Background The first COVID-19 wave started in February 2020 in France. The influx of patients requiring emergency care and high-level technicity led healthcare professionals to fear saturation of available care. In that context, the multidisciplinary Ethics- Support Cell (EST) was created to help medical teams consider the decisions that could potentially be sources of ethical dilemmas. Objectives The primary objective was to prospectively collect information on requests for EST assistance from 23 March to 9 May 2020. The secondary aim was (...) to describe the Cell’s functions during that period. Research design This observational, real-time study of requests for Cell consultations concerned ethical dilemmas arising during a public health crisis. The EST created a grid to collect relevant information (clinical, patient’s/designated representative’s preferences and ethical principles strained by the situation), thereby assuring that each EST asked the same questions, in the same order. Participants and research context Only our university hospital’s clinicians could request EST intervention. Ethical considerations The hospital Research Ethics Committee approved this study (no. CER-2020-107). The patient, his/her family, or designated representative was informed of this ethics consultation and most met with EST members, which enabled them to express their preferences and/or opposition. Findings/results 33 requests (patients’ mean age: 80.8 years; 29 had COVID-19: 24 with dyspnea, 30 with comorbidities). 17 Emergency Department solicitations concerned ICU admission, without reference to resource constraints; others addressed therapeutic proportionality dilemmas. Discussion Intervention-request motives concerned limited resources and treatment intensity. Management revolved around three axes: the treatment option most appropriate for the patient, the feasibility of implementation, and dignified care for the patient. Conclusions COVID-19 crisis forced hospitals to envisage prioritization of ICU access. Established decision-making criteria and protocols do not enable healthcare professionals to escape ethical dilemmas. That acknowledgement highlights ethical risks, enhances the added-value of nursing and encourages all players to be vigilant to pursue collective deliberations to achieve clear and transparent decisions. (shrink)

This book provides an in-depth introduction to, and analysis of, the issues relating to the implementation of the recent Responsibility to Protect principle in international relations The Responsibility to Protect has come a long way in a short space of time. It was endorsed by the General Assembly of the UN in 2005, and unanimously reaffirmed by the Security Council in 2006 and 2009. UN Secretary-General Ban Ki-moon has identified the challenge of implementing RtoP as one of the cornerstones of (...) his Secretary-Generalship. The principle has also become part of the working language of international engagement with humanitarian crises and has been debated in relation to almost every recent international crisis âe" including Sudan, Sri Lanka, Myanmar, Georgia, the Democratic Republic of Congo, Darfur and Somalia. Concentrating mainly on implementation challenges including the prevention of genocide and mass atrocities, strengthening the UNâes capacity to respond, and the role of regional organizations, this book introducing readers to contemporary debates on R2P and provides the first book-length analysis of the implementation agenda. The book will be of great interest to students of the responsibility to protect, humanitarian intervention, human rights, foreign policy, security studies and IR and politics in general. (shrink)

In Liberalism and Pluralism, Richard Bellamy explores the challenges posed by conflicting values, interests and identities to liberal democracy. Conventional liberal thought is no longer suited to the complex, plural societies of today. By analyzing the three major strands of liberal thought as represented by Hayek, Rawls and Walzer, the author reveals how standard liberalism has tried to circumvent unstable settlements. This book establishes a more satisfactory alternative: namely, negotiated compromise.

Sugar, pork, beer, corn, cider, scrapple, and hoppin' John all became staples in the diet of colonial America. The ways Americans cultivated and prepared food and the values they attributed to it played an important role in shaping the identity of the newborn nation. In A Revolution in Eating, James E. McWilliams presents a colorful and spirited tour of culinary attitudes, tastes, and techniques throughout colonial America. Confronted by strange new animals, plants, and landscapes, settlers in the colonies and West (...) Indies found new ways to produce food. Integrating their British and European tastes with the demands and bounty of the rugged American environment, early Americans developed a range of regional cuisines. From the kitchen tables of typical Puritan families to Iroquois longhouses in the backcountry and slave kitchens on southern plantations, McWilliams portrays the grand variety and inventiveness that characterized colonial cuisine. As colonial America grew, so did its palate, as interactions among European settlers, Native Americans, and African slaves created new dishes and attitudes about food. McWilliams considers how Indian corn, once thought by the colonists as "fit for swine," became a fixture in the colonial diet. He also examines the ways in which African slaves influenced West Indian and American southern cuisine. While a mania for all things British was a unifying feature of eighteenth-century cuisine, the colonies discovered a national beverage in domestically brewed beer, which came to symbolize solidarity and loyalty to the patriotic cause in the Revolutionary era. The beer and alcohol industry also instigated unprecedented trade among the colonies and further integrated colonial habits and tastes. Victory in the American Revolution initiated a "culinary declaration of independence," prompting the antimonarchical habits of simplicity, frugality, and frontier ruggedness to define American cuisine. McWilliams demonstrates that this was a shift not so much in new ingredients or cooking methods, as in the way Americans imbued food and cuisine with values that continue to shape American attitudes to this day. (shrink)

During the 1990s, international society increasingly recognised that states who abuse their citizens in the most egregious ways ought to lose their sovereign inviolability and be subject to humanitarian intervention. The emergence of this norm has given renewed significance to the debate concerning what it is about humanitarian intervention that makes it legitimate. The most popular view is that it is humanitarian motivations that legitimise intervention. Others insist that humanitarian outcomes are more important that an actor's motivations, pointing for instance (...) to the ousting of the Khmer Rouge by Vietnam. Given the centrality of this debate, this article reinvestigates the ?motives versus outcomes? debate and suggests an alternative reading based on the classic Just War tradition. It argues that an actor's intentions are vital to assessing the legitimacy of an intervention. (shrink)

“Indulging herself in air and exercise” as she wanders down a lane near the great house of Rosings, Elizabeth Bennet is unaware that she is just about to experience one of her most difficult challenges, and that Mr. Darcy is on his way with his letter.1 Just like present-day personality theorists, Jane Austen manifestly directed a great deal of creative and intellectual energy into devising a great variety of tests. But what are such situations designed to test for? What aspects (...) of character or personality, or traits and abilities, are meant to be scrutinized? A likely response from critics interested in Austen’s ethics is that such challenges should reveal which, if any, of the virtues are in good working order. .. (shrink)

It is fortunate for the community in which she lives that one of the things about which Elinor Dashwood cares a great deal is the social duty of “general civility”—the practice, in Hume’s words, of “gentle usage.” The heroine of Sense and Sensibility is respectful and considerate toward others, whether or not these are dearly loved family members or comparative strangers. According to Karen Stohr, throughout the novel, “Elinor is the exemplar of moderation, propriety and moral rectitude,” and the reader’s (...) assessment is seemingly quite straightforward: we can rest assured that although others may be unscrupulous, self-aggrandizing, and/or self-deceiving, Elinor Dashwood is virtuous from beginning to end.1.. (shrink)

To Wayne Booth it was clear, authors seek to exert control and writers like Jane Austen endeavor to satisfy this imperative through rhetorical techniques that may include the creation of a wise male figure who can be counted upon to provide the necessary guidance for flawed heroine and reader alike. We require help "to direct our reactions," and thus throughout Austen's novel Emma, her hero and "chief corrective," Mr. Knightley, stands in the reader's mind for what Emma lacks.1 Subsequent scholars (...) have questioned Booth's interpretation of Mr. Knightley's role and narrative status, and the subtitle of Mary Waldron's influential essay—"The Confusions of Mr. Knightley"—anticipates her views on the subject.2In... (shrink)

As of this writing, twenty‐one states have passed laws barring transgender youth‐athletes from competing on public‐school sports teams in accordance with their gender identity. Proponents of these regulations claim that transgender females in particular have inherent physiological advantages that threaten a “level playing field” for their cisgender competitors. Existing evidence is limited but does not support these restrictions. Gathering more robust data will require allowing transgender youth to compete (rather than preemptively barring them), but even if trans females are shown (...) to retain some advantage, this would not have greater moral significance than the many other “fair” physical and economic advantages found across sports. These regulations deprive transgender youth, an exceptionally vulnerable population, from the vast physical, mental, and social benefits of sports. While we advocate for transgender inclusion under our current, gender‐segregated model of sport, we propose changes to the overarching structure that would promote a more inclusive and fairer athletic environment. (shrink)

Social problems such as racism, sexism, and inequality are often cited as structural rather than individual in nature. What does it mean to invoke a social structural explanation, and how do such explanations relate to individualistic ones? This article explores recent philosophical debates concerning the nature and usages of social structural explanation. I distinguish between two central kinds of social structural explanation: those that are autonomous from psychology, and those that are not. This distinction will help clarify the explanatory power (...) that each type of SSE has, points of convergence with methodological traditions such as critical theory and rational choice theory, and the difficulties that each type of SSE faces. (shrink)

(2014). Tin Men: Ethics, Cybernetics and the Importance of Soul. Journal of Military Ethics: Vol. 13, No. 1, pp. 3-19. doi: 10.1080/15027570.2014.908011.

Recent years have seen a revival of interest in Michael Walzer's doctrine of ‘supreme emergency’. Simply put, the doctrine holds that, when a state confronts an opponent who threatens annihilation, it can be morally legitimate to violate one of the cardinal rules of the war convention – the principle of non-combatant immunity. Walzer cites the case of Britain's decision to bomb German cities in 1940 as a case in point. Although the theory of supreme emergency has been scrutinised, the historical (...) case that Walzer refers to has not been looked at in depth. This article seeks to remedy this problem by asking whether the principle actors involved in the decision to bomb German cities understood themselves to be in a supreme emergency. It argues that the British leadership never openly admitted that they were in fact targeting German civilians, and that the principle reason for this was a widespread belief that the British and American publics would not support such a campaign. As a result, throughout the war, the British government publicly maintained the fiction that the devastation of German cities was a collateral product of attacks on its industrial infrastructure. This, in turn, suggests that liberal societies – even those facing imminent destruction – do not tend to support a relaxing of the rules of non-combatant immunity, suggesting that the prohibition on deliberately killing non-combatants may be more embedded than has hitherto been thought. (shrink)

This article explores the different moral and legal arguments used by protagonists in the debate about whether or not to conduct a humanitarian intervention in Darfur. The first section briefly outlines four moral and legal positions on whether there is (and should be) a right and/or duty of humanitarian intervention: communitarianism, restrictionist and counter-restrictionist legal positivism and liberal cosmopolitanism. The second section then provides an overview of the Security Council's debate about responding to Darfur's crisis, showing how its policy was (...) influenced by both normative concerns and hard-nosed political calculations. The article concludes by asking what Darfur's case reveals about the legitimacy and likelihood of humanitarian intervention in such catastrophes and the role of the UN Security Council as the primary authorising body for the use of international force. The authors argue that this case demonstrates that for the cosmopolitan/counter-restrictionist case to prevail pivotal states need to put humanitarian emergencies on the global agenda and express a willingness to act without Council authorisation, though the question of how to proceed in cases where the Council is deadlocked remains vexed. (shrink)

Where it was once a term of art employed by a handful of likeminded countries, activists, and scholars, but regarded with suspicion by much of the rest of the world, RtoP has become a commonly accepted frame of reference for preventing and responding to mass atrocities.

To what extent should we focus on implicit bias in order to eradicate persistent social injustice? Structural prioritizers argue that we should focus less on individual minds than on unjust social structures, while equal prioritizers think that both are equally important. This article introduces the framework of transactive memory into the debate to defend the equal priority view. The transactive memory framework helps us see how structure can emerge from individual interactions as an irreducibly social product. If this is right, (...) then debiasing interventions are structural interventions. One upshot is that the utility of the individual versus structural distinction is not apparent for the purposes of intervention. (shrink)

How should you live? Should you devote yourself to perfecting a single talent or try to live a balanced life? Should you lighten up and have more fun, or buckle down and try to achieve greatness? Should you try to be a better friend? Should you be self-critical or self-accepting? And how should you decide among the possibilities open to you? Should you consult experts, listen to your parents, or should you do lots of research? Should you make lists of (...) pros and cons, or go with your gut? These are not questions that can be answered in general or in the abstract. Rather, these questions are addressed to the first person point of view, to the perspective each of us occupies when we reflect on how to live without knowing exactly what we're aiming for. To answer them, this book focuses on the process of living one's life from the inside, rather than on defining goals from the outside. Drawing on traditional philosophical sources as well as literature and recent work in social psychology, this book argues that to live well, we need to develop reflective wisdom: to care about things that will sustain us and give us good experiences, to have perspective on our successes and failures, and to be moderately self-aware and cautiously optimistic about human nature. Further, we need to know when to think about our values, character, and choices, and when not to. A crucial part of wisdom, the book maintains, is being able to shift perspectives: to be self-critical; to be realistic; to examine life when reflection is appropriate, but not when we should lose ourselves in experience. (shrink)

What is well-being? This is one of humanity's oldest and deepest questions; Valerie Tiberius offers a fresh answer. She argues that our lives go well to the extent that we succeed in what matters to us emotionally, reflectively, and over the long term. So when we want to help others achieve well-being, we should pay attention to their values.

It is commonly accepted that what we ought to do collectively does not imply anything about what each of us ought to do individually. According to this line of reasoning, if cooperating will make no difference to an outcome, then you are not morally required to do it. And if cooperating will be personally costly to you as well, this is an even stronger reason to not do it. However, this reasoning results in a self-defeating, yet entirely predictable outcome. If (...) everyone is rational, no one will cooperate, resulting in an aggregate outcome that is devastating for everyone. This dismal analysis explains why climate change and other collective action problems are so difficult to ameliorate. The goal of this paper is to provide a different, exploratory framework for thinking about individual reasons for action in collective action problems. I argue that the concept of commitment gives us a new perspective on collective action problems. Once we take the structure of commitment into account, this activates requirements of diachronic rationality that give individuals instrumental reasons to cooperate in collective action problems. (shrink)

The debate on the nature of the European Union hasbecome a test case of the kind of political andinstitutional arrangements appropriate in an age ofglobalization. This paper explores three views of theEU. The two main positions that have hithertoconfronted each other appeal to either cosmopolitan orcommunitarian values. Advocates of the former arguefor some form of federal structure in Europe and areconvinced that the sovereignty of the nation statebelongs to the past. Proponents of the latter make acase on both socio-political and (...) normative grounds fora Europe of nations. However a third position,favoured by the authors, is gaining ground. This viewcombines cosmopolitan and communitarian conceptions.It emphasises the mixed nature of the European polityand conceives the constitutionalization process asopen-ended. The paper concludes that from this perspectivea bricoleur's Europe of ‘bits and pieces’may not necessarily lack justification and legitimacy. (shrink)

This paper argues that some widely used laws of implication are false, and arguments based upon them invalid. These laws are Exportation, Commutation, (as well as various restricted forms of these), Exported Syllogism and Disjunctive Syllogism. All these laws are false for the same reason – that they license the suppression or replacement in some position of some class of propositions which cannot legitimately be suppressed or replaced. These laws fail to preserve the property of sufficiency of premiss set for (...) conclusion. They are false, and can be seen to be false, independently of their respon- sibility for the paradoxes. Hence the main ‘independent’ argument for the paradoxes – that they follow from an allegedly immaculate set of laws – is undermined. Counterexamples to all these laws are produced. (shrink)

There is a bias in neuroscience toward localizing and modularizing brain functions. Single cell recording, imaging studies, and the study of neurological deficits all feed into the Gallian view that different brain areas do different things and the things being done are confined to particular processing streams. At the same time, there is a growing sentiment that brains probably don’t work like that after all; it is better to conceive of them as fundamentally distributed units, multi‐tasking at every level. This (...) sentiment, however, is much less congenial to the tried‐and‐true experimental protocols available today and to theorizing about the brain in general. This essay examines the tension between current experimental methods and large-scale views of the brain. We argue that this disconnection between experiment and what really are guiding theoretical metaphors seriously impedes progress in neuroscience. (shrink)

Feminist Political Theory provides both a wide-ranging history of western feminist thought and a lucid analysis of contemporary debates. It offers an accessible and thought-provoking account of complex theories, which it relates to 'real-life' issues such as sexual violence, political representation and the family. This timely new edition has been thoroughly updated to incorporate the most recent developments in feminism and feminist scholarship throughout, in particular taking into account the impact of black and postmodern feminist thought on feminist political theory.

What does the world's engagement with the unfolding crisis in Darfur tell us about the impact of the Iraq war on the norm of humanitarian intervention? Is a global consensus about a “responsibility to protect” more or less likely? There are at least three potential answers to these questions. Some argue that the merging of strategic interests and humanitarian goods amplified by the intervention in Afghanistan makes it more likely that the world's most powerful states will act to prevent or (...) halt humanitarian crises. Others insist that the widespread perception that the United States and its allies “abused” humanitarian justifications to legitimate its invasion of Iraq has set back efforts to build a global consensus about humanitarian action. A third group argues that the “responsibility to protect” inhibits the potential for abuse and, as a result, consensus is likely to strengthen post-Iraq for precisely this reason. Through a detailed study of the international engagement with Darfur, I suggest that the latter two arguments have merit but need to be adjusted. I argue that the humanitarian intervention norm has changed in two subtle ways. First, while the strength of the norm itself has not changed, the credibility of the United States and U.K. as “norm carriers” has been significantly undermined. Second, while the “responsibility to protect” has been invoked to support international activism, it has also re-legitimated anti-interventionist arguments. (shrink)

This is the first philosophy textbook in moral psychology, introducing students to a range of philosophical topics and debates such as: What is moral motivation? Do reasons for action always depend on desires? Is emotion or reason at the heart of moral judgment? Under what conditions are people morally responsible? Are there self-interested reasons for people to be moral? Moral Psychology: A Contemporary Introduction presents research by philosophers and psychologists on these topics, and addresses the overarching question of how empirical (...) research is relevant to philosophical inquiry. (shrink)

The first study, along with edition and translation, of Chrysostomus Javelli’s epitome of the _Liber de bona fortuna_ (1531), a work permitting insight into the early modern understanding of fortune, fate, and free will.

Trust and Governance asks several important questions: Is trust really essential to good governance, or are strong laws more important? What leads people either to trust or to distrust government, and what makes officials decide to be trustworthy? Can too much trust render the public vulnerable to government corruption, and if so what safeguards are necessary? In approaching these questions, the contributors draw upon an abundance of resources to offer different perspectives on the role of trust in government. Enriched by (...) perspectives from political science, sociology, psychology, economics, history, and philosophy, Trust and Governance opens a new dialogue on the role of trust in the vital relationship between citizenry and government. (shrink)

The healthcare environment is knowledge driven and knowledge and human resource dependent. Despite the paucity of evidence on which to shape and evaluate organizational change, health‐care in Canada has undergone many changes in the last 15 years. In the pursuit of enhanced productivity, healthcare administrators have turned to industrial and engineering models. Using available Canadian research and policy reports, and where necessary, American literature, this paper describes the impact of re‐engineering on nursing and on the relationship between nursing and patient (...) outcomes. It also identifies emerging trends and ways forward. (shrink)

One hundred and three participants solved conflict and non-conflict versions of four reasoning tasks using a two-response procedure: a base rate task, a causal reasoning task, a denominator neglect task, and a categorical syllogisms task. Participants were asked to give their first, intuitive answer, to make a Feeling of Rightness judgment, and then were given as much time as needed to rethink their answer. They also completed a standardized measure of IQ and the actively open-minded thinking questionnaire. The FORs of (...) both high- and low-capacity reasoners were responsive to conflict, such that FORs were lower for conflict relative to non-conflict problems. Consistent with the quantity hypothesis, high-capacity reasoners made a greater distinction between conflict and non-conflict items on measures of Type 2 thinking, namely, rethinking time and probability of changing answers. In contrast to the quality hypothesis, however, this rethinking time did not advantage the ability of the high-capacity group to produce normative answers, except for the base rate task. Indeed, we observed that the correlation between capacity and the probability of normative answers emerged at the initial response, rather than after rethinking. (shrink)

During the Covid‐19 pandemic, as resources dwindled, clinicians, health care institutions, and policymakers have expressed concern about potential legal liability for following crisis standards of care (CSC) plans. Although there is no robust empirical research to demonstrate that liability protections actually influence physician behavior, we argue that limited liability protections for health care professionals who follow established CSC plans may instead be justified by reliance on the principle of reciprocity. Expecting physicians to do something they know will harm their patients (...) causes moral distress and suffering that may leave lasting scars. Limited liability shields are both appropriate and proportionate to the risk physicians are being asked to take in such circumstances. Under certain narrow circumstances, it remains unclear that the standard of care is sufficiently flexible to protect physicians from liability. Given this uncertainty, the likelihood that physicians would be sued for such an act, and their desire for such immunity, this limited protection is morally legitimate. (shrink)

There is a difference between someone breaking a glass by accidentally brushing up against it and smashing a glass in a fit of anger. In the first case, the person’s cognitive state has little to do with the event, but in the second, the mental state qua anger is quite relevant. How are we to understand this difference? What is the proper way to understand the relation between the mind, the brain, and the resultant behavior? This paper explores the popular (...) “middle ground” reply in which mental phenomena are claimed to be “as real as” other higher level properties. It argues that this solution fails to answer epistemological difficulties surrounding how to chose the appropriate factors in an explanation. A more sophisticated understanding of scientific theorizing and of the relation between ontology and explanation give us a framework in which we can determine when we should refer to mental states as being the causally efficacious agents for some behavior. (shrink)

Freedom of conscience is a core element of human rights respected by most European countries. It allows abortion through the inclusion of a conscience clause, which permits opting out of providing such services. However, the grounds for invoking conscientious objection lack clarity. Our aim in this paper is to take a step in this direction by carrying out a systematic review of reasons by midwives and nurses for declining, on conscience grounds, to participate in abortion. We conducted a systematic review (...) of ethical arguments asking, “What reasons have been reported in the argument based literature for or against conscientious objection to abortion provision by nurses or midwives?” We particularly wanted to identify any discussion of the responsibilities of midwives and nurses in this area. Search terms were conscientious objection and abortion or termination and nurse or midwife or midwives or physicians or doctors or medics within the dates 2000–2016 on: HEIN legal, Medline, CINAHL, Psychinfo, Academic Search Complete, Web of Science including publications in English, German and Dutch. Final articles were subjected to a rigorous analysis, coding and classifying each line into reason mentions, narrow and broad reasons for or against conscientious objection. Of an initial 1085 articles, 10 were included. We identified 23 broad reasons, containing 116narrow reasons and 269 reason mentions. Eighty one narrow reasons argued in favour of and 35 against conscientious objection. Using predetermined categories of moral, practical, religious or legal reasons, “moral reasons” contained the largest number of narrow reasons. The reasons and their associated mentions in this category outnumber those in the sum of the other three categories. We identified no absolute argument either for or against conscientious objection by midwives or nurses. An invisibility of midwives and nurses exists in the whole debate concerning conscientious objection reflecting a gap between literature and practice, as it is they whom WHO recommend as providers of this service. While the arguments in the literature emphasize the need for provision of conscientious objection, a balanced debate is necessary in this field, which includes all relevant health professionals. (shrink)

Judicial review by constitutional courts is often presented as a necessary supplement to democracy. This book questions its effectiveness and legitimacy. Drawing on the republican tradition, Richard Bellamy argues that the democratic mechanisms of open elections between competing parties and decision-making by majority rule offer superior and sufficient methods for upholding rights and the rule of law. The absence of popular accountability renders judicial review a form of arbitrary rule which lacks the incentive structure democracy provides to ensure rulers (...) treat the ruled with equal concern and respect. Rights based judicial review undermines the constitutionality of democracy. Its counter-majoritarian bias promotes privileged against unprivileged minorities, while its legalism and focus on individual cases distort public debate. Rather than constraining democracy with written constitutions and greater judicial oversight, attention should be paid to improving democratic processes through such measures as reformed electoral systems and enhanced parliamentary scrutiny. (shrink)

In the winter of 1872, while still a young professor in Basel, having just published his first book, The Birth of Tragedy, Friedrich Nietzsche delivered a series of lectures entitled “On the Future of Our Educational Institutions.”1 These five lectures were well received at the time. It appears that Nietzsche intended to add two more lectures and to publish the whole series as a book. By the end of the year, however, the title of the series featured only as the (...) second title in his self-parodying essay, “Five Forwards to Five Unwritten Books.”2 The lectures remained unpublished during Nietzsche's lifetime…. (shrink)