La question de l'allégeance morale au libéralisme politique occupe une place centrale dans la théorie de John Rawls. J'arguerai d'abord que, dans la conception de Rawls, le moral et le politique entretiennent un rapport paradoxal qui risque de compromettre l'institutionnalisation de la raison publique telle que Rawls la conçoit. Je proposerai ensuite une nouvelle définition des conditions de l'allégeance morale au libéralisme politique. J'arguerai que ma définition, tout en évitant la tension relevée chez Rawls entre le politique et le moral, (...) est aussi mieux adaptée aux représentations contemporaines du citoyen en tant qu'agent moral et plus conforme aux intuitions courantes concernant le rôle de la moralité dans une démocratie constitutionnelle.The problem of the moral allegiance to political liberalism is central in the theory of John Rawls. It will be argued first, that, as Rawls conceive them, the moral and the political practically stand in a paradoxical relationship which undermines the possibilities for the implementation of "public reason". A new characterization of the conditions of moral allegiance will be articulated. I will then argue that my characterization removes the tensions between the moral and the political I noticed in Rawls. It also yields a better understanding of the actual representation of the citizen as a moral agent and finally, gives a more accurate account of the role of morality in contemporary constitutional democracies. (shrink)

L'hypothèse qui guide le présent article est que les méthodes et techniques de dérivation ou de modélisation utilisées en éthique contemporaine, ont une incidence sur les contenus proprement moraux de la théorie morale ; vues comme de simples outils à l'usage du philosophe moral, elles agissent en fait comme des sources de normativité morale. Cette hypothèse n'est pas une simple reformulation de l'idée voulant qu'il existe, au sein de la théorie morale, un rapport entre explication et justification ou entre méta-éthique (...) et éthique. Pour le montrer, je m'appuierai d'abord sur une caractéristisation générale de ces composantes de la théorie morale et des rapports qu'elles entretiennent entre elles. Dans un deuxième temps j'arguerai que l'usage d'outils méthodologiques particuliers peut avoir une incidence sur les contenus moraux proprement dits. Pour caractériser cette incidence et en décrire les mécanismes, je ferai d'abord appel à une approche pragmatique de l'explication, puis je donnerai deux exemples, tirés de la philosophie morale contemporaine, et illustrant le fait que certains contenus moraux ainsi introduits échappent de fait à une justification en bonne et due forme.The central claim made in this article is that the various methodological devices used by contemporary moral philosophers in order to represent or derive moral principles affect the very moral content of their theory; seen by them as mere tools for philosophers, they in fact are sources of moral normativity. This claim is not a mere reformulation of the idea that there is within moral theory a connection between explanation and justification or between metaethics and ethics. To show that this is so, I first give a general characterization of the various components of moral theory and of their relationships. I then argue that the use of particular methodological devices affect the very moral content of the theory. To characterize such incidence and its mechanisms, I first appeal to a pragmatic conception of explanation and, finally, I discuss two examples from contemporary moral theory showing that substantive moral claims so introduced, in fact fail to be justified. (shrink)

J’arguerai ici que tout en repoussant d’une main une conception du changement social basé sur la sélection naturelle des pratiques sociales et des individus qui y participent, les théories normatives qui font appel à des modélisations des choix sociaux, qu’ils soient de nature économique, politique ou morale, en entretiennent potentiellement les conséquences. Plus précisément, j’arguerai que les modèles que l’on utilise encore le plus volontiers dans les sciences sociales, c’est-à-dire ceux de la théorie des jeux, de la théorie de la (...) décision ou de la négociation rationnelle, contribuent à répercuter, au plan normatif, les deux aspects — social et individuel — de la sélection naturelle. L’argument s’appuie sur une analyse de la théorie standard de l’utilité et montre que la conception de la rationalité maximisante définie dans ce cadre formel incorpore les exigences de la sélection à celles de la rationalité.I shall argue that though most theoreticians of social change firmly refuse normatively to endorse the natural selection of practices and individuals, they sometimes tacitly validate the consequences of such a conception of social change. More precisely, I shall argue that the formal apparatus still often used in social sciences — such as game theory, bargaining theory or decision theory — contribute to carrying on, at the normative level the social and individual aspects of natural selection. The argument rests on an analysis of what has come to be regarded the standard theory of utility and attempts to show that maximising rationality defined in that framework incorporates the requirement of the selection to those of rationality. (shrink)

In Wrong Medicine, Lawrence J. Schneiderman, M.D., and Nancy S. Jecker, Ph.D., address issues that have occupied the media and the courts since the time of Karen Ann Quinlan. The authors examine the ethics of cases in which medical treatment is offered--or mandated--even if a patient lacks the capacity to appreciate its benefit or if the treatment will still leave a patient totally dependent on intensive medical care. In exploring these timely issues Schneiderman and Jecker reexamine the doctor-patient relationship and (...) call for a restoration of common sense and reality to what we expect from medicine. They discuss economic, historical, and demographic factors that affect medical care and offer clear definitions of what constitutes futile medical treatment. And they address such topics as the limits on unwanted treatment, the shift from the "Age of Physician Paternalism" to the "Age of Patient Autonomy," health care rationing, and the adoption of new ethical standards. (shrink)

The management of ethics within organisations typically occurs within a problem-solving frame of reference. This often results in a reactive, problem-based and externally induced approach to managing ethics. Although basing ethics management interventions on dealing with and preventing current and possible future unethical behaviour are often effective in that it ensures compliance with rules and regulations, the approach is not necessarily conducive to the creation of sustained ethical cultures. Nor does the approach afford (mainly internal) stakeholders the opportunity to be (...) co-designers of the organisation's ethical future. The aim of this paper is to present Appreciative Inquiry (AI) as an alternative approach for developing a shared meaning of ethics within an organisation with a view to embrace and entrench ethics, thereby creating a foundation for the development of an ethical culture over time. A descriptive case study based on an application of AI is used to illustrate the utility of AI as a way of thinking and doing to precede and complement problem-based ethics management systems and interventions. (shrink)

Health care services increasingly face patient populations with high levels of ethnic and cultural diversity. Cultures are associated with distinctive ways of life; concepts of personhood; value systems; and visions of the good that affect illness experience, help seeking, and clinical decision-making. Cultural differences may impede access to health care, accurate diagnosis, and effective treatment. The clinical encounter, therefore, must recognize relevant cultural differences, negotiate common ground in terms of problem definition and potential solutions, accommodate differences that are associated with (...) good clinical outcomes, and manage irresolvable differences. Clinical attention to and respect for cultural difference (a) can provide experiences of recognition that increase trust in and commitment to the institutions of the larger society, (b) can help sustain a cultural community through recognition of its distinct language, knowledge, values, and healing practices, and (c) to the extent that it is institutionalized, can contribute to building a pluralistic civil society. (shrink)

Recent policy developments in the area of livestock husbandry have suggested that, from the perspective of optimizing animal welfare, new animal husbandry systems should be developed that provide opportunities for livestock animals to be raised in environments where they are permitted to engage in “natural behavior.” It is not known whether consumers regard animal husbandry issues as important, and whether they differentiate between animal husbandry and other animal welfare issues. The responsibility for the development of such systems is allocated jointly (...) between farmers, regulators, different actors in the food chain, and consumers. This research focuses on understanding consumer attitudes and preferences regarding the development and introduction of such systems, to ensure that they are acceptable to consumers as well as producers, regulators, and scientists. Consumer perceptions of animal welfare and animal husbandry practices were evaluated using quantitative consumer survey, which focused on two animal husbandry issues – farmed pigs and farmed fish. Following pilot work, 1000 representative Dutch consumers were sampled about their attitudes to either pig or fish husbandry. The results indicated that consumers think about animal welfare in terms of two broad categories related to their health and living environment, but do not think about welfare issues at a more detailed level. Greater concern was expressed about the welfare of pigs compared to fish. Consumer trust in labeling also emerged as an important issue, since consumers need to trust different food chain actors with responsibility for promoting animal welfare, and are reluctant to consider the details of animal husbandry systems. As a consequence, a transparent, enforceable, and traceable monitoring system for animal welfare friendly products is likely to be important for consumers. (shrink)

Recent policy developments in the area of livestock husbandry have suggested that, from the perspective of optimizing animal welfare, new animal husbandry systems should be developed that provide opportunities for livestock animals to be raised in environments where they are permitted to engage in “natural behavior.” It is not known whether consumers regard animal husbandry issues as important, and whether they differentiate between animal husbandry and other animal welfare issues. The responsibility for the development of such systems is allocated jointly (...) between farmers, regulators, different actors in the food chain, and consumers. This research focuses on understanding consumer attitudes and preferences regarding the development and introduction of such systems, to ensure that they are acceptable to consumers as well as producers, regulators, and scientists. Consumer perceptions of animal welfare and animal husbandry practices were evaluated using quantitative consumer survey, which focused on two animal husbandry issues – farmed pigs and farmed fish. Following pilot work, 1000 representative Dutch consumers were sampled about their attitudes to either pig or fish husbandry. The results indicated that consumers think about animal welfare in terms of two broad categories related to their health and living environment, but do not think about welfare issues at a more detailed level. Greater concern was expressed about the welfare of pigs compared to fish. Consumer trust in labeling also emerged as an important issue, since consumers need to trust different food chain actors with responsibility for promoting animal welfare, and are reluctant to consider the details of animal husbandry systems. As a consequence, a transparent, enforceable, and traceable monitoring system for animal welfare friendly products is likely to be important for consumers. (shrink)

Background Informed consent is an integral component of good medical practice. Many researchers have investigated measures to improve the quality of informed consent, but it is not clear which techniques work best and why. To address this problem, we propose developing a core outcome set to evaluate interventions designed to improve the consent process for surgery in adult patients with capacity. Part of this process involves reviewing existing research that has reported what is important to patients and doctors in the (...) informed consent process. Methods This qualitative synthesis comprises four phases: identification of published papers and determining their relevance; appraisal of the quality of the papers; identification and summary of the key findings from each paper while determining the definitiveness of each finding against the primary data; comparison of key themes between papers such that findings are linked across studies. Results Searches of bibliographic databases returned 11,073 titles. Of these, 16 studies met the inclusion criteria. Studies were published between 1996 and 2016 and included a total of 367 patients and 74 health care providers. Thirteen studies collected data using in-depth interviews and constant comparison was the most common means of qualitative analysis. A total of 94 findings were extracted from the primary papers and divided into 17 categories and ultimately 6 synthesised findings related to: patient characteristics, knowledge, communication, the model patient, trust and decision making. Conclusions This qualitative meta-aggregation is the first to examine the issue of informed consent for surgery. It has revealed several outcomes deemed important to capture by patients and clinicians when evaluating the quality of a consent process. Some of these outcomes have not been examined previously in research comparing methods for informed consent. This review is an important step in the development of a COS to evaluate interventions designed to improve the consent process for surgery. Registration The study protocol was registered on the international prospective register for systematic reviews. (shrink)

An alternative notion of an existential quantifier on four-valued Łukasiewicz algebras is introduced. The class of four-valued Łukasiewicz algebras endowed with this existential quantifier determines a variety which is denoted by \. It is shown that the alternative existential quantifier is interdefinable with the standard existential quantifier on a four-valued Łukasiewicz algebra. Some connections between the new existential quantifier and the existential quantifiers defined on bounded distributive lattices and Boolean algebras are given. Finally, a completeness theorem for the monadic four-valued (...) Łukasiewicz predicate calculus corresponding to the dual of the alternative existential quantifier is proven. (shrink)

The literature on public perceptions of, and attitudes towards, nanotechnology used in the agrifood sector is reviewed. Research into consumer perceptions and attitudes has focused on general applications of nanotechnology, rather than within the agrifood sector. Perceptions of risk and benefit associated with different applications of nanotechnology, including agrifood applications, shape consumer attitudes, and acceptance, together with ethical concerns related to environmental impact or animal welfare. Attitudes are currently moderately positive across all areas of application. The occurrence of a negative (...) or positive incident in the agri-food sector may crystallise consumer views regarding acceptance or rejection of nanotechnology products. •Acceptance of agrifood nanotechnology based on perceptions of risk, benefit and ethics.•Attitudes towards nanotechnology in general are currently moderately positive.•Occurrence of a major nanotechnology-related "event" may crystallise consumer attitude. (shrink)

Philosophical Studies Vol. 2, No. 2, p. 163, l. 24 for ‘Pocreon’ read “Creon’ and p. 165, l.4 for “Nereus” read “Nessus”, l. 16 for “Corrolate” read “Correlate” and l. 27 for “ Trachinae ” read “ Trachiniae ”. Proffessor Mackinnon should also have been described as Norris-Hulse Professor of Divinity in the University of Cambridge and Fellow of Corpus Christi College.

Putting in writing what you want -- What may happen if you don't make it "clear and convincing" -- Facts and statistics -- Empathy and the imagination -- Ancient myth and modern medicine: what can we learn from the past? -- Hoping for a miracle -- What could be wrong with hope? -- Medical futility -- Beyond futility to an ethic of care -- Future decisions we may all have to make.