Television pictures of starvation and depredation are not the only way that famine and political instability in the horn of Africa have affected the United States. Many people from that region of the world are seeking political or economic refuge here, and they are exposing us to a culture that is in some ways — most notably, in the practice of female circumcision – so radically different from the prevailing American cultures that we have been stunned. They are also forcing (...) hospital ethics committees to face issues that cannot be resolved by the facile application of the settled principles that have guided those institutions for the past several years. Autonomy and multiculturalism, long the foundations of most ethics committee decision making, have started to give way to a list of formally articulated rights and wrongs – perhaps to a restatement and adoption of rules said to be based in natural law. Female circumcision, argues one newspaper letter writer, “is just a sickening display of male power disguised as legitimate dogma. (shrink)

As ethics committees become involved in discussing the propriety of euthanasia and assisted suicide, and as healthcare providers begin to seriously consider whether they might ever have a role in hastening the dying process, many have looked to The Netherlands as the only real example of a nation that permits euthanasia in limited circumstances. Unfortunately, partisans in the Dutch debate have often written about the Dutch experience as advocates rather than as neutral observers. Some have argued that euthanasia, which, they (...) claim, is rarely actually practiced, is universally accepted within The Netherlands; others have reported that the Dutch social fabric has been rended irreparably by what they claim, is a practice far more widespread than is generally understood. The debate in the United States has also been colored by a misunderstanding of the legal regulation of euthanasia in The Netherlands. (shrink)

In many countries the debate over the role that physicians may play in ending life has been limited to the judiciary and other law making institutions, professional medical organizations; and academics. Because of their multidisciplinary and diverse membership, ethics committees may be a particularly appropriate venue through which these discussions can be expanded to include a much larger community. In addition, ethics committees generally act in only advisory capacities because they do not actually make decisions, so they may provide a (...) forum for open discussions in ways that the court and the medical boards cannot. (shrink)

Over the past year the debate over physician-assisted death has been waged in several courts and legislatures, and before at least one electorate as well. Measure 16, the Oregon Death With Dignity initiative that would permit physician-assisted suicide in some circumstances, was approved by the electorate; but it remains on hold while a permanent injunction issued against it by a Federal judge is reviewed by the United States Court of Appeals. Another Federal court judge's decision that the Washington statute criminalizing (...) physician-assisted suicide was unconstitutional when applied to the case of a competent terminally ill patient in intractable pain, was reversed by a three judge panel of that same United States Court of Appeals. (shrink)

Most of us find the surgeon's surprise at this patient' request understandable, and it is hard to imagine any surgeon acceding to this patient's demand. On the other hand, the patient is right—the surgeon is denying his technical skill because his values are different from those of the patient, whose values the surgeon does not respect. The autonomy of the patient is being limited by the values of the doctor whose own interests, other than his interest in practicing medicine according (...) to his own ethical values, would remain unaffected by his decision to provide the service. (shrink)

Smokers impose a terrible cost on all of the rest of us. Those who choose to smoke are more likely than nonsmokers to suffer from cancer, heart disease, and a host of other diseases that require intensive and expensive medical intervention. Although they may suffer these diseases, we all pay for their habit through higher healthcare costs, which are reflected in higher insurance premiums, higher taxes, and fewer healthcare resources available for nonsmokers. It is simply unfair for smokers to impose (...) this cost on the rest of us; they should bear this self-induced cost themselves. (shrink)

While vaccination rates in the United States are high — generally over 90 percent — rates of exemptions have been going up, and preventable diseases coming back. Aside from their human cost and the financial cost of treatment imposed on those who become ill, outbreaks impose financial costs on an already burdened public health system, diverting resources from other areas. This article examines the financial costs of non-vaccination, showing how high they can be and what they include. It makes a (...) case for requiring those who do not vaccinate to cover the costs of outbreak caused by their choice. Such recouping is justified because the choice not to vaccinate can easily be seen as negligent. But even if it is not, that choice involves imposing costs on others, and there are good reasons to require the actors to internalize those costs. The article proposes alternative statutory and regulatory schemes to cover the costs imposed on the public purse, focusing on no-fault mechanisms. We consider both ex ante mechanisms like a tax or a fee that will go into a no-fault fund to cover the costs and ex post mechanisms like a statutory authorization for recoupment of those costs by health officials. (shrink)

The following description is based upon an actual case in which a patient initiated legal action after suffering a complication subsequent to an invasive diagnostic procedure performed by a senior fellow. Named as codefendants were the senior fellow, attending physician, and the hospital. Because any hospital with house staff is potentially vulnerable to similar litigation, Ethics Committees at Work is addressing the questions raised by this dilemma.

In recent papers [1997, in press] I have explored how two seemingly conflicting paradigms inform the conception and study of picture perception. The dominant paradigm, one especially favored by vision theorists, claims that seeing a pictorial representation of an object is, with qualifications, like seeing the object itself. The picture, being a geometrically sanctioned projection of its object, resembles it, or otherwise serves as a mimetic surrogate, “re-presenting” what it depicts [Danto, 1982]. Accordingly, pictorial representation is at its best when, (...) as in trompe l’oeil paintings, viewers can not tell the picture, the stand in or substitute, from the real thing. An alternative paradigm, the symbolic model, championed most forcefully by Nelson Goodman [1968], focuses attention on syntactic and semantic features of pictures. On this account, pictures are importantly allied with other forms of representation, including languages, maps, and music notation, and picture perception is to be understood in this context. (shrink)

In recent papers [1997, in press] I have explored how two seemingly conflicting paradigms inform the conception and study of picture perception. The dominant paradigm, one especially favored by vision theorists, claims that seeing a pictorial representation of an object is, with qualifications, like seeing the object itself. The picture, being a geometrically sanctioned projection of its object, resembles it, or otherwise serves as a mimetic surrogate, “re-presenting” what it depicts [Danto, 1982]. Accordingly, pictorial representation is at its best when, (...) as in trompe l’oeil paintings, viewers can not tell the picture, the stand in or substitute, from the real thing. An alternative paradigm, the symbolic model, championed most forcefully by Nelson Goodman [1968], focuses attention on syntactic and semantic features of pictures. On this account, pictures are importantly allied with other forms of representation, including languages, maps, and music notation, and picture perception is to be understood in this context. (shrink)

Written with the general reader in mind, this collection will prove useful by both scholar and student, and will lead the general reader to encounter one of the ...

Part I. An introduction to honor: introduction; honor and value; honor and identity -- Part II. External honor: prestige; shame; face; esteem; affiliated honor; glory -- Part III. Internal honor: honorableness; dignity -- Part IV. The politics of honor: rebellion and revolution; lessons from honor -- Appendix I: key concepts.

John Dewey's moral philosophy in contemporary perspective -- Consequentialism and its consequences -- The limited relevance of analytical ethics to the problems of bioethics -- The concept of corporate responsibility -- University neutrality and ROTC -- The philosophy of political realism in international affairs -- The challenge of nonviolence in the new world order -- St. Augustine and the just war theory -- War, power, and nonviolence -- Violence and nonviolence -- The morality of nonviolence -- Terrorism, violence, and nonviolence (...) -- Understanding evil from the perspective of nonviolence -- Jallianwala Bagh and the Boston tea party: -- Nonviolent roots of the Indian and American anti-imperialism -- Toward a nonviolent American revolution -- My (non-)teaching philosophy. (shrink)

The just war tradition stands as the moral and prudential alternative to both pacifism and realism. It forms the only reasonable ethical basis for the understanding of state initiated force. As applied to questions of nuclear deterrence, just war theory is incompatible with Mutual Assured Destruction and with the threat of MAD. Just war theory entails a move toward counterforce with discriminate targeting of military capabilities and away from city targeting. This is now becoming possible technically and is morally indicated. (...) The counterforce option is realistic in that nuclear disarmament is an extremely remote possibility and alternate strategies such as bluff ore not workable. A counterforce strategy would be both discriminate and proportional as well as being in accord with political realism. (shrink)

How do you decide what is ethically wrong and right? Few people make moral judgments by taking the theory first. Specifically written with the interests, needs, and experience of students in mind, this textbook approaches thinking ethically as you do in real life – by first encountering practical moral problems and then introducing theory to understand and integrate the issues. Built around engaging case studies from news media, court hearings, famous speeches and philosophical writings, each of the 15 chapters: - (...) explains and defines the moral problem dealt with - provides excerpts of readings on all sides of the issue - analyses the problem, using the relevant theory The examples are recognizable ethical problems, including judgments about racism and sexism, controversial debates such as assisted suicide and the death penalty, and contemporary concerns like privacy and technology, corporate responsibility, and the environment. The mission of the book is to assist you to engage in informed, independent, critical thinking and to enable you to enter into ethical discussions in the classroom and beyond. Supported by learning features, including study questions, key quotes, handy definitions and a companion website, this book is essential for any student of moral philosophy. (shrink)

Addressing both collegiate and professional sports, the updated edition of Fair Play explores the ethical presuppositions of competitive athletics and their ...

Addressing both collegiate and professional sports, the updated edition of Fair Play: The Ethics of Sport explores the ethical presuppositions of competitive athletics and their connection both to ethical theory and to concrete moral dilemmas that arise in actual athletic competition. This fourth edition has been updated with new examples, including a discussion of Spygate by the New England Patriots and recent discoveries on the use of performance enhancing drugs by top athletes. Two additional authors, Cesar R. Torres and Peter (...) F. Hager, bring to this edition a discussion of the moral issues involved in youth sports and the ethics of being a fan, as well as a fresh perspective on the theories of broad internalism and the quest for excellence. Furthermore, major criticisms of broad internalism by philosophers William J. Morgan and Scott Kretchmar add a new dimension to the discussion on the moral foundations of winning. (shrink)

Use of the concept of `areasonable person and his or her expectations'is widely found in legal reasoning. This legalconstruct is employed in the present article toexamine privacy questions associated withcontemporary information technology, especiallythe internet. In particular, reasonableexpectations of privacy while browsing theworld-wide-web and while sending and receivinge-mail are analyzed.

Contemporary scientific theories assume a primarily micro-deterministic view of nature. This paper explores the question of whether micro-determinism is incompatible with the alleged emergence of properties and laws that some biologists and philosophers assert occurs in various biological systems. I argue that a preferable unified treatment of these emergence claims takes properties, rather than laws, to be the units of emergence. Four distinct conceptions of emergence are explored and three shown to be compatible with micro-determinism. The remaining concept of emergence, (...) direct macro-determination, does not, I argue, meet the general requirement that an adequate scientific explanation provide a coherent mechanism or effective means of determination. (shrink)

Increasingly, US-sponsored research is carried out in developing countries, but how US Institutional Review Boards (IRBs) approach the challenges they then face is unclear.METHODS: I conducted in-depth interviews of about 2 hours each, with 46 IRB chairs, directors, administrators and members. I contacted the leadership of 60 IRBs in the United States (US) (every fourth one in the list of the top 240 institutions by National Institutes of Health (NIH) funding), and interviewed IRB leaders from 34 (55%).RESULTS: US IRBs face (...) ethical and logistical challenges in interpreting and applying principles and regulations in developing countries, given economic and health disparities, and limited contextual knowledge. These IRBs perceive wide variations in developing world IRBs/RECs' quality, resources and training; and health systems in some countries may have long-standing practices of corruption. These US IRBs often know little of local contexts, regulations and standards of care, and struggle with understandings of other cultures' differing views of autonomy, and risks and benefits of daily life. US IRBs thus face difficult decisions, including how to interpret principles, how much to pay subjects and how much sustainability to require from researchers. IRB responses and solutions include trying to maintain higher standards for developing world research, obtain cultural expertise, build IRB infrastructure abroad, communicate with foreign IRBs, and ‘negotiate’ for maximum benefits for participants and fearing ‘worst-case scenarios’.CONCLUSIONS: US and foreign IRBs confront a series of tensions and dilemmas in reviewing developing world research. These data have important implications for increased education of IRBs/RECs and researchers in the US and abroad, and for research and practice. (shrink)

The nature of measurement is a topic of central concern in the philosophy of science and, indeed, measurement is the essential link between science and mathematics. Professor Ellis's book, originally published in 1966, is the first general exposition of the philosophical and logical principles involved in measurement since N. R. Campbell's Principles of Measurement and Calculation, and P. W. Bridgman's Dimensional Analysis. Professor Ellis writes from an empiricist standpoint. His object is to distinguish and define the basic concepts in measurement, (...) for example: scale, quantity, unit. dimension, number and probability. He discusses the problem of classifying scales of measurement and the special logical problems associated with each kind of scale. A translation of mach's Critique on the Concept of Temperature, which gives his views on the nature of measurement more fully than in any of his other works, is given as an appendix. (shrink)

A standard objection to act utilitarian theories is that they are not helpful in deciding what it is morally permissible for us to do when we actually have to make a choice between alternatives. That is, such theories are worthless as decision procedures. A standard reply to this objection is that act utilitarian theories can be evaluated solely as theories about right-making characteristics and, when so evaluated, their inadequacy as decision procedures is irrelevant. Even if somewhat unappealing, this is an (...) effective reply to the standard objection. (shrink)

Advertisers often have been accused of using techniques which manipulate and control the behavior of consumers and hence violate their autonomy. Some of these techniques are puffery, subliminal advertising, and indirect information transfer. After examining both criticisms and defenses of such practices, this paper presents an analysis of four of the concepts involved in the debate — the concepts of autonomous desire, rational desire, free choice, and control. Applying the results to the case of advertising, it is shown that advertising (...) cannot be found guilty of intrinsically or frequently violating the consumer's autonomy in any of the relevant senses of this notion. (shrink)

The threat to the survival of humankind posed by nuclear weapons has been a frightening and essential focus of public debate for the last four decades and must continue to be so if we are to avoid destroying ourselves and the natural world around us. One unfortunate result of preoccupation with the nuclear threat, however, has been a new kind of "respectability" accorded to conventional war. In this radical and cogent argument for pacifism, Robert Holmes asserts that all war--not (...) just nuclear war--has become morally impermissible in the modern world. Addressing a wide audience of informed and concerned readers, he raises dramatic questions about the concepts of "political realism" and nuclear deterrence, makes a number of persuasive suggestions for nonviolent alternatives to war, and presents a rich panorama of thinking about war from St. Augustine to Reinhold Niebuhr and Herman Kahn. Holmes's positions are compellingly presented and will provoke discussion both among convinced pacifists and among those whom he calls "militarists." "Militarists," we realize after reading this book, include the majority of us who live a friendly and peaceful personal life while supporting a system which, if Holmes is correct, guarantees war and risks eventual human extinction. Originally published in 1989. The Princeton Legacy Library uses the latest print-on-demand technology to again make available previously out-of-print books from the distinguished backlist of Princeton University Press. These editions preserve the original texts of these important books while presenting them in durable paperback and hardcover editions. The goal of the Princeton Legacy Library is to vastly increase access to the rich scholarly heritage found in the thousands of books published by Princeton University Press since its founding in 1905. (shrink)