In the Gorgias, Socrates argues that just punishment, though painful, benefits the unjust person by removing injustice from her soul. This paper argues that Socrates thinks the true judge (i) will never use corporal punishment, because such procedures do not remove injustice from the soul; (ii) will use refutations and rebukes as punishments that reveal and focus attention on psychological disorder (= injustice); and (iii) will use confiscation, exile, and death to remove external goods that facilitate unjust action.

This Critical Guide offers detailed analysis of all parts of Plato's Gorgias, together with diverse perspectives on its advocacy of a philosophical, just life as against a life of rhetoric and injustice.

This book takes on two main tasks. The first is to argue that anti-hedonism lies at the center of Plato's critical project in both ethics and politics. Plato sees pleasure and pain as our sole sources of empirical evidence about good and bad. But as sources of evidence they are highly fallible; contrast effects with pain intensify certain pleasures, including most pleasures related to the body and social standing. This leads us to believe that the causes of such pleasures (e.g. (...) food, drink, sex, status) are greater goods than they are, and greater goods than other, more important goods (e.g. virtue, knowledge). As a result, hedonic error produces the belief that vice, including injustice, can be prudent. Hedonic error leads to other misconceptions of virtue as well, such as that wisdom is weak and can be ruled by the passions. These cognitive distortions can only be corrected by reference to some non-hedonic standard, so hedonists reliably fall prey to them. This entire system of attitudes—hedonism and its associated misconceptions of virtue—is widely held and constitutes popular morality. Popular morality's basic source is hedonic error, but it is also transmitted and sustained in society through shame and fear of punishment. However, avoiding shame and punishment requires a sort of double-think: adherents of popular morality must accept certain views that they cannot acknowledge too clearly or too publicly. For example, they must hold that injustice can be prudent and must be willing to wrong out-groups (e.g. another city), but openly acknowledging this same view threatens in-groups (one's own city) by implying willingness to wrong some in the city to benefit a closer in-group (e.g. one's class, clique, or family). // -/- The book's second task is to tackle a seeming outlier to Plato's anti-hedonism: the _Protagoras_, where Socrates appears to defend hedonism. I argue that the _Protagoras_ actually perfectly illustrates Plato's anti-hedonism, as explained above. Protagoras and other sophists think they shape public opinion, but in fact they have internalized popular morality through shame and fear. As a result, Protagoras accepts but refuses to openly endorse three parts of popular morality: that injustice can be prudent (333c), that pleasure is the good (351c-d), and that wisdom is weak and can be ruled by the passions (352c-d). Each time, his concealed view is (aptly!) attributed to "the many". So, when Socrates appears to endorse hedonism in the _Protagoras_, he actually introduces and develops the view as part of his examination of Protagoras' covert ethical commitments. (shrink)

This paper argues that Socrates does not claim to be a political expert at Gorgias 521d6-8, as many scholars say. Still, Socrates does claim a special grasp of true politics. His special grasp (i) results from divine dispensation; (ii) is coherent true belief about politics; and (iii) also is Socratic wisdom about his own epistemic shortcomings. This condition falls short of expertise in two ways: Socrates sometimes lacks fully determinate answers to political questions, and he does not grasp the first (...) principles of politics. (shrink)

This paper reads Republic 583b-608b as a single, continuous line of argument. First, Socrates distinguishes real from apparent pleasure and argues that justice is more pleasant than injustice. Next, he describes how pleasures nourish the soul. This line of argument continues into the second discussion of poetry: tragic pleasures are mixed pleasures in the soul that seem greater than they are; indulging them nourishes appetite and corrupts the soul. The paper argues that Plato has a novel account of the ‘paradox (...) of tragedy’, and that the Republic and Philebus contain complementary discussions of tragic and comic pleasure. (shrink)

Polus admires orators for the tyrannical power they have. However, Socrates argues that orators and tyrants lack power worth having: the ability to satisfy one's wishes or wants (boulēseis). He distinguishes wanting from thinking best, and grants that orators and tyrants do what they think best while denying that they do what they want. His account is often thought to involve two conflicting requirements: wants must be attributable to the wanter from their own perspective (to count as their desires), but (...) wants must also be directed at objects that are genuinely good (in order for failure to satisfy them to matter). We offer an account of wanting as reflective, coherent desire, which allows Socrates to satisfy both desiderata. We then explain why he thinks that orators and tyrants want to act justly, though they do greater injustices than anyone else and so frustrate their own wants more than anyone else. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Socratic Virtue: Making the Best of the Neither-Good-Nor-BadJ. Clerk ShawNaomi Reshotko. Socratic Virtue: Making the Best of the Neither-Good-Nor-Bad. Cambridge-New York: Cambridge University Press, 2006. Pp. xiv + 204. Cloth, $68.00.In this engaging and provocative book, Naomi Reshotko advances a naturalistic interpretation of Socratic philosophy, i.e., of those views expressed by Plato’s Socrates that best comport with Aristotle’s descriptions of Socrates. She contrasts her reading with those (...) that project foreign commitments onto the text, including: (i) moralism, or the separation of ethics from empirical science; (ii) two-dimensional semantics, or theories of meaning that distinguish the semantic contribution to a psychological state made by its subject’s conception of its objects from that made by its actual objects; and (iii) privileged access, or psychological theories that grant human beings incorrigibility concerning some aspect of their own psyches.Part I reviews and synthesizes views that the author shares with Terry Penner: that all desire is for one’s own real (not apparent) good, so that an agent’s belief about what is overall best for her invariably guides her actions; that all human virtue is identical to wisdom; and that virtue, so understood, guarantees the greatest possible satisfaction of the desire for one’s own real good, and so makes one live as well as possible.Part II places the distinction among the good, the bad, and the neither-good-nor-bad (NGNB) at the center of Socratic ethics. On Reshotko’s reading, the only goods are virtue and happiness, and the only bads vice and misery. She does not adequately explain why all actions are NGNB (16, 173), even though actions are individuated by their actual consequences (34–36), so that every action is either good or bad (98). Virtue’s goodness is due to its stable nomological (not conceptual or logical) connection to happiness. This makes virtue the only unconditional, other-generated good, while happiness is the only unconditional, self-generated good—its goodness does not depend on any nomological relation it enters into.Part III provides more detail about virtue and happiness. First, Reshotko explains that virtue is wisdom because it is the science of human happiness, and that this science is identical to every other science. Strictly speaking, nobody knows anything without knowing everything, although some people do grasp “some parts of knowledge” (160). Reshotko advocates this view as a solution to the closing puzzles of the Charmides. Socrates and Critias cannot figure out how temperance benefits, first because they assume that it is knowledge [End Page 132] of all things except good and bad, and then because they assume that it is knowledge of good and bad in isolation from other sciences (173a–175a). But if Socratic wisdom is the structured grasp of everything, then their puzzle is resolved. Second, Reshotko claims that happiness is a life maximally composed of pleasures. While she is sympathetic with the view that happiness is composed of modal pleasures (see G. Rudebusch, Socrates, Pleasure, and Value, Oxford 1999), she concludes that sensate pleasures can also be parts of happiness (185n7).The book’s major flaw is its limited engagement with textual evidence that seems to tell against the author’s readings and its limited coverage of alternative interpretations from the secondary literature. I mention three striking examples here.First, Reshotko argues that harming others is inconsistent with self-benefit because of the likelihood of reciprocal harm (65–71). She then notes passages where Socrates speaks as though harming others harms one’s soul simply by making it more unjust, which makes vice sound like a self-generated bad. Gorgias 472c–481b is particularly problematic in this respect, since Socrates claims there that doing injustice is less painful (but worse) than suffering it. Reshotko tries to make such passages conform with her initial explanation: harming others tends to entrench false beliefs that harming others is consistent with self-benefit, which leads to more harm of others and so more reciprocal harm (71–72, 174). This may be workable, but absent more extensive argument, it seems like an ad hoc maneuver.Second, Reshotko wants to avoid giving... (shrink)

In his exciting new book, Plato’s Anti-hedonism and the Protagoras, J. Clerk Shaw paints a masterful portrait of the Athenian majority, or “the many,” as portrayed by Plato not just in the Protagoras (as the title advertises), but throughout the Platonic corpus. Shaw offers an incisive diagnosis of popular “double-think,” which balances the incoherent complex of commitments to hedonism (the view the pleasure is the good), to the possibility of akrasia (weakness of will) and to the belief (...) that injustice is prudent, i.e. in one’s own self-interest to do. Shaw also puts the dialectical context of the Protagoras to good use in identifying the double-talk that Protagoras is forced into by his own conflicting claims and commitments. The central thesis I question is that the sophists have internalized the opinions of the many, thus absorbing conventional morality as their own as opposed to waking the tightrope of popular opinion. Certainly the sophists’ currency is the opinions of the many, reflecting their own views back to them, and this creates difficulties and tensions in their stances (not least because they are reflecting the incoherent double-think that Shaw so beautifully brings out). However, all this can be true independently of the possibility of the sophists’ actually internalizing the views of the many, i.e. without speculating about their psychology at all. I argue that this thesis of Shaw’s is not necessary for his core insights about the many, and (likewise) that we can resist two other interpretative moves he makes. Shaw’s readings of the Protagoras—of Socrates as committed to spirit (thumos), and of the argument that akrasia is ignorance and courage is wisdom as independent of the commitment to hedonis—reveal his sympathies for a so-called “unitarian” interpretation of Plato, which takes the corpus to provide a unified doctrine rather than reflecting the author’s intellectual development. Here too, I suggest, Shaw’s insights can be preserved without running afoul of this interpretive disagreement. (shrink)

Shaw introduces an important and compelling line of argumentation concerning the relationship between pleasure and the good into the literature on Plato’s dialogues with ramifications beyond any commitment that Plato has Socrates make to hedonism at Protagoras 351b–357e. To appreciate Shaw’s argument, the term ‘hedonism’ must be understood to indicate that the good is identical to bodily pleasure—not to both sensate and modal pleasure understood as a dichotomy, and not to all pleasures of the soul and body understood (...) as a blended, commensurable, spectrum. Chapter 1 characterizes hedonism in a narrower way.. (shrink)

Philosophy and Phenomenological Research, EarlyView.

The new western way of war from Vietnam in Iraq -- Theories of the new western way of war -- The global surveillance mode of warfare -- Rules of risk-transfer war -- Iraq: risk economy of a war -- A way of war in crisis.

This introduction provides brief outlines of the articles collected in this special issue of the International Journal of Philosophical Studies on the topic of Ethics and Emotions. It also announces the winners of the 2021 Robert Papazian and PERITIA prizes.

Background The ethical governance of Artificial Intelligence (AI) in health care and public health continues to be an urgent issue for attention in policy, research, and practice. In this paper we report on central themes related to challenges and strategies for promoting ethics in research involving AI in global health, arising from the Global Forum on Bioethics in Research (GFBR), held in Cape Town, South Africa in November 2022. Methods The GFBR is an annual meeting organized by the World Health (...) Organization and supported by the Wellcome Trust, the US National Institutes of Health, the UK Medical Research Council (MRC) and the South African MRC. The forum aims to bring together ethicists, researchers, policymakers, research ethics committee members and other actors to engage with challenges and opportunities specifically related to research ethics. In 2022 the focus of the GFBR was “Ethics of AI in Global Health Research”. The forum consisted of 6 case study presentations, 16 governance presentations, and a series of small group and large group discussions. A total of 87 participants attended the forum from 31 countries around the world, representing disciplines of bioethics, AI, health policy, health professional practice, research funding, and bioinformatics. In this paper, we highlight central insights arising from GFBR 2022. Results We describe the significance of four thematic insights arising from the forum: (1) Appropriateness of building AI, (2) Transferability of AI systems, (3) Accountability for AI decision-making and outcomes, and (4) Individual consent. We then describe eight recommendations for governance leaders to enhance the ethical governance of AI in global health research, addressing issues such as AI impact assessments, environmental values, and fair partnerships. Conclusions The 2022 Global Forum on Bioethics in Research illustrated several innovations in ethical governance of AI for global health research, as well as several areas in need of urgent attention internationally. This summary is intended to inform international and domestic efforts to strengthen research ethics and support the evolution of governance leadership to meet the demands of AI in global health research. (shrink)

Business education is at a critical juncture. How are we to justify the curriculum in undergraduate business awards in Aotearoa New Zealand? This essay suggests a philosophical framework for the analysis the business curriculum in Western countries. This framework helps us to see curriculum in a context of global academic communities and national needs. It situates the business degree in the essential tension which modernity (Western metaphysics) creates and which is expressed in an increasingly globalised economy. The tension is between (...) those who insist that the degree is to serve modernity and those who hope that it may contribute to a new era of justice and harmony with nature. One critical battle ground for the business curriculum is the subject Business Ethics. The business ethics curriculum often indicates the intention of the business ethics degree itself. Kant's distinction between heteronomy (rule following) and autonomy (making your own decisions) provides us with a means to judge the purposes of business ethics courses: there are courses which seek to produce reliable and compliant (heteronomous) employees, and there are those which seek to produce independent creative (autonomous) human beings. The question for this conference is: what do we as business educators see as our task? (shrink)

The effect of the rotating-wave approximation (RWA) on the coupling between an atom and the electromagnetic field is studied in the dipole approximation. It is demonstrated that use of the RWA results in an explicitly nonlocal interaction.

This thesis develops a hermeneutic philosophy of science to provide insights into physics education. -/- Modernity cloaks the authentic character of modern physics whenever discoveries entertain us or we judge theory by its use. Those who justify physics education through an appeal to its utility, or who reject truth as an aspect of physics, relativists and constructivists, misunderstand the nature of physics. Demonstrations, not experiments, reveal the essence of physics as two characteristic engagements with truth. First, truth in its guise (...) as correspondence enables a human being to prepare for the distinctive event of physics. -/- Second, the event of physics occurs in human perception when someone forces a hidden reality to disclose an aspect of itself. Thus, the ground of physics is our human involvement with reality achieved by way of truth. -/- To support this account of physics, the thesis reports phenomenological investigations into Isaac Newton’s involvement with optics and a secondary school physics laboratory. These involve interpretations of Heidegger’s theory of beings, schema and signification. The project draws upon, and contributes to, the hermeneutic phenomenology of modern physics, a tradition in continental philosophy that begins with Immanuel Kant, and advances particularly from Martin Heidegger to Patrick Heelan. -/- The thesis advocates an ontological pedagogy for modern physics which has as its purpose each individual student’s engagement with reality and truth. Students may achieve this through demonstrations of phenomena that will enable them to dwell with physics, an experience that contrasts with their embroilment in modernity, and which perpetuates nature’s own science. (shrink)

In this chapter I consider the narrow and wider benefits of permitting assisted dying in the specific context of organ donation and transplantation. In addition to the commonly used arguments, there are two other neglected reasons for permitting assisted suicide and/or euthanasia: assisted dying enables those who do not wish to remain alive to prolong the lives of those who do, and also allows many more people to fulfill their wish to donate organs after death. In the first part of (...) this chapter I explore the possibility of allowing those who die with assistance to donate their organs and the potential benefits of doing so in countries where some form of assisted dying is legal; in the second part I consider the added force that organ donation considerations bring to the argument in favour of legalizing assisted dying in countries where such practices remain forbidden. (shrink)

The nature and scope of jurisprudence -- Rights and justice -- Law and morality -- Classical and modern natural law -- Classical and modern legal positivism -- Legal realism -- Sociological jurisprudence -- Critical legal studies.

What is it about evil that we find so compelling? From our obsession with serial killers to violence in pop culture, we seem inescapably drawn to the stories of monstrous acts and the aberrant people who commit them. But evil, Dr. Julia Shaw argues, is largely subjective. What one may consider normal, like sex before marriage, eating meat, or working on Wall Street, others find abhorrent. And if evil is only in the eye of the beholder, can it be (...) said to exist at all? In [this book], Shaw uses an engrossing mix of science, popular culture, and real-life examples to break down timely and provocative issues. How similar is your brain to a psychopath's? How many people have murder fantasies? Can artificial intelligence be evil? Do your sexual proclivities make you a bad person? Who becomes a terrorist? If you could travel back in time, would you kill baby Hitler? In asking these questions, Shaw urges readers to discover empathy and to rethink and reshape what it means to be bad. [This book] is a wide-ranging exploration into a fascinating, darkly compelling subject from a wickedly smart and talented writer."--Dust jacket. (shrink)

Globalisation is widely understood as a set of processes driven by technological, economic and cultural change. Few have successfully defined the changing character and role of politics in global change. Political institutions such as the nation-state have been seen as undermined by globalisation, or needing to respond to it. This book clarifies the tensions which global change has provoked in our understanding of politics. Politics and Globalisation suggests that globalisation is a process which is politically contested and even politically constituted. (...) The volume presents five key intellectual and political contests in globalisation: · the extent and political significance of globalising changes in economy and society · how and how far the relations and forms of nation-state organisation are transformed · whether the given concepts and methods of political science as a discipline can be applied to global and regional politics, and whether they require radical reformulation; · the role and significance of ethical questions in global change · whether global change is constituted by, or denies, radical political agency. (shrink)

The poetry of Walt Whitman, whose Leaves of Grass was called ôthe secular Scripture of the United Statesö by literary critic Harold Bloom, is a sublime source of contemporary inspiration.

COVID-19 has truly affected most of the world over the past many months, perhaps more than any other event in recent history. In the wake of this pandemic are patients, family members, and various types of care providers, all of whom share different levels of moral distress. Moral conflict occurs in disputes when individuals or groups have differences over, or are unable to translate to each other, deeply held beliefs, knowledge, and values. Such conflicts can seriously affect healthcare providers and (...) cause distress during disastrous situations such as pandemics when medical and human resources are stretched to the point of exhaustion. In the current pandemic, most hospitals and healthcare institutions in the United States have not allowed visitors to come to the hospitals to see their family or loved ones, even when the patient is dying. The moral conflict and moral distress among care providers when they see their patients dying alone can be unbearable and lead to ongoing grief and sadness. This paper will explore the concepts of moral distress and conflict among hospital staff and how a system-wide provider wellness programme can make a difference in healing and health. (shrink)

`This book grew out of the conviction, not in itself strange or startling, that the ordinary person can and should think straight rather than crooked.' Patrick Shaw has written a commonsense introduction to the use of logic in everyday thought and argument. It explains some of the rules of good argument and some of the ways in which arguments can fail, drawing illustrations from a variety of contemporary and international sources, such as the press, radio, and television. Symbols and (...) technicalities are kept to a minimum in this thorough and provocative investigation of the rational approach to thought - and its limitations. Logic and Its Limits emphasizes the use of logic in helping to settle and clarify disputes. It will help the reader to avoid bad arguments, to detect them in others, and so to think and argue more effectively. A wide range of thought-provoking examples and exercises concerned with contemporary social and political issues make this a readable and stimulating guide for the student and general reader alike. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Aristotle on the Sources of the Ethical Life by Sylvia BerrymanElizabeth C. Shaw and Staff*BERRYMAN, Sylvia. Aristotle on the Sources of the Ethical Life. Oxford: Oxford University Press, 2019. vii + 220 pp. Cloth, $70.00—Berryman’s goals in Aristotle on the Sources of the Ethical Life are threefold: to establish that Aristotle practiced what contemporary philosophers call metaethics; to refute the idea that Aristotle justified those ethics by (...) recourse to human nature, understood as an “external point” for “establishing substantial ethical truths from a value-neutral perspective”; and to demonstrate that, for Aristotle, the source and justification for ethical demands is human practical reason.Locating the source of normativity in practical reason does not mean that there are no “standards of truth other than human beings as a species.” Positioning Aristotle against both “Archimedean” naturalisms as well as relativisms and subjectivisms, Berryman sees Aristotle’s appeals to nature as delimiting “the kinds of normative positions that could guide practical reason,” and practical reason as responsive to biological constraints. Still, nature is no fulcrum. It does not mandate the contents of the life we should live. All of this together makes Berryman’s Aristotle a “constitutive constructivist,” which is to say, a nonskeptical, cognitivist nonfoundationalist.Chapter 1’s “Introduction” sets the stage for the book’s metaethical project. Chapters 2 and 3 argue against two versions of the claim that “Aristotle was not reflective on the sources and justifications for his ethical views.” Chapter 2 places “Aristotle in the Ethics Wars” of the twentieth and twenty-first centuries, challenging the historicist view that “the kind of metaethical reflection about the sources of normativity” that preoccupies modern philosophy in response to “‘disenchantment’ of the modern world picture” would not have been available to Aristotle. Chapter 3, “Nature and the Sources of Normativity,” positions itself against scholars who maintain that Aristotle was complacent about the values of his own society and/or “too philosophically naïve to even reflect on the sources and justifications of ethical claims.” Inhabiting Aristotle’s social and intellectual milieu, it shows how the epistemological questions, commitments to materialist-scientific worldviews, as well as challenges to divine authority posed by fifth-century sophists, Plato, and fourth-century [End Page 381] hedonists meant that “a philosopher in Aristotle’s position could hardly avoid being reflective on questions of the status of ethics.”After establishing in chapter 3 that Aristotle could have grounded ethical claims in his natural philosophy, chapters 4 through 6 make the case that he did not. Exploring the philosophical work done by Aristotle’s appeals to nature, chapter 4, “Is Aristotle an Archimedean Naturalist?”, focuses on the apparent directionality of human development as well as references to “natural justice” and “natural virtue” in Aristotle’s ethical writings, while chapter 5, “Naturalism in Aristotle’s Politics,” scrutinizes the “naturalness of the polis” and “natural slavery” in Politics 1. Finding “only very minimal appeal to human nature” in the ethical treatises, Berryman sees Aristotle’s recourse to nature in Politics 1 as “the main anomaly” for which her refutation of Archimedean naturalism must account. Based on internal evidence in the Politics and comparison with Aristotle’s biological writings, Berryman concludes that Aristotle wrote the Politics before he “developed his more detailed biological theories.” Rather than evidence of naturalism, Aristotle’s appeals to nature in Politics 1, Berryman argues, are an early reflection of the “nomos-phusis distinction found in sophistic controversies” and a “kind of rhetorical move” based on thorough “prejudice and not reasoned inference.” Concluding “The Case Against a Naturalist Reading,” chapter 6 sets the stage for Berryman’s resourcing of Aristotle’s metaethics away from nature by exploring the inadequacies of the instrumental and theoretical rule-guiding reasoning implicit in naturalist accounts of Aristotelian practical reason.Chapters 7 and 8 offer the book’s positive account. After elaborating Aristotle’s rejection of “metaphysical abstractions” as action-guiding, chapter 7, “Aristotle’s Metaethics,” recovers from the Eudemian Ethics human agency as the source of normativity in Aristotle. Action “carries with it an implicit commitment to the norms of practical reasoning,” and “Aristotle’s insight,” Berryman writes, “is the metaethical recognition that the practical... (shrink)

This chapter discusses whether patients should face penalties for unhealthy lifestyle choices. The idea that people should be held responsible for their bad health decisions is often associated with “luck egalitarianism”. This chapter explains the connection between responsibility-sensitive health care policies and luck egalitarianism and outlines some criticisms that have been made of luck egalitarianism in this context. It then highlights the implications of moral responsibility scepticism for luck egalitarians and other proponents of similarly responsibility-sensitive approaches to health care. Theorists (...) who have discussed the practical implications of moral responsibility scepticism have focused primarily on criminal punishment and, in that context, have often invoked an epistemic argument, maintaining that there are at least serious doubts about whether people are morally responsible (in the sense required for retributive punishment) and that, in view of this uncertainty, retributive punishment is unjust, given the serious harm it inflicts on offenders. This chapter argues that this type of reasoning also implies that we should not take patients’ responsibility for their poor health into account when deciding whether to give these patients treatments and that the health system should not impose significant penalties on individuals for harming their own health. Culpability-based desert seems to stand a better chance of helping luck egalitarians (and others with related views) to justify responsibility-sensitive health care policies compared with some alternative approaches. However, this chapter casts doubt on the idea that responsibility-sensitive health care policies based on this kind of desert are justifiable, focusing on doubts about whether people are morally responsible for harming their own health, whether harming one’s own health is morally wrong, and whether significant penalties for harming one’s health would be proportionate. (shrink)

Applications of artificial intelligence/machine learning in health care are dynamic and rapidly growing. One strategy for anticipating and addressing ethical challenges related to AI/ml for health care is patient and public involvement in the design of those technologies – often referred to as ‘co-design’. Co-design has a diverse intellectual and practical history, however, and has been conceptualized in many different ways. Moreover, AI/ml introduces challenges to co-design that are often underappreciated. Informed by perspectives from critical data studies and critical digital (...) health studies, we review the research literature on involvement in health care, and involvement in design, and examine the extent to which co-design as commonly conceptualized is capable of addressing the range of normative issues raised by AI/ml for health care. We suggest that AI/ml technologies have amplified and modified existing challenges related to patient and public involvement, and created entirely new challenges. We outline three pitfalls associated with co-design for ethical AI/ml for health care and conclude with suggestions for addressing these practical and conceptual challenges. (shrink)

ABSTRACT In recent decades poverty has been defined as a relative rather than absolute notion. Those in poverty have been seen as poor relative to a level of income, or social condition, accepted as average or normal for a society. Poverty has been redefined as ‘relative deprivation’. This paper argues, first, that the redefinition of poverty as relative to social norms is a radical departure from the traditional notion of poverty. Secondly, it considers whether such a redefinition gives support to (...) the view that the claims of those in poverty (relative) may be considered as morally equivalent to the claims of those in poverty (absolute). The paper concludes by arguing that the notion of relative poverty is advanced to give support to social and economic policies whose primary aim is equality rather than the relief of poverty. (shrink)

Doctors and dentists have traditionally used antibiotic prophylaxis in certain patient groups in order to prevent infective endocarditis (IE). New guidelines, however, suggest that the risk to patients from using antibiotics is higher than the risk from IE. This paper analyses the relative risks of prescribing and not prescribing antibiotic prophylaxis against the background of Pascal’s Wager, the infamous assertion that it is better to believe in God regardless of evidence, because of the prospective benefits should He exist. Many doctors (...) seem to believe the parallel proposition that it is better to prescribe antibiotics, regardless of evidence, because of the prospective benefit conferred upon the patient. This has been called the “no lose philosophy” in medicine: better safe than sorry, even if the evidence inconveniently suggests that following this mantra is potentially more likely to result in sorry than safe. It transpires that, just as Pascal’s Wager fails to convince because of a lack of evidence to support it and the costs incurred by trying to believe, so the “belts and braces” approach of prescribing antibiotic prophylaxis is unjustifiable given the actual evidence of potential risk and benefit to the patient. Ultimately, there is no no-lose if your clinical decisions, like Pascal’s Wager, are based on faith rather than evidence. (shrink)

The series of 'trolley' examples issue a challenge to moral principles based on intentions, since it seems that these give the wrong answers in two important cases: 'Fat Man', where they seem to say that it is permissible to push someone in front of a trolley to save others, and 'Loop', where they seem to say that it is wrong to divert a trolley towards a single person whose body will stop it and save others. I reply, first, that there (...) is a parallel between the wrongful intention to mutilate in 'Transplant', where one person's vital organs are removed to save others' lives, and the intention to assault in Fat Man. Secondly, I defend Frances Kamm's view that in Loop one can divert the trolley towards the one without an intention to kill or assault, since good potential side-effects can be taken into account in deciding what to do, without their becoming intentions. (shrink)

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

The validity of the double effect doctrine is examined in euthanasia and abortion. In these two situations killing is a method of treatment. It is argued that the doctrine cannot apply to the care of the dying. Firstly, doctors are obliged to harm patients in order to do good to them. Secondly, patients should make their own value judgments about being mutilated or killed. Thirdly, there is little intuitive moral difference between direct and indirect killing. Nor can the doctrine apply (...) to abortion. Doctors kill fetuses as a means of treating the mother. They also kill them as an inevitable side effect of other treatment. Drawing a moral distinction between the direct and the indirect killing gives counterintuitive results. It is suggested that pragmatic rules, not ethics, govern practices around euthanasia and cause it to be more restricted than abortion. (shrink)