Members of the Clinical Ethics Consultation Affairs Standing Committee of the American Society for Bioethics and Humanities present a collection of insights and recommendations developed from their collective experience, intended for those engaged in the work of healthcare ethics consultation.

Volume 20, Issue 3, March 2020, Page 44-46.

. This study measures social desirability bias (SD bias) by comparing the level of discipline sales managers believe they would administer when supervising unethical selling behavior with the level of discipline they perceive other sales managers would select. Results indicate the presence of SD bias; the sales manager respondents consistently claimed that they would be stricter while their peers would be more lenient. Using an analytical technique that takes social desirability bias into account, it appears that sales managers use of (...) discipline is affected by the sales performance of the salesperson being disciplined resulting in more lenient discipline for top sales performers. In addition, the more lenient treatment for top sales performers persists even when there is a pattern of a prior ethical infraction and the existence of an explicit organizational policy proscribing the act in question. Sales managers believe that, like themselves, others would be stricter when an unethical act is committed for the second time but not as strict as they personally would be. A within-subjects interaction effect indicates more SD bias under the condition of the unethical act being committed for the second time. (shrink)

IN A RECENT ARTICLE, the late Isaac Franck presented both Maimonides and Aquinas as prominent proponents of negative theology; he went on to defend negative theology against a number of contemporary criticisms. More specifically, Franck set out to defend what he called "a radical negative theology." By this he meant.

Bracken synthesizes Polanyi’s notion of morphogentic field and Whitehead’s notion of societies of actual occasions. These comments emphasize the implications of the metaphors involved in these notions. The rnetaphor of plants growing in afield lies beyond the concept of a morphogenetic field, and the metaphor of a society of interacting persons lies behind the concept of a society of actual occasions. I suggest that one of the implications of this metaphor is that there is not, as Bracken argues, a problem (...) of continuity in Whitehead’s metaphysics of events. (shrink)

During the Middle Ages, philosophers and theologians argued over the extramental reality of universal forms or essences. In the early modern period, the relation between subjectivity and objectivity, the individual self and knowledge of the outside world, was a rich subject of debate. Today, there is considerable argument about the relation between spontaneity and determinism within the evolutionary process, whether a principle of spontaneous self-organization as well as natural selection is at work in the aggregation of molecules into cells and (...) the development of primitive forms of life into complex organisms. In _Subjectivity, Objectivity and Intersubjectivity_, Joseph A. Bracken proposes that what is ultimately at stake here is the age-old problem of the relationship between the One and the Many, universality and particularity on different levels of existence and activity within nature. Bracken rejects traditional models of this relationship, wherein either the One or the Many is presupposed to have priority over the other. He instead suggests that a new social ontology—one that is grounded in a theory of universal intersubjectivity—protects both the concrete particularity of individual entities in their specific relations to one another and their enduring corporate reality as a stable community or environment within Nature. What emerges is a bold reimagining of the sometimes strained relationship between religion and science. Bracken's clear writing, sophisticated philosophical analysis, and exemplary scholarship will lend this new work an enthusiastic appreciation by readers with deep interests in philosophy and philosophical theology. (shrink)

Patients who are imminently dying sometimes experience symptoms refractory to traditional palliative interventions, and in rare cases, continuous sedation is offered. Samuel H. LiPuma, in a recent article in this Journal, argues that continuous sedation until death is equivalent to physician-assisted suicide/euthanasia based on a higher brain neocortical definition of death. We contest his position that continuous sedation involves killing and offer four objections to the equivalency thesis. First, sedation practices are proportional in a way that physician-assisted suicide/euthanasia is not. (...) Second, continuous sedation may not entirely abolish consciousness. Third, LiPuma’s particular version of higher brain neocortical death relies on an implausibly weak construal of irreversibility—a position that is especially problematic in the case of continuous sedation. Finally, we explain why continuous sedation until death is not functionally equivalent to neocortical death and, hence, physician-assisted suicide/euthanasia. Concluding remarks review the differences between these two end-of-life practices. (shrink)

The deeply entrenched, sometimes heated conflict between the disability movement and the profession of bioethics is well known and well documented. Critiques of prenatal diagnosis and selective abortion are probably the most salient and most sophisticated of disability studies scholars’ engagements with bioethics, but there are many other topics over which disability activists and scholars have encountered the field of bioethics in an adversarial way, including health care rationing, growth-attenuation interventions, assisted reproduction technology, and physician-assisted suicide. The tension between the (...) analyses of the disabilities studies scholars and mainstream bioethics is not merely a conflict between two insular political groups, however; it is, rather, also an encounter between those who have experienced disability and those who have not. This paper explores that idea. I maintain that it is a mistake to think of this conflict as arising just from a difference in ideology or political commitments because it represents a much deeper difference—one rooted in variations in how human beings perceive and reason about moral problems. These are what I will refer to as variations of moral psychology. The lived experiences of disability produce variations in moral psychology that are at the heart of the moral conflict between the disability movement and mainstream bioethics. I will illustrate this point by exploring how the disability movement and mainstream bioethics come into conflict when perceiving and analyzing the moral problem of physician-assisted suicide via the lens of the principle of respect for autonomy. To reconcile its contemporary and historical conflict with the disability movement, the field of bioethics must engage with and fully consider the two groups’ differences in moral perception and reasoning, not just the explicit moral and political arguments of the disability movement. (shrink)

The deeply entrenched, sometimes heated conflict between the disability movement and the profession of bioethics is well known and well documented. Critiques of prenatal diagnosis and selective abortion are probably the most salient and most sophisticated of disability studies scholars’ engagements with bioethics, but there are many other topics over which disability activists and scholars have encountered the field of bioethics in an adversarial way, including health care rationing, growth-attenuation interventions, assisted reproduction technology, and physician-assisted suicide. -/- The tension between (...) the analyses of the disabilities studies scholars and mainstream bioethics is not merely a conflict between two insular political groups, however; it is, rather, also an encounter between those who have experienced disability and those who have not. This paper explores that idea. I maintain that it is a mistake to think of this conflict as arising just from a difference in ideology or political commitments because it represents a much deeper difference—one rooted in variations in how human beings perceive and reason about moral problems. These are what I will refer to as variations of moral psychology. The lived experiences of disability produce variations in moral psychology that are at the heart of the moral conflict between the disability movement and mainstream bioethics. I will illustrate this point by exploring how the disability movement and mainstream bioethics come into conflict when perceiving and analyzing the moral problem of physician-assisted suicide via the lens of the principle of respect for autonomy. To reconcile its contemporary and historical conflict with the disability movement, the field of bioethics must engage with and fully consider the two groups’ differences in moral perception and reasoning, not just the explicit moral and political arguments of the disability movement. (shrink)

Columbia University Press's multivolume _Prison Notebooks_ is the only complete critical edition of Antonio Gramsci's seminal writings in English. Based on the authoritative Italian edition of Gramsci's work, _Quaderni del Carcere_, this comprehensive translation presents the intellectual as he ought to be read and understood, with critical notes that clarify Gramsci's history, culture, and sources; an index of names; and a contextualization of the thinker's ideas against his earlier writings and letters. This set includes notebooks 1 through 8 with all (...) attendant notes and materials and is an indispensible resource for scholars in the humanities and social sciences. (shrink)

Alfred North Whitehead's master work, Process and Reality, is intended to extend the cosmological vision of Whitehead in a new direction. By interpreting societies within Whitehead's scheme as structured fields of activity, the author projects a universe of hierarchically ordered fields of activity, up to and including the all-compassing field of activity constituted by the Christian Trinity.

It is sometimes argued that medical professionals should protect a future child's rights by prohibiting disabled parents from using technology to deliberately have a disabled child because disability is taken as an inevitable, severe threat to a child's otherwise “open” future. I will first argue that the open future that allegedly protects a child's future autonomy is precluded by the very conditions needed to develop that future autonomy. Any child's future will be narrowed as they are socialized in a way (...) that gives them the capacity for autonomous choice. However, oppressive master narratives can diminish a future child's autonomy by distorting their narrative identity and constricting their agency. In fact, the open future argument does just this by advancing one of the most damaging master narratives about disability: that disability inevitably and severely restricts a person's autonomy and closes their future. (shrink)

The essays in this book deal with philosophical issues in the thought of Maimonides. Included are: The Literary Character of the Guide for the Perplexed by Leo Staus, The Purpose of the Law According to Maimonides by Miriam Galston, and Essence and Existence in Maimonides by Alexander Altmann.

Abstract.Russell Stannard distinguishes between objective time as measured in theoretical physics and subjective time, or time as experienced by human beings in normal consciousness. Because objective time, or four‐dimensional space‐time for the physicist, does not change but exists all at once, Stannard argues that this is presumably how God views time from eternity which is beyond time. We human beings are limited to experiencing the moments of time successively and thus cannot know the future as already existing in the same (...) way that God does. I argue that Stannard is basically correct in his theological assumptions about God's understanding of time but that his explanation would be more persuasive within the context of a neo‐Whiteheadian metaphysics. The key points in that metaphysics are (1) that creation is contained within the structured field of activity proper to the three divine persons of the Christian doctrine of the Trinity and (2) that the spontaneous decisions of creatures are continually ordered and reordered into an ever‐expanding totality already known in its fullness by the divine persons. (shrink)

It may seem obvious that causing disability in another person is morally problematic in a way that removing or preventing a disability is not. This suggests that there is a moral asymmetry between causing disability and causing non-disability. This chapter investigates whether there are any differences between these two types of actions that might explain the existence of a general moral asymmetry. After setting aside the possibility that having a disability is almost always bad or harmful for a person (a (...) view that we have critiqued at length elsewhere), seven putative differences are considered. Ultimately, it is concluded that none of these seven factors can ground a general moral asymmetry between causing disability and causing non-disability, though each factor can provide some moral reason to avoid causing disability in certain particular cases. (shrink)

Both mainstream and disability bioethics sometimes contend that the self-assessment of disabled people about their own well-being is distorted by adaptive preferences that are only held because other, better options are unavailable. I will argue that both of the most common ways of understanding adaptive preferences—the autonomy-based account and the well-being account—would reject blanket claims that disabled people’s QOL self-assessment has been distorted, whether those claims come from mainstream bioethicists or from disability bioethicists. However, rejecting these generalizations for a more (...) nuanced view still has dramatic implications for the status quo in both health policy and clinical ethics. (shrink)

In this paper, I argue that, even when disability rights activists are most clearly acting as activists, they can advance the scholarly activity of disability bioethics. In particular, I will argue that even engaging in non-violent direct action, including civil disobedience, is an important way in which disability rights activists directly support the efforts of disability bioethics scholars. I will begin by drawing upon Hilde Lindemann’s work on relational narrative identity to describe how certain damaging master narratives about disability hinder (...) the uptake of arguments from disability bioethics. Then, I will argue that disability activism, especially non-violent direct action and civil disobedience, provides an effective counterstory to some of the worst of these master narratives, thereby laying the groundwork for the scholarly argument s of disability bioethicists to be given more serious consideration. Ultimately, I conclude that the field of bioethics is improved when it abandons the gross grained, generalizations about who disabled people are and how they act put forth by oppressive master narratives in favor of the more nuanced self-descriptions offered by the counterstories being offered by disabled people themselves. So it is that, by challenging these oppressive master narratives that constrain and distort the social meaning of disability, disability activism can improve mainstream bioethics. (shrink)

A number of recent discussions of atheism allude to cosmological arguments in support of theism. The five ways of Aquinas are classic instances, offered as rational justification for theistic belief. However, the five ways receive short shrift. They are curtly dismissed as vacuous, arbitrary, and even insulting to reason. I contend that the atheistic critique of the Thomistic five ways, and similarly formulated cosmological arguments, argues at cross purposes because it misrepresents them. I first lay out the context, intent and (...) structure of Aquinas’ arguments, then show in what way recent discussions misrepresent them, and finally conclude with a comment on metaphysical orientation, which I take to be central, not only to a proper understanding of the Thomistic five ways but generally to the debate between atheism and theism on the existence of God. (shrink)

It is widely assumed that disability is typically a bad thing for those who are disabled. Our purpose in this essay is to critique this view and defend a more nuanced picture of the relationship between disability and well-being. We first examine four interpretations of the above view and argue that it is false on each interpretation. We then ask whether disability is thereby a neutral trait. Our view is that most disabilities are neutral in one sense, though we cannot (...) make simple generalizations about disability's relationship to well-being in other important senses. After defending this view, we discuss its practical implications for selective abortion for disability, nondisabled people's interactions with disabled people, and the use of QALYs in health policy. (shrink)

In “Bioethics and the Moral Authority of Experience,” Nelson et al. explore what they refer to as “The Paradox of Experience.” The authors characterize this paradox formally as follows:(A) Personal...

False belief tasks have enjoyed a monopoly in the research on children’s development of a theory of mind. They have been granted this status because they promise to deliver an unambiguous assessment of children’s understanding of the representational nature of mental states. Their poor cousins, true belief tasks, have been relegated to occasional service as control tasks. That this is their only role has been due to the universal assumption that correct answers on true belief tasks are inherently ambiguous regarding (...) the level of the child’s understanding of mental states. It has also been due to the universal assumption that nothing in the child’s developing theory of mind would lead to systematically incorrect answers on true belief tasks. We review new findings that 4- and 5-year-olds do err, systematically and profoundly, on the true belief versions of all the extant belief tasks. This reveals an intermediate level of understanding in the development of children’s theory of mind. Researchers have been unaware of this intermediate level because it produces correct answers in false belief tasks. A simple two-task battery—one true belief task and one false belief task—is sufficient to remove the ambiguity from each task. The new findings show that children do not acquire an understanding of beliefs, and hence a representational theory of mind, until after 6 years of age, or 2 years later than most developmental psychologists have concluded. This raises the question of how to interpret other new findings that infants are able to pass false belief tasks. We review these new infant studies, as well as recent studies on chimpanzees, in light of older children’s failure on true belief tasks, and end with some speculation about how all of these new findings might be reconciled. (shrink)

The author argues that, while logical rigor requires Whiteheadians to emphasize the ontological priority of the notion of actual entity as a self-constituting subject of experience for the proper understanding of physical reality. Whitehead's understanding of the key category of society in his metaphysics, especially the way that societies and their constituent actual entities reciprocally "constrain " one another's existence and activity and the way that societies are hierarchically ordered to one another within the evolutionary process will presumably have more (...) empirical resonance with natural scientists in their own efforts to understand the emergence of life from non-life, the progressive growth of self-awareness among higher-order animal species, etc. So, in dialogue with natural scientists, why not start with what is psychologically more interesting to the listener? (shrink)

Management Ethics: Integrity at Work redefines what it means for a manager to function with integrity in the private and public sectorsùdomestically and globally. It integrates the latest theoretical work in both descriptive and normative ethics, and incorporates legal, communication, quality, and organizational theories into a conceptual framework that improves managerial judgment in the handling of moral complexity at work. The authors use their organizational ethics consulting and academic research experience to provide practical assessment and decision-making tools that convert ethics (...) theories into sound action steps. The book examines three key dimensions of management integrityùjudgment, process, and developmental dimensionsùand applies them to individual chapters devoted to the subprocesses of ethical planning, organizing, leading, and controlling. The authors focus their theories and tools on 28 ethics minicases related to each management function in seven allied management application clusters: accounting, auditing management; finance, investment management; marketing, advertising management; business management, business law, human resource management; technology, quality operations, organizational behavior management; public, nonprofit, health care management; and international, environmental, public policy management. Management Ethics: Integrity at Work builds management integrity by linking and enhancing both ethics and management competence in responsible planning, organizing, leading, and controlling for use by professionals and students in the private and public sectorsùdomestically and globally. (shrink)

Selection type theories solve adaptation problems. Natural selection, clonal selection for antibody production, and selective theories of higher brain function are examples. An abstract characterization of typical selection processes is generated by analyzing and extending previous work on the nature of natural selection. Once constructed, this abstraction provides a useful tool for analyzing the nature of other selection theories and may be of use in new instances of theory construction. This suggests the potential fruitfulness of research to find other theory (...) types and construct their abstractions. (shrink)

The shortage of organs for transplantation by its nature prompts ethical dilemmas. For example, although there is an imperative to save human life and reduce suffering by maximising the supply of vital organs, there is an equally important obligation to ensure that the process by which we increase the supply respects the rights of all stakeholders. In a relatively unexamined practice in the USA, organs are procured from unrepresented decedents without their express consent. Unrepresented decedents have no known healthcare wishes (...) or advance care planning document; they also lack a surrogate. The Revised Uniform Anatomical Gift Act of 2006 sends a mixed message about the procurement of organs from this patient population and there are hospitals that authorise donation. In addition, in adopting the RUAGA, some states included provisions that clearly allow organ procurement from unrepresented decedents. An important unanswered question is whether this practice meets the canons of ethical permissibility. The current Brief Report presents two principled approaches to the topic as a way of highlighting some of the complexities involved. Concluding remarks offer suggestions for future research and discussion. (shrink)