relationship was weak when instrumental thinking was high. The results also showed that instrumental thinking moderated both direct and indirect relationships between ethical leadership and knowledge hiding, such that the relationships were weak when instrumental thinking was high. The study carries important practical implications for managers concerned about the destructive consequences of knowledge hiding. (shrink)

Technology moves us to a better world. We contend that through technology people can simplify and solve moral tasks when they are in presence of incomplete information and possess a diminished capacity to act morally. Many external things, usually inert from the moral point of view, can be transformed into the so-called moral mediators. Hence, not all of the moral tools are inside the head, many of them are shared and distributed in “external” objects and structures which function as ethical (...) devices. (shrink)

The paper begins by reviewing two problems for fallibilism: the lottery problem, or the problem of explaining why fallible evidence, though otherwise excellent, is not enough to know that one will lose the lottery, and Gettier problems. It is then argued that both problems can be resolved if we note an important illocutionary force of knowledge attributions: namely, that when we attribute knowledge to someone we mean to give the person credit for getting things right. Alternatively, to say (...) that a person knows is to say that she got things right due to her own abilities, efforts and actions, rather than due to dumb luck, or blind chance, or something else. (shrink)

BackgroundHealthcare ethics is neglected in clinical practice in LMICs such as Nepal. The main objective of this study was to assess the current status of knowledge, attitude and practice of healthcare ethics among resident doctors and ward nurses in a tertiary teaching hospital in Nepal.MethodsThis was a cross sectional study conducted among resident doctors and ward nurses in the largest tertiary care teaching hospital of Nepal during January- February 2016 with a self-administered questionnaire. A Cramer’s V value (...) was assessed to ascertain the strength of the differences in the variables between doctors and nurses. Association of variables were determined by Chi square and statistical significance was considered if p value was less than 0.05.ResultsOur study demonstrated that a significant proportion of the doctors and nurses were unaware of major documents of healthcare ethics: Hippocratic Oath, Nuremberg code and Helsinki Declaration. A high percentage of respondents said that their major source of information on healthcare ethics were lectures, books, and journals. Attitude of doctors and nurses were significantly different in 9 out of 22 questions pertaining to different aspects of healthcare ethics. More nurses had agreement than doctors on the tested statements pertaining to different aspects of healthcare ethics except for need of integration of medical ethics in ungraduate curricula,paternalistic attitude of doctor was disagreed more by doctors. Notably, only few doctors stood in support of physician-assisted dying.ConclusionsSignificant proportion of doctors and nurses were unaware of three major documents on healthcare ethics which are the core principles in clinical practice. Provided that a high percentage of respondents had motivation for learning medical ethics and asked for inclusion of medical ethics in the curriculum, it is imperative to avail information on medical ethics through subscription of journals and books on ethics in medical libraries in addition to lectures and training at workplace on medical ethics which can significantly improve the current paucity of knowledge on medical ethics. (shrink)

Background: Ethics consultants (ECs) are increasingly expected to possess core knowledge and skills. Few data address whether ECs actually possess recommended core knowledge. We aimed to measure pediatric ECs’ understanding of ethical principles, identify knowledge gaps, and explore associations between experience/training and knowledge in pediatric ethics consultations. Methods: We identified the 2 ECs most knowledgeable in pediatric ethics from each of 45 freestanding children's hospitals and an equal number of general teaching hospitals in (...) the United States. This yielded a sample of 159 eligible pediatric ECs. Pediatric ECs were sent a survey measuring ethics training, characteristics of the ethics consultation service, and EC knowledge, as assessed by a previously validated scale entitled the Test of Residents’ Ethics Knowledge for Pediatrics (TREK-P). Of 102 completed surveys received, 99 were used in the analysis. Results: Seventy-three percent of ECs had completed ≥1 formal training modality, most commonly bioethics mini-courses, master's degrees, or certificate programs (20–30% each). Respondents infrequently received salary support (32%) or had a budget (28%) to support ethics work. The median TREK-P score was 19 (interquartile range [IQR] 17–21). Forty percent of subjects scored ≥20, surpassing the threshold of adequate performance proposed in previous work. Median scores were significantly higher among ECs with formal training in ethics but did not differ significantly by other variables. In secondary analyses, high scores (≥20) were significantly more common among ECs receiving salary support (55% vs. 33%, p = 0.04) and who had formal ethics training (47% vs. 22%, p = 0.02). Items pertaining to privacy, genetic testing, and assent, were answered incorrectly by >33% of ECs. Conclusions: High scores on a validated ethics knowledge scale were more common among ECs with salary support or formal ethics training. The study highlights knowledge gaps that warrant consideration as EC becomes a professionalized endeavor. (shrink)

Slips of the tongue, unwitting favoritism and stereotyped assumptions are just some examples of microaggression. Nearly all of us commit microaggressions at some point, even if we don’t intend to. Yet over time a pattern of microaggression can cause considerable harm by reminding members of marginalized groups of their precarious position. The Ethics of Microaggression is a much needed and clearly written exploration of this pervasive yet complex problem. What is microaggression and how do we know when it is (...) occurring? Can we be held responsible for microaggressions and if so, how? How has social media affected the problem? What role can philosophy play in understanding microaggression? Regina Rini explores these highly topical and controversial questions in an engaging and fair-minded way, arguing that an event is a microaggression precisely because it causes a marginalized person to experience an ambiguous encounter with oppression. She illustrates her argument with compelling examples from media, politics and psychology and explains the significance of essential concepts, such as media representation, reparative renaming, and safe spaces. The Ethics of Microaggression explains what microaggression is and offers strategies for combating it. Assuming no prior knowledge of the topic or philosophy, it demystifies a controversial and extremely important topic in clear language. It is ideal for anyone coming to the topic for the first time and for students in philosophy, gender studies, race theory, disability theory and social and political philosophy. (shrink)

Surveillance programs supporting the management of One Health issues such as antibiotic resistance are complex systems in themselves. Designing ethical surveillance systems is thus a complex task (retroactive and iterative), yet one that is also complicated to implement and evaluate (e.g., sharing, collaboration, and governance). The governance of health surveillance requires attention to ethical concerns about data and knowledge (e.g., performance, trust, accountability, and transparency) and empowerment ethics, also referred to as a form of responsible self-governance. Ethics (...) in reflexive governance operates as a systematic critical-thinking procedure that aims to define its value: What are the “right” criteria to justify how to govern “good” actions for a “better” future? The objective is to lay the foundations for a methodological framework in empirical bioethics, the rudiments of which have been applied to a case study to building reflexive governance in One Health. This ongoing critical thinking process involves “mapping, framing, and shaping” the dynamics of interests and perspectives that could jeopardize a “better” future. This paper proposes to hybridize methods to combine insights from collective deliberation and expert evaluation through a reflexive governance functioning as a community-based action-ethics methodology. The intention is to empower individuals and associations in a dialogue with society, which operation is carried out using a case study approach on data sharing systems. We based our reasoning on a feasibility study conducted in Québec, Canada (2018–2021), envisioning an antibiotic use surveillance program in animal health for 2023. Using the adaptive cycle and governance techniques and perspectives, we synthesize an alternative governance model rooted in the value of empowerment. The framework, depicted as a new “research and design (R&D)” practice, is linking operation and innovation by bridging the gap between Reflexive, Evaluative, and Deliberative reasonings and by intellectualizing the management of democratizing critical thinking locally (collective ethics) by recognizing its context (social ethics). Drawing on the literature in One Health and sustainable development studies, this article describes how a communitarian and pragmatic approach can broaden the vision of feasibility studies to ease collaboration through public-private-academic partnerships. The result is a process that “reassembles” the One Health paradigm under the perspective of global bioethics to create bridges between the person and the ecosystem through pragmatic ethics. (shrink)

This book offers a unified collection of published and unpublished papers by Robert Audi, a renowned defender of the rationalist position in ethics. Taken together, the essays present a vigorous, broadly-based argument in moral epistemology and a related account of reasons for action and their bearing on moral justification and moral character. Part I details Audi's compelling moral epistemology while Part II offers a unique vision of ethical concepts and an account of moral explanation, as well as a powerful (...) model of moral realism. Part III extends this account of moral explanation to moral responsibility for both actions and character and to the relation between virtue and the actions that express it. Part IV elaborates a theory of reasons for action that locates them in relation to three of their traditionally major sources: desire, moral judgment, and value. Clear and illuminating, Audi's introduction outlines and interconnects the self-contained but cumulatively arranged essays. It also places them in relation to classical and contemporary literature, and directs readers to large segments of thematically connected material spread throughout the book. Audi ends with a powerfully synthetic final essay. (shrink)

In this article I compare and, especially, contrast Aristotle’s conception of virtue with one typical of sub-Saharan philosophers. I point out that the latter is strictly other-regarding, and specifically communitarian, and contend that the former, while including such elements, also includes some self-regarding or individualist virtues, such as temperance and knowledge. I also argue that Aristotle’s conception of human excellence is more attractive than the sub-Saharan view as a complete account of how to live, but that the African conception (...) is a strong contender for a limited group of the most important virtues related to morality qua rightness. (shrink)

Argues that we know without observation or inference at least some of what we are doing intentionally and that this possibility must be explained in terms of knowledge-how. It is a consequence of the argument that knowing how to do something cannot be identified with knowledge of a proposition.

This baseline study was conducted to find out the knowledge, attitudes and practices of medical ethics among the undergraduate medical interns who did not have structured ethics curriculum in their course. A descriptive, cross-sectional study was carried out using a self-administered structured questionnaire among the medical undergraduate interns of Maharajgunj Medical Campus, the pioneer medical college of Nepal which enrols 60 students in a year. A total of 46 interns participated in the study. The most common source (...) of knowledge on ethics was lectures/seminars (35.7%) followed by experience at work (24.5%), training (21.4%) and own reading (17.3%). The main contents of Hippocratic Oath were known to 98.8% while 60.9% knew the main contents of Nepal Medical Council (NMC) code of ethics. Great majority (91.3%) regard ethics as very important in medical profession. “Doctors know the best irrespective of patients’ opinion” was disagreed by only 39.1% indicating the paternalistic attitude. However, 78.3% were in favour of adhering to the patient’s wish. None of the participant agreed to abandon confidentiality. Only about one-fourth (26.1%) claim to encounter ethical dilemma every day while the highest number (43.5%) had once in a month. To deal with the situation of ethical dilemma, majority approached to immediate supervisor followed by head of the department and colleagues. Eighty-seven percent of participating interns were involved in research activities involving human subjects. Only one of the participants had encountered the ethical issue on end-of-life and it was do-not-resuscitate consent in a terminally ill patient. On implementation of the curriculum on medical ethics focus should be - principles of biomedical ethics, sensitive ethical dilemmas like end-of-life care and practical experiences with participation in deliberations of the ethics committee. (shrink)

The commentaries on the Ethica nova and the Ethica vetus written by some masters of the arts – presumably operating in the Paris faculty – in the first half of the thirteenth century expound in an original way the doctrine of the virtutes consuetudinales which Aristotle, at the end of the first book of his Ethica (I 13), distinguishes into the two main classes of the “moral virtues” and the “intellectual virtues”. The present paper aims at highlighting the particularly important (...) task which is assigned to the intellectual virtues in these early commentaries: joining man to God directly, through a contemplation which becomes love. The masters of the arts maintain that the moral virtues, in spite of the definition given by Aristotle (habitus a quo quis bonus est et opus eius bene reddit), are not sufficient alone to bring man to perfection, but that other more perfect virtues, namely the intellectual ones, are needed in order to make him know and love the supreme good. Having no knowledge of the sixth book of the Ethica, in which Aristotle deals in particular with the intellectual virtues, our masters know only their general description and are concerned with clarifying their relationships with the moral virtues, compared to which they appear to be sometimes really distinct and sometimes united to them in sharing the recta ratio, so much that they may constitute a double virtue. Although the masters of the arts seem to be well-informed about the teaching of the theologians – which they often cite without opposing to it, albeit stressing their own philosophical point of view –, it is significant that no reference whatsoever is made by them to the theological virtues and that they have recourse to the themes of Avicennian mysticism such as the doctrine of the two faces of the soul. Besides presenting the commentaries on the Ethica vetus from a general point of view, I will focus on the Paris commentary in Ethicam veterem (Paris BN lat. 3804A, ff. 152ra-159vb, 241ra-247vb; Paris BN lat. 3572, ff. 226ra-235ra), of which I am preparing a critical edition. The Paris commentary contains in fact a special and original discussion of the doctrine of the virtutes intellectuales. (shrink)

According to social learning theory, we explored the relation between ethical leadership and knowledge hiding. We developed a moderated mediation model of the psychological safety linking ethical leadership and knowledge hiding. Surveying 436 employees in 78 teams, we found that ethical leadership was negatively related to knowledge hiding, and that this relation was mediated by psychological safety. We further found that the effect of ethical leadership on knowledge hiding was contingent on a mastery climate. Finally, theoretical (...) and practical implications were discussed for leadership and knowledge management. (shrink)