Background: Patient autonomy has been promoted as the most important principle to guide difficult clinical decisions. To examine whether practising physicians indeed value patient autonomy above other considerations, physicians were asked to weight patient autonomy against three other criteria that often influence doctors’ decisions. Associations between physicians’ religious characteristics and their weighting of the criteria were also examined. Methods: Mailed survey in 2007 of a stratified random sample of 1000 US primary care physicians, selected from the American Medical Association masterfile. (...) Physicians were asked how much weight should be given to the following: (1) the patient’s expressed wishes and values, (2) the physician’s own judgment about what is in the patient’s best interest, (3) standards and recommendations from professional medical bodies and (4) moral guidelines from religious traditions. Results: Response rate 51% (446/879). Half of physicians (55%) gave the patient’s expressed wishes and values “the highest possible weight”. In comparative analysis, 40% gave patient wishes more weight than the other three factors, and 13% ranked patient wishes behind some other factor. Religious doctors tended to give less weight to the patient’s expressed wishes. For example, 47% of doctors with high intrinsic religious motivation gave patient wishes the “highest possible weight”, versus 67% of those with low (OR 0.5; 95% CI 0.3 to 0.8). Conclusions: Doctors believe patient wishes and values are important, but other considerations are often equally or more important. This suggests that patient autonomy does not guide physicians’ decisions as much as is often recommended in the ethics literature. (shrink)

Hume's is/ought distinction has long limited the role of empirical research in ethics, saying that data about what something is cannot yield conclusions about the way things ought to be. However, interest in empirical research in ethics has been growing despite this countervailing principle. We attribute some of this increased interest to a conceptual breakdown of the is/ought distinction. MacIntyre, in reviewing the history of the is/ought distinction, argues that is and ought are not strictly separate realms but exist in (...) a close relationship that is clarified by adopting a teleological orientation. We propose that, instead of recovering a teleological orientation, society tends to generate its own goals via democratic methods like those described by Rousseau or adopt agnosticism about teleology such as described by Richard Rorty. In both latter scenarios, the distinction between is and ought is obscured, and the role for empirical research grows, but for controversial reasons. MacIntyre warns that the is/ought distinction should remain, but reminds ethicists to make careful arguments about when and why it is legitimate to move from is to ought. (shrink)

Deep brain stimulation is an experimental procedure for treatment-resistant depression. Some results show promise, but blinded trials had limited success. Ethical questions center on vulnerability: especially on whether depressed patients can weigh the risks and benefits effectively, whether depression causes “desperation,” and whether media portrayals create unrealistic hopes. We interviewed 24 psychiatric inpatients with treatment-resistant depression, qualitatively analyzing their comments. Most had minimal interest in deep brain stimulators. Some might consider them if their depression worsened, if alternatives were exhausted, or (...) if the evidence were stronger. Fears focused on the surgery, adverse effects, and the novelty of the device. Patients felt the depression interfered with their ability to weigh the risks and benefits. Patients seemed highly attuned to the risks, and were skeptical that the treatment would be effective. We conclude that ethical concerns about vulnerability remain, yet patients with treatment-resistant depression were thoughtful and cautious about trying a novel therapy. (shrink)

Background: Genetic tests for schizophrenia may introduce risks and benefits. Among young adults at clinical high risk for psychosis, little is known about their concerns and how they assess potential risks. Methods: We conducted semistructured interviews with 15 young adults at clinical high risk for psychosis to ask about their concerns. Results: Participants expressed concerns about test reliability, data interpretation, stigma, psychological harm, family planning, and privacy. Participants’ responses showed some departure from the ethics literature insofar as participants were primarily (...) interested in reporting their results to people to whom they felt emotionally close, and expressed little consideration of biological closeness. Additionally, if tests showed an increased genetic risk for schizophrenia, four clinical high-risk persons felt obligated to tell an employer and another three would “maybe” tell an employer, even in the absence of clinical symptoms. Conclusions: These findings suggest opportunities for clinicians and genetic counselors to intervene with education and support. (shrink)

In the past ten years, there has been growing interest in and concern about protecting the privacy of personal medical information. Insofar as medical records increasingly are stored electronically, and electronic information can be shared easily and widely, there have been legislative efforts as well as scholarly analyses calling for greater privacy protections to ensure that patients can feel safe disclosing personal information to their health-care providers. At the same time, the volume of biomedical research conducted in this country continues (...) to grow. The budget of the National Institutes of Health, for example, was $20,298 million in 2001, having more than doubled from a budget of $9,218 million 10 years before. This growing body of research includes increased efforts to use stored medical records as a source of data for health services, epidemiologic, and clinical studies. (shrink)

In the past ten years, there has been growing interest in and concern about protecting the privacy of personal medical information. Insofar as medical records increasingly are stored electronically, and electronic information can be shared easily and widely, there have been legislative efforts as well as scholarly analyses calling for greater privacy protections to ensure that patients can feel safe disclosing personal information to their health-care providers. At the same time, the volume of biomedical research conducted in this country continues (...) to grow. The budget of the National Institutes of Health, for example, was $20,298 million in 2001, having more than doubled from a budget of $9,218 million 10 years before. This growing body of research includes increased efforts to use stored medical records as a source of data for health services, epidemiologic, and clinical studies. (shrink)

The hemidesmosome is a complex junction containing many proteins. The keratin cytoskeleton attaches to its cytoplasmic plaque, while its transmembrane elements interact with components of the extracellular matrix. Hemidesmosome assembly involves recruitment of α6β4 integrin heterodimers, as well as cytoskeletal elements and cytoskeleton-associated proteins to the cell surface. In our cell culture models, these phenomena appear to be triggered by laminin-5 in the extracellular matrix. Cell interaction with laminin-5 apparently induces both phosphorylation and dephosphorylation of subunits of α6β4 integrin. There (...) is emerging evidence that such events are necessary for subsequent cytoskeleton anchorage to the hemidesmosome cytoplasmic plaque. Once assembled, the hemidesmosome plays an essential role in maintaining firm epithelial adhesion to the basement membrane, with hemidesmosome disruption being a hallmark of certain devastating blistering diseases. However, the hemidesmosome is more than just a stable anchor, as it may also be the site of signal transduction, mediated by its α6β4 integrin component. This review discusses our current knowledge of the structure and assembly of the hemidesmosome. BioEssays 20:488–494, 1998. © 1998 John Wiley & Sons, Inc. (shrink)

Public health ethics, like the field of public health it addresses, traditionally has focused more on practice and particular cases than on theory, with the result that some concepts, methods, and boundaries remain largely undefined. This paper attempts to provide a rough conceptual map of the terrain of public health ethics. We begin by briefly defining public health and identifying general features of the field that are particularly relevant for a discussion of public health ethics.Public health is primarily concerned with (...) the health of the entire population, rather than the health of individuals. Its features include an emphasis on the promotion of health and the prevention of disease and disability; the collection and use of epidemiological data, population surveillance, and other forms of empirical quantitative assessment; a recognition of the multidimensional nature of the determinants of health; and a focus on the complex interactions of many factors—biological, behavioral, social, and environmental—in developing effective interventions. (shrink)

Few figures of the Middle Ages command the attention of so many modern disciplines as Robert Grosseteste (c. 1170-1253). Theology, Philosophy, History, and Science are all areas which his life and thought continue to have significance and to inspire re-interpretation. Accompanied by a series of original commentaries, this new edition of Grosseteste's work, with English translation, draws together the perspectives of modern scientists and medieval specialists. Volume I of a six volume series, Knowing and Speaking presents two of the earliest (...) of Grosseteste's works, the treatises On the Liberal Arts and On the Generation of Sounds. These are accompanied by a significant Middle English treatise on the Seven Liberal Arts whose anonymous fifteenth-century author translated and excerpted passages from Grosseteste's treatises in a re-imagining of their structure and function.0Each work is treated separately within the volume, which is constructed in three parts. On the Liberal Arts sets Grosseteste's thoughts on the arts subjects and emphasises moral concerns about the purpose of learning. On the Generation of Sounds builds on the theories and statements of On the Liberal Arts in connection to the production of sound, elaborating the earlier position, relating the generation of sounds to human vocal and speech production. (shrink)

Pancreatitis is a complex, progressively destructive inflammatory disorder. Alcohol was long thought to be the primary causative agent, but genetic contributions have been of interest since the discovery that rare PRSS1, CFTR and SPINK1 variants were associated with pancreatitis risk. We now report two associations at genome-wide significance identified and replicated at PRSS1-PRSS2 and X-linked CLDN2 through a two-stage genome-wide study. The PRSS1 variant likely affects disease susceptibility by altering expression of the primary trypsinogen gene. The CLDN2 risk allele is (...) associated with atypical localization of claudin-2 in pancreatic acinar cells. The homozygous CLDN2 genotype confers the greatest risk, and its alleles interact with alcohol consumption to amplify risk. These results could partially explain the high frequency of alcohol-related pancreatitis in men. © 2012 Nature America, Inc. All rights reserved. (shrink)

Progressive supranuclear palsy is a movement disorder with prominent tau neuropathology. Brain diseases with abnormal tau deposits are called tauopathies, the most common of which is Alzheimer's disease. Environmental causes of tauopathies include repetitive head trauma associated with some sports. To identify common genetic variation contributing to risk for tauopathies, we carried out a genome-wide association study of 1,114 individuals with PSP and 3,247 controls followed by a second stage in which we genotyped 1,051 cases and 3,560 controls for the (...) stage 1 SNPs that yielded P ≤ 10-3. We found significant previously unidentified signals associated with PSP risk at STX6, EIF2AK3 and MOBP. We confirmed two independent variants in MAPT affecting risk for PSP, one of which influences MAPT brain expression. The genes implicated encode proteins for vesicle-membrane fusion at the Golgi-endosomal interface, for the endoplasmic reticulum unfolded protein response and for a myelin structural component. © 2011 Nature America, Inc. All rights reserved. (shrink)

The earlier volume in this series dealt with two religions of Indian origin, namely, Buddhism and Jainism. The Indian religious scene, however, is characterized by not only religions which originated in India but also by religions which entered India from outside India and made their home here. Thus religious life in India has been enlivened throughout its history by the presence of religions of foreign origin on its soil almost from the very time they came into existence. This volume covers (...) three such religions—Zoraoastrianism, Judaism, and Islam. In the case of Zoraostianism, even its very beginnings are intertwined with India, as Zoroastrianism reformed a preexisting religion which had strong links to the Vedic heritage of India. This relationship took on a new dimension when a Zoroastrian community, fearing persecution in Persia after its Arab conquest, sought shelter in western India and ultimately went on to produce India’s pioneering nationalist in the figure of Dadabhai Naoroji ( 1825-1917), also known as the Grand Old Man of India. Jews found refuge in south India after the destruction of the Temple by the Romans in 70 C.E. and have remained a part of the Indian religious scene since then, some even returning to Israel after it was founded in 1948. Islam arrived in Kerala as soon as it was founded and one of the earliest mosques in the history of Islam is found in India. Islam differs from the previously mentioned religions inasmuch as it went on to gain political hegemony over parts of the country for considerable periods of time, which meant that its impact on the religious life of the subcontinent has been greater compared to the other religions. It has also meant that Islam has existed in a religiously plural environment in India for a longer period than elsewhere in the world so that not only has Islam left a mark on India, India has also left its mark on it. Indeed all the three religions covered in this volume share this dual feature, that they have profoundly influenced Indian religious life and have also in turn been profoundly influenced by their presence in India. (shrink)

The earlier volume in this series dealt with two religions of Indian origin, namely, Buddhism and Jainism. The Indian religious scene, however, is characterized by not only religions which originated in India but also by religions which entered India from outside India and made their home here. Thus religious life in India has been enlivened throughout its history by the presence of religions of foreign origin on its soil almost from the very time they came into existence. This volume covers (...) three such religions—Zoraoastrianism, Judaism, and Islam. In the case of Zoraostianism, even its very beginnings are intertwined with India, as Zoroastrianism reformed a preexisting religion which had strong links to the Vedic heritage of India. This relationship took on a new dimension when a Zoroastrian community, fearing persecution in Persia after its Arab conquest, sought shelter in western India and ultimately went on to produce India’s pioneering nationalist in the figure of Dadabhai Naoroji ( 1825-1917), also known as the Grand Old Man of India. Jews found refuge in south India after the destruction of the Temple by the Romans in 70 C.E. and have remained a part of the Indian religious scene since then, some even returning to Israel after it was founded in 1948. Islam arrived in Kerala as soon as it was founded and one of the earliest mosques in the history of Islam is found in India. Islam differs from the previously mentioned religions inasmuch as it went on to gain political hegemony over parts of the country for considerable periods of time, which meant that its impact on the religious life of the subcontinent has been greater compared to the other religions. It has also meant that Islam has existed in a religiously plural environment in India for a longer period than elsewhere in the world so that not only has Islam left a mark on India, India has also left its mark on it. Indeed all the three religions covered in this volume share this dual feature, that they have profoundly influenced Indian religious life and have also in turn been profoundly influenced by their presence in India. (shrink)

In the face of environmental crises such as climate change, pollution and biodiversity loss—which all adversely impact on health—Gils-Schmidt and Salloch explore whether physicians can be justified in taking climate issues into account in clinical care.1 While their approach centres on the ‘climate-sensitive’ decisions, physicians can carry out on the micro-level of clinical decision-making, they encourage further discussions on how climate-related issues can be included across different levels of decision-making in healthcare. We propose a list of tasks and a model (...) to assist with navigating the range of factors and structural elements an environmentally sensitive ethics must address. Stephen Gardiner’s notion of a perfect moral storm is central to understanding these issues.2 Gardiner describes how a perfect moral storm occurs in the centre of three overlapping conditions for human action and policymaking in the face of climate change. This storm is driven by: (1) a lack of interest among current generations to meet global needs and accommodate the well-being of future generations, (2) a lack of ecological concerns for other parts of nature than humans and (3) weak ethical and political theories and institutions shaping policy decisions on issues with severe implications across borders and generations. Moreover, these conditions are embedded in the existing, complex world of ethically unjustified power imbalances and social injustice. The growing awareness of healthcare’s climate footprint has amplified and accelerated global, grassroots action to make healthcare more environmentally friendly. This includes incorporating environmental impacts into quality improvement methodologies, building communities of practice to explore how to make …. (shrink)

These 13 essays by noted American and German scholars provide a focused discussion of many of the issues raised by the integration of philosophical and psychological theories of moral development. The essays pivot around two key contributions, by Lawrence Kohlberg and his associates and by JA1⁄4rgen Habermas. Kohlberg's major work was a description of the stages of development of moral understanding in children. This book contains the final formulation of his view of the end point of moral development (Stage (...) 6). Habermas's insightful response to that formulation, which seeks to fit Kohlberg's perceptions into the framework of a communicative ethics, is an important extension of his own moral theory. In three parts, the essays map out the relationship between philosophy and psychology in the study of the moral domain, explore the way the moral point of view is understood within Kohlberg's cognitive-developmental model, and discuss the place of moral development in terms of various models of personality and decision making. The contributors are Augusto Blasi, Dwight R. Boyd, Rainer Dobert, Wolfgang Edelstein, JA1⁄4rgen Habermas, Helen Haste, Monika Keller, Lawrence Kohlberg, Charles Levine, Mordecai Nisan, Gil G. Noam, Gertrud Nunner-Winkler, Bill Puka, Ernst Tugendhat, and Thomas E. Wren. Thomas E. Wren is Professor of Philosophy at Loyola University of Chicago. The Moral Domain is included in the series Studies in Contemporary German Social Thought, edited by Thomas McCarthy. (shrink)

The thesis of this article is that there has never been any ground for the controversy between the doctrine of free will and determinism, that it is based upon a misapprehension, that the two assertions are entirely consistent, that one of them strictly implies the other, that they have been opposed only because of our natural want of the analytical imagination. In so saying I do not tamper with the meaning of either phrase. That would be unpardonable. I mean free (...) will in the natural and usual sense, in the fullest, the most absolute sense in which for the purposes of the personal and moral life the term is ever employed. I mean it as implying responsibility, merit and demerit, guilt and desert. I mean it as implying, after an act has been performed, that one " could have done otherwise " than one did. I mean it as conveying these things also, not in any subtly modified sense but in exactly the sense in which we conceive them in life and in law and in ethics. These two doctrines have been opposed because we have not realised that free will can be analysed without being destroyed, and that determinism is merely a feature of the analysis of it. And if we are tempted to take refuge in the thought of an "ultimate ", an "innermost" liberty that eludes the analysis, then we have implied a deterministic basis and constitution for this liberty as well. For such a basis and constitution lie in the idea of liberty. -/- The thesis is not, like that of Green or Bradley, that the contending opinions are reconciled if we adopt a certain metaphysic of the ego, as that it is timeless, and identifies itself with a desire by a " timeless act". This is to say that the two are irreconcilable, as they are popularly supposed to be, except by a theory that delivers us from the conflict by taking us out of time. Our view on the contrary is that from the natural and temporal point of view itself there never was any need of a reconciliation but only of a comprehension of the meaning of terms. (The metaphysical nature of the self and its identity through time is a problem for all who confront memory, anticipation, etc.; it has no peculiar difficulties arising from the present problem.) -/- I am not maintaining that determinism is true; only that it is true insofar as we have free will. That we are free in willing is, broadly speaking, a fact of experience. That broad fact is more assured than any philosophical analysis. It is therefore surer than the deterministic analysis of it, entirely adequate as that in the end appears to be. But it is not here affirmed that there are no small exceptions, no slight undetermined swervings, no ingredient of absolute chance. All that is here said is that such absence of determination, if and so far as it exists, is no gain to freedom, but sheer loss of it; no advantage to the moral life, but blank subtraction from it. -- When I speak below of "the indeterminist" I mean the libertarian indeterminist, that is, him who believes in free will and holds that it involves indetermination. (shrink)

Codes of ethics exist in many, if not the majority, of all large U.S. companies today. But how the impact of these written codes affect managerial attitudes and behavior is still not clearly documented or explained. This study takes a step in that direction by proposing that attention should shift from the codes themselves as the sources of ethical behavior to the persons whose behavior is the focus of these codes. In particular, this study investigates the role of code familiarity (...) as a factor impacting the influence of an ethics code on manager behavior. Data collected from 286 executives from companies in the direct selling industry are used to test hypotheses (1) that the perceived usefulness of ethics codes is positively related to the degree of familiarity with the code, and (2) that ethical climate as assessed by managers is positively related to the code''s perceived usefulness. Both hypotheses are supported, and their implications and further research directions are discussed. (shrink)

This study represents an improvement in the ethics scales inventory published in a 1988 Journal of Business Ethics article. The article presents the distillation and validation process whereby the original 33 item inventory was reduced to eight items. These eight items comprise the following ethical dimensions: a moral equity dimension, a relativism dimension, and a contractualism dimension. The multidimensional ethics scale demonstrates significant predictive ability.

Racism as an independent topic of investigation in philosophy has considerably developed since the 1990s, when it appeared as part of growing debates that, on the one hand, investigated the political meaning of race and, on the other, its ontology and whether it existed at all. Likewise, with the idea of racism, its broadly normative meaning is critiqued by some philosophers, while others ask how best to conceive of it and identify its immorality. There were a few early and significant (...) forays in philosophy about the nature of racism, of which three works stand out because of the way they set the terms of the debate: David Theo Goldberg's Racist Culture, Charles W. Mills’ The Racial Contract, and Jorge L.A. Garcia's “The Heart of Racism.”1 This collection reacts to the latter fork in the discussion but does so in ways that significantly touch on the former.The collection begins with Jorge L. Garcia's “Virtue Ethics in Social Theory: Defending a Volitional Analysis of Racism from Tommie Shelby's Challenges.” It is a clarification and defense of his influential volitional analysis of racism (VAR) from three prominent objections: that VAR inadequately accounts for the immorality of racism because it relies on the assumed wrongness of racism built into ordinary usage of the term ‘racist;’ that it mistakenly separates intention from belief; and that it does not fully account for the racism of some troubling mental states that cannot be traced back to a racist ill-will. Garcia's account of racism as fundamentally rooted in racist ill-will, along with Lawrence Blum's, is representative of agent-centered theories of racism. Not only do they attempt to explain individual or personal racism, but they also hold that racism in institutions, structures, or systems traces back to the racism of persons.Current accounts of structural racism, however, claim that it exists and operates independently of infection from intentionally racist persons, that the focus on racist persons cannot adequately account for how racism works in society, and that, instead, we should concentrate on structures and ideologies. Amelia Wirts sharply defends this view in her, “What does it mean to say ‘The Criminal Justice System is Racist’?” She explains how structural racism applies to America's criminal justice system and other “intermediate” (between individual and societal level) structures. Wirts argues that personal accounts of racism, and in particular Garcia's VAR, do not adequately account for the patterns of racial disparity in the criminal justice system or its disproportionate harm to black people. She advocates, instead, for a patterned view of structural racism, the patterns of which operate “as if it were designed to disproportionately harm” some racialized group. Additionally, Wirts adds that such patterns are particularly racist when they fuel racist ideological symbols, as the criminal justice system does in relation to the idea of the black criminal.Structural analyses of racism are powerfully instructive, and Alisa Bierria, in “Structural Racism Within Reason,” offers an account that takes an epistemic turn that advances our understanding of their meaning. More than the idea that personal and structural racism beget each other in continuous looping effects, and more than the view that racism is best understood as an ideology that provides the content to racist attitudes or policy proscriptions, she argues that structural racism structures reason. Drawing on the 2012 case of Marissa Alexander, who unsuccessfully tried to use Florida's Stand Your Ground Law to justify her firing a warning shot at her estranged, abusive husband to protect herself from his murderous threat, Bierra argues that structural racism extends constructed and controlling intentions onto its targets, and, as in the case she discusses, it uses those constructed and fictional intentions to justify their punishment and depriving them of equal justice.Structural analyses of racism are essential additions to the philosophical understanding of racism that have appropriately challenged the centrality of agent-centered accounts. The increasing academic focus on structural explanations, however, along with the current overuse of “systemic racism” in popular discourse, threatens to eclipse the value of accounts of agent-centered accounts. In “Is Racism Essentially Systemic?” Michael Hardimon counsels against this trend. He reminds us that racism is not essentially systemic, and that the dominance of structural explanations could obscure its other forms and even the proper understanding of structural racism. Indeed, structures once constructed might operate independently of human intention, but they are designed, initiated, and often operated by persons.After considering the direction of the current philosophical discussion about the meaning of racism and its immorality, the next set of articles expands the discussion into matters of class, xenophobia, and white nationalism. Lawrence Blum's “Race and Class Together” starts it off. Blum builds class into his analysis of racism and critiques its absence in anti-racist theory. He argues that paying attention to class is required to secure justice for the victims of racism because pursuing justice is often a matter of both. Blum contends that race and class are “normatively distinct axes of injustice” and that, depending on the question, racial injustice needs to be addressed separately. However, there are aspects of racial injustice that can only be dealt with through a class analysis and require class or combined class–race focused policies. Pointing to the fact that many of the members of groups targeted by racism (he considers blacks, Indigenous peoples, and Latinxs) share cross-class interests, which includes shared interests with some whites, which they do not share with more economically privileged members of their own groups, Blum argues that these interests should be addressed through “class-focused policies,” in a manner that will secure justice for disadvantaged racial groups.Shifting from the class-race analysis, José Jorge Mendoza, in “‘Go Back to Where You Came From!’ Racism, Xenophobia, and White Nationalism,” turns our attention toward white nationalism to examine whether it is best understood as an expression of racism or xenophobia. Although he recognizes the importance of xenophobia in white nationalism, Mendoza does not neglect its connections with racist ideas. However, he acknowledges that emphasizing the role of race in condemnations of white nationalism risks overextending the concept of race, i.e., in regards to pan-racial groups, because some members of those groups are racially identified as white. Thus, the charge of racism against white nationalism in such cases may not clearly apply. To deal with those cases, Mendoza cleverly decouples the ideas of “radicalization” and “racial formation,” and he puts forward a new concept, “racial disintegration,” to account for the operation and shifting targets of white nationalism.In the final piece, David H. Kim and I discuss xenophobia and racism in the case of “Anti-Asian Racism.” We move from general theories of racism to inquire about what is at the base of anti-Asian racism. Little is said in contemporary accounts of racism about anti-Asian racism. This is due, in part, to the high level of abstraction in those discussions but also because much of the literature takes anti-blackness as the model of racism. Our piece addresses this lacuna in a manner not beholden to the black-white binary. We discuss how the idea of anti-Asian racism is a conceptual problem in the American context dominated by that binary. We then argue that xenophobia as a form of civic ostracism, and to some extent xenophilia, play a particular role in how anti-Asian racism functions and its immorality.The pieces in this collection resonate with current events and controversies involving racism and illustrate the potential of the debate to relate to and speak those events, not just to the specialized interests of a cloistered academic conversation. Each piece demonstrates the potential for extending vital lines of debate and discussion that touches the raw nerve of the public discussion of racism. (shrink)

No one is excused from doing what he ought to do merely because he is unwilling to do it. But what if others are unwilling to play their necessary role in some joint venture that you all ought to undertake: might that excuse you from doing what you yourself ought to do as part of that? It would, if you were genuinely willing to play your necessary part if they were. But the unwillingness of everyone involved cannot reciprocally serve to (...) excuse one another from doing what they ought to do. (shrink)

Translational ethics (TE) has been developed into a specific approach, which revolves around the argument that strategies for bridging the theory‐practice gap in bioethics must themselves be justified on ethical terms. This version of TE incorporates normative, empirical and foundational ethics research and continues to develop through application and in the face of new ethical challenges. Here, I explore the idea that the academic field of bioethics has not yet sufficiently analysed its own philosophical foundation for how it can, and (...) should, be practically relevant; neither has it comprehensively discussed the limitations on what impacts bioethicists should pursue. As a result, there has not been adequate training on how to suitably and appropriately impact real‐world practices. Moreover, bioethical perspectives are often competing with other strong interests, for example, economic and political, which may weaken their impact on policy‐making. The TE approach I propose can not only facilitate practical impacts of academic bioethics by being better informed by real‐world ethical issues but it also supports targeted and ethical justifications of the actual impact of academic work in real‐world contexts. In this paper, I clarify the premises for this TE approach, identify further challenges and sketch out potential solutions for the implementation of this methodological framework. (shrink)

Book reviewed in this article: Protecting The Vulnerable: A Reanalysis of Our Social Responsibilities. By Robert E. Goodin. Chicago: University of Chicago Press.

Translational research in medicine requires researchers to identify the steps to transfer basic scientific discoveries from laboratory benches to bedside decision-making, and eventually into clinical practice. On a parallel track, philosophical work in ethics has not been obliged to identify the steps to translate theoretical conclusions into adequate practice. The medical ethicist A. Cribb suggested some years ago that it is now time to debate ‘the business of translational’ in medical ethics. Despite the very interesting and useful perspective on the (...) field of medical ethics launched by Cribb, the debate is still missing. In this paper, I take up Cribb’s invitation and discuss further analytic distinctions needed to base an ethics aiming to translate between theory and practice. (shrink)

I shall be dealing, throughout this book, with a set of related problems: the relationship between morality and reasoning in general, the way in which moral reasoning is properly to be carried on, and why morality is not arbitrary. The solutions to these problems come out of the same train of argument. Morality is not arbitrary, I shall argue, because the acceptance of certain qualities of character as virtues and the rejection of others as vices is forced on us by (...) the co-operative basis of human life. The co-operation in human life is unavoidable; the alternative is a literal Hobbesian state of nature, and that is impossible. It is not that co-operation between people is a good thing or even a very good thing; it is simply unavoidable in human life, and it is impossible unless the qualities of character counted as virtues are encouraged and are at least fairly common. The possibility of human life presupposes a theory of human nature, and working out that theory of human nature is the main job of moral philosophy. These virtues or qualities of character or attitudes lead us towards a theory of reasons. A person with a sense of justice is a person inclined to accept certain sorts of facts as reasons for acting, and if the virtues are presupposed by human life then the acceptance of those sorts of facts as reasons for acting is presupposed by human life. A condition of the life of reasoning beings (a more accurate term here than 'human beings') is that moral reasons are reasons for acting and are at the very basis of reasoning. And from this it follows that properly conducted moral reasoning is ultimately guided by the virtues rather than ultimately guided by a set of rules. (shrink)