The article propounds a justification of public health interventionism grounded on personal health as an intermediate human end in the ethical domain, on an interpretation of Aristotle. This goes beyond the position taken by some liberals that health should be understood as a prudential good alone. A second, but independent, argument is advanced in the domain of the political, namely, that population health can be justified as a political value in its own right as a primary social good, following an (...) interpretation of John Rawls’s evolved understanding of such goods in his later works. The article sets the scene for these positions by highlighting how liberal theories focusing on freedom as non-interference, or making the harm principle the basis of legitimate public health interventions, undercut the capacity of the state to actively promote population health. The article points to theoretical resources on legitimacy and liberty—the ‘salient coordinator account’ of authority and freedom as non-domination—that may help avoid this risk. The role of reflective equilibrium incorporating incompletely theorized mid-level principles is emphasized to ensure that interventions are soundly justified. The application of these principles would ensure that interventions do not exceed the proper moral/political boundaries limiting the role of government. (shrink)

The aim of this article is to review the recent popularity of casuistry as a model of moral inquiry. I argue that proponents of casuistry do not endorse the particularist epistemology that seems to be implied by their position, and that this is why casuistry does not seem to present something really new in comparison to 'top-down' generalist approaches. I contend that casuistry should develop itself as a (moderately) particularist position and that the challenge for the defender of casuistry is (...) to come up with ideas that strengthen the ('intuitionist') model of rationality that underlies most forms of particularism. (shrink)

ABSTRACTGiven its intimate relationship with the human body and its environment, biotechnology innovation, and more particularly stem cell research innovations as a part thereof, implicate diverse social and moral/ethical issues. This paper explores some of the most important and controversial moral concerns raised by human embryonic stem cell research , focusing on concerns relating to the wellbeing of the embryo and the wellbeing of society . It then considers how and whether these concerns are dealt with in regulatory instruments in (...) Argentina, a southern developing country, examining in particular whether the values underlying these concerns have been translated into practical and effective rules reflective of the primary moral positions advanced. It concludes that Argentina's current state of stem cell research governance fails to consistently reflect the moral positions that have formed and is inadequate given Argentina's activity in this field. (shrink)

ABSTRACT In this paper I attempt to show that our commonly shared ideas of justice, which include principles of fair distribution and of compensation for past injustices, tend to come into conflict in practice, and generate serious dilemmas for persons in certain positions of authority, such as managers. I identify the source and nature of such dilemmas, and sketch a rough pattern for analysing and partially resolving conflicts between the duty not to discriminate unfairly and the duty to compensate for (...) past unfair discrimination. After stating what I regard as widely shared ideas of justice, I emphasise their application to actual policy decisions of the small‐scale sort, using general precepts for avoiding or minimising conflicts. The precepts include a commitment to the priority of compensatory justice. The paper includes theoretical portions, principally defences of my position against other views on the relationship between compensation and fair distribution. I end with an examination of the virtues and limitations of money as a tool for compensatory social policies. (shrink)

This paper challenges the traditional assumption that descriptive and prescriptive sciences are essentially distinct by presenting a study on the implicit normativity of the production and presentation of biomedical scientific facts within evidence-based medicine. This interdisciplinary study serves as an illustration of the potential worth of the concept of implicit normativity for bioethics in general and for integrated empirical ethics research in particular. It demonstrates how both the production and presentation of scientific information in an evidence-based decision-support contain implicit presuppositions (...) and values, which pre-structure the moral environment of the clinical process of decision-making. As a consequence, the evidence-based decision support did not only support the clinical decision-making process; it also transformed it in a morally significant way. This phenomenon undermines the assumption within much of the literature on patient autonomy that information disclosure is a conditional requirement before patient autonomy even starts; patient autonomy is already influenced during the production and presentation of information. These results imply an increased responsibility of those who produce and present evidence-based facts(i.e. scientists in general and physicians in particular). The insights of this study not only involve a different focus on both theory and practice of patient autonomy and informed consent, but they also call for a broader scope of morality than does traditional empirical research in bioethics. The concept of implicit normativity within integrated empirical ethics research calls for a strong cooperation between bioethicists and descriptive scientists, i.e., a cooperation that goes beyond the discipline-specific epistemic values and that takes place during all phases of the research process. (shrink)

The dominant approach to the analysis of issues in business ethics consists in the articulation and use of a set of mid-level moral principles. This approach is geared to business practitioners who are not interested in the difficult problems of moral and political theory. I argue that this "practitioner model" is philosophically suspect. I show how the theoretical frameworks prominent business ethicists employ are insufficiently developed. I also show how many of their analyses presuppose substantive views about issues of social (...) justice which they rarely defend or acknowledge. Since no neutral position on these issues is available, I argue that the only alternative is to address the problems such issue's raise for the analysis of institutions and the conduct of persons acting under those institutions. I offer suggestions about how we can develop a more philosophically defensible approach to business ethics. (shrink)

Applied ethics is at a watershed. In all its domains a gulf between the theory of applied ethics and the practice of applied ethics is now being recognized. In medical ethics, for example, it has been observed that “practicing clinicians often feel let down by bioethics.” The disappointment of clinicians is attributed in part to their own unrealistic expectations but is also said to be a function ofthe extent to which bioethics as a discipline doesn't seem to be in possession (...) of the realities of practice. Bioethicists tend to leave the “facts” of clinical medicine to the doctors; their task is then to apply elegant and compelling arguments drawn from first principles of ethics … to these undisputed and indisputable facts. Unfortunately, when the relationship between clinical medicine and bioethics is conceived … [in this way], the result is a very sterile discourse. (shrink)

The topic of Chief Executive Officer (CEO) compensation has been a focus of interest for many years. The purpose of this article is to explore the ethical dimensions of various generally accepted theories of CEO renumeration. We argue that a contractarian approach, based on the Kantian ethical framework, can be used to augment the existing contingent pay models.While the neoclassical economic model of the firm views the maximization of the shareholders'' wealth as the sole responsibility of top management, a contractarian (...) approach regards the balancing of various stakeholders'' interests as the primary task of top management. Ethical problems emerge when there are divergent, yet equally justifiable interests which compete in order to channel organizational resources to meet their own needs. In this situation, given the inherent ambiguities and ever present possibilities of multiple perspectives, it may not always be feasible to provide a categorical answer to the question of whether the CEO''s decisions are ethical. We suggest that a broad interpretation of the neoclassical theory of the firm, one that is grounded in Kantian and contractarian ethics, can serve as a basis for a reconciliation of different theories of executive compensation. (shrink)

Linking abstract principles and concrete cases is not always easy. Beginning deductively with ethical theory requires an a priori choice of ethical principles which, when applied, may not take account of the complexity of real problems. But beginning with cases can result in a situationalism in which the normative role of ethical principles is slighted. Casuistry, a case-centered methodology, offers one way to bridge this gap. Casuistry's bottom-up strategy develops policy guidelines out of case analysis, building a middle ground between (...) practice and principle. This article identifies the key features of casuistry and its link to ethical theory. The development of a code of ethics and the use of anonymous sources at a daily newspaper test casuistry's relevance for journalism ethics. (shrink)

Ethicists differ considerably in their reasons for using empirical data. This paper presents a brief overview of four traditional approaches to the use of empirical data: “the prescriptive applied ethicists,” “the theorists,” “the critical applied ethicists,” and “the particularists.” The main aim of this paper is to introduce a fifth approach of more recent date (i.e. “integrated empirical ethics”) and to offer some methodological directives for research in integrated empirical ethics. All five approaches are presented in a table for heuristic (...) purposes. The table consists of eight columns: “view on distinction descriptive-prescriptive sciences,” “location of moral authority,” “central goal(s),” “types of normativity,” “use of empirical data,” “method,” “interaction empirical data and moral theory,” and “cooperation with descriptive sciences.” Ethicists can use the table in order to identify their own approach. Reflection on these issues prior to starting research in empirical ethics should lead to harmonization of the different scientific disciplines and effective planning of the final research design. Integrated empirical ethics (IEE) refers to studies in which ethicists and descriptive scientists cooperate together continuously and intensively. Both disciplines try to integrate moral theory and empirical data in order to reach a normative conclusion with respect to a specific social practice. IEE is not wholly prescriptive or wholly descriptive since IEE assumes an interdepence between facts and values and between the empirical and the normative. The paper ends with three suggestions for consideration on some of the future challenges of integrated empirical ethics. (shrink)

Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...) emerged to deal with dynamic processes of practice improvement. An example is responsive evaluation. In this article we investigate the relationship between moral deliberation and responsive evaluation, describe their common basis in dialogical ethics and pragmatic hermeneutics, and explore the relevance of both for improving the quality of care. The synergy between the approaches is illustrated by a case example in which both play a distinct and complementary role. It concerns the implementation of quality criteria for coercion in Dutch psychiatry. (shrink)

The aim of this paper is to offer some philosophical remarks concerning the concept of moral application in applied ethics. In doing so, I argue in favour of a philosophical approach towards applied ethics as a unitary form of moral experience. In fact every form of applied ethics, no matter how specific, moves from a problem of application and tries to fill a gap between moral theory and practice. This essential unity of applied ethics as a moral phenomenon is of (...) great philosophical interest, since it belongs to the core problem from which moral thinking itself originates. For this reason, what applied ethics may reveal to a philosophical inquiry could provide valuable insight into the nature of moral experience itself. This is why it is important to reflect on what applied ethics is and whether the way in which application is usually framed be ts the properties of moral experience or not. In the first section I submit some preliminary remarks concerning the theoretical requirements to any philosophical approach to applied ethics. In the second section I present how application is commonly understood in the applied ethics debate by discussing the deductive and the procedural models of application. Both models, however, draw upon a technological conception of application which fails to t the structure of moral experience. Finally, I brie y sketch out the main features and the future tasks of what seems to me to be the most promising approach to the issue, i.e., the hermeneutic concept of application. (shrink)