Stem cell research. Drug company influence. Abortion. Contraception. Long-term and end-of-life care. Human participants research. Informed consent. The list of ethical issues in science, medicine, and public health is long and continually growing. These complex issues pose a daunting task for professionals in the expanding field of bioethics. But what of the practice of bioethics itself? What issues do ethicists and bioethicists confront in their efforts to facilitate sound moral reasoning and judgment in a variety of venues? Are those immersed (...) in the field capable of making the right decisions? How and why do they face moral challenge -- and even compromise -- as ethicists? What values should guide them? In The Ethics of Bioethics, Lisa A. Eckenwiler and Felicia G. Cohn tackle these questions head on, bringing together notable medical ethicists and people outside the discipline to discuss common criticisms, the field's inherent tensions, and efforts to assign values and assess success. Through twenty-five lively essays examining the field's history and trends, shortcomings and strengths, and the political and policy interplay within the bioethical realm, this comprehensive book begins a much-needed critical and constructive discussion of the moral landscape of bioethics. (shrink)

In this issue, Ellen Fox and colleagues report on their national study on ethics consultation in U.S. hospitals, following up on the previous 1999–2000 landmark study. Th...

Volume 20, Issue 3, March 2020, Page 1-5.

Terminally ill elderly and long-term disabled persons under our system of health care are eligible for Medicare and may qualify for the hospice care benefit. Despite such provisions, research shows that individuals still frequently do not receive the health care they need. But, as inadequate as end-of-life care can be for the general population, these inadequacies are exacerbated for individuals incarcerated in U.S. prisons and jails. Although inmates are guaranteed a basic level of health care under the Eighth Amendment and (...) Due Process Clause, they lack the mobility or freedom to choose their health care coverage, and they are dependent on an institutional system for such care. Inside prison, security and access issues affect the care inmates receive. Further, the availability of adequate clinical resources, especially for high-cost procedures, may be problematic in some jurisdictions.In addition to the practical, institutional, and legal barriers to providing and improving general end-of-life care, efforts to improve end-of-life care for prisoners may also encounter a lack of public sympathy. (shrink)

Terminally ill elderly and long-term disabled persons under our system of health care are eligible for Medicare and may qualify for the hospice care benefit. Despite such provisions, research shows that individuals still frequently do not receive the health care they need. But, as inadequate as end-of-life care can be for the general population, these inadequacies are exacerbated for individuals incarcerated in U.S. prisons and jails. Although inmates are guaranteed a basic level of health care under the Eighth Amendment and (...) Due Process Clause, they lack the mobility or freedom to choose their health care coverage, and they are dependent on an institutional system for such care. Inside prison, security and access issues affect the care inmates receive. Further, the availability of adequate clinical resources, especially for high-cost procedures, may be problematic in some jurisdictions.In addition to the practical, institutional, and legal barriers to providing and improving general end-of-life care, efforts to improve end-of-life care for prisoners may also encounter a lack of public sympathy. (shrink)

Although clinical ethics consultation is a high-stakes endeavor with an increasing prominence in health care systems, progress in developing standards for quality is challenging. In this article, we describe the results of a pilot project utilizing portfolios as an evaluation tool. We found that this approach is feasible and resulted in a reasonably wide distribution of scores among the 23 submitted portfolios that we evaluated. We discuss limitations and implications of these results, and suggest that this is a significant step (...) on the pathway to an eventual certification process for clinical ethics consultants. (shrink)

Clinical ethics consultation is largely outside the scope of regulation and oversight, despite its importance. For decades, the bioethics community has been unable to reach a consensus on whether there should be accountability in this work, as there is for other clinical activities that influence the care of patients. The American Society for Bioethics and Humanities, the primary society of bioethicists and scholars in the medical humanities and the organizational home for individuals who perform CEC in the United States, has (...) initiated a two‐step quality attestation process as a means to assess clinical ethics consultants and help identify individuals who are qualified to perform this role. This article describes the process. (shrink)

Lisa A. Eckenwiler and Felicia G. Cohn, The ethics of bioethics: Mapping the moral landscape, Baltimore: The Johns Hopkins University Press, 2009, reviewed by Carolyn Ells.

This article reviews the history of medical and research abuses experienced by American Indians since European colonization. This article examines the unethical research of American Indians/Alaska Natives in light of the Tuskegee Study of Untreated Syphilis in the Negro Male. Literature citations indicate that significant unethical research and medical care incidents occurred both before and after the Tuskegee Syphilis Study among American Indians/Alaska Natives. The majority of these unethical abuses were committed by the federal government and within the historical context (...) of a long-term contentious relationship between American Indians and the federal government. Although President Clinton issued a highly visible public apology to the African American survivors of the Tuskegee syphilis experiment in 1997, American Indians have yet to experience such visible federal acknowledgment. To ensure ethical research in which benefits outweigh risks and findings are not value-laden or misrepresented, tribes have instituted their own Institutional Review Boards coupled with community-participatory activities. (shrink)

Reproduktion des Originals: Führende Denker von Jonas Cohn.

t. 7. Die philosophie im Zeitalter des Spezialismus (Nachkantische philosophie, Zweite hälfte) von Jonas Cohn.

Ce livre prend position sur les enjeux et les visées des oeuvres d'art en matière de vérité et de morale : il répond, par un retour sur l'époque des Lumières, aux questions contemporaines sur l'idée d'un perfectionnement moral de l'individu (S. Cavell, M. Nussbaum, S. Laugier). Car les Lumières ont remis au coeur de la création artistique les émotions, les affects et les sentiments, mues par la conviction de l'efficacité d'une éducation esthétique de l'homme, d'une éducation sensible par le sensible, (...) en l'occurrence par les oeuvres. La vérité a-t-elle un sens en matière artistique? Notre besoin d'art est-il lié à notre conviction qu'elles nous rendent meilleurs et nous font mieux connaître le monde? L'autonomie de l'oeuvre, la liberté du créateur, la dévaluation de tout canon au nom d'un global turn qui contraint au relativisme rendent aujourd'hui difficile l'affirmation d'une vérité. (shrink)

Number terms and quantifiers share a range of linguistic (syntactic, semantic, and pragmatic) properties. On the basis of these similarities, one might expect these 2 classes of linguistic expression to pose similar problems to children acquiring language. We report here the results of an experiment that explicitly compared the acquisition of numerical expressions (two, four) and quantificational (some, all) expressions in younger and older 3-year-olds. Each group showed adult-like preferences for “exact” interpretations when evaluating number terms; however they did not (...) use the corresponding upper bounded interpretation when evaluating the quantifier some. Apparently, children follow different procedures for learning and evaluating numerals and quantifiers. These findings have implications for theories of number representation in child and adult grammars. (shrink)

There is a global shortage of nurses that affects healthcare delivery, which will be exacerbated with the increasing demand for healthcare professionals by the aging population. The growing shortage requires an ethical exploration on the issue of nurse migration. In this article, we discuss how migration respects the autonomy of nurses, increases cultural diversity, and leads to improved patient satisfaction and health outcomes. We also discuss the potential for negative impacts on public health infrastructures, lack of respect for cultural diversity, (...) and ethical concerns related to autonomy and justice, including coercion and discrimination. This analysis is written from a rights-based ethics approach by referring to rights held by nurses and patient populations. Nurse migration highlights conflicts between nurses and between nurses and healthcare systems. Increased awareness of ethical challenges surrounding nurse migration must be addressed to enhance the well-being of nurses and patient populations. (shrink)

I am indebted to many people, especially Dorsey Armstrong, Shannon French, and Kenneth Hodges, for helpful discussions of this material. An early version of this essay was read at the Thirty-Sixth International Congress on Medieval Studies.This essay is dedicated to the glorious memory of Nina Lindsey.

What does it mean to know who you are? Is it a matter of knowing your name? The things that you’ve done? The people you love? Such indispensible knowledge is somehow not enough; I can know all of these things, and still feel puzzled about who I am. “I am not the person I once was,” “I am not myself today,” and “I am learning who I am,” are all commonplace poems of a kind: expressive sentences completely at home both (...) in literature and ordinary life. Such a poem is the sentence “I know who I am.” This last is one of the many grand and emblematic boasts of Miguel de Cervantes’s hilariously self-fashioned knight, Don Quixote de la Mancha, a boast that can seem both impossible and yet utterly sensible, part quixotic and... (shrink)

A common contention of literary criticism is that literary forms can express, reflect, shape, represent or otherwise give form to human life. Literature can seem to offer the same idea as a promise of life’s meaningfulness; where expressive form is powerful, life need not be empty. Can literary forms give form to human life? I will argue for one sense in which this is true. As will become clear, at stake in this inquiry is not simply an idea about the (...) meaningfulness of literature’s poetry, but a way of answering the question of what it means to be human. (shrink)

En danse comme dans les autres arts – même en science – écrit Hélène Marquié, le premier pas pour les études de genre est de donner de la visibilité aux femmes dans l’archive historique afin de reconstruire une histoire « mixte » (p. 218). L’auteure explique que c’est seulement avec les rapports de 2006 et de 2009 sur « l’accès égal » des hommes et des femmes aux performances et aux structures chorégraphiques que le féminisme à tonalité politique a commencé (...) à s’implanter dans la danse françai... (shrink)

Nurses have traditionally been regarded as clinicians that deliver compassionate, safe, and empathetic health care (Nurses again outpace other professions for honesty & ethics, 2018). Caring is a fundamental characteristic, expectation, and moral obligation of the nursing and caregiving professions (Nursing: Scope and standards of practice, American Nurses Association, Silver Spring, MD, 2015). Along with caring, nurses are expected to undertake ever‐expanding duties and complex tasks. In part because of the growing physical, intellectual and emotional demandingness, of nursing as well (...) as technological advances, artificial intelligence (AI) and AI care robots are rapidly changing the healthcare landscape. As technology becomes more advanced, efficient, and economical, opportunities and pressure to introduce AI into nursing care will only increase. In the first part of the article, we review recent and existing applications of AI in nursing and speculate on future use. Second, situate our project within the recent literature on the ethics of nursing and AI. Third, we explore three dominant theories of caring and the two paradigmatic expressions of caring (touch and presence) and conclude that AI—at least for the foreseeable future—is incapable of caring in the sense central to nursing and caregiving ethics. We conclude that for AI to be implemented ethically, it cannot transgress the core values of nursing, usurp aspects of caring that can only meaningfully be carried out by human beings, and it must support, open, or improve opportunities for nurses to provide the uniquely human aspects of care. (shrink)

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