Knowledge about human wellbeing is a central part of ethical knowledge. But it is a neglected topic not only in ethics in general, but also in wellbeing theorizing, which has focused on enumerating the basic elements of wellbeing rather than on how to gauge, foster and maintain wellbeing in actual human lives. I consider the prospects for a procedural approach to wellbeing that sees it as depending on a process of continual adjustment between values, preferences, actions and (...) emotions. The value-fulfilment theory of Valerie Tiberius provides a model for such an approach, but needs to be corrected and supplemented in certain respects. I propose a version of the approach that is only partly, but still significantly procedural, and which does not privilege higher-order mental states. Considering the relevance of such an approach for ethics, I finally suggest that (certain forms of) moral agency may be best analyzed as an intersubjective process of adjustment and fulfilment of values and desires (etc.), and as a process of acquiring and exercising collective moral knowing how. (shrink)

The author begins with an outline of Bernard William's moral philosophy, within which he locates William's notorious doctrine that reflection can destroy ethical knowledge. He then gives a partial defence of this doctrine, exploiting an analogy between ethical judgements and tensed judgements. The basic idea is that what the passage of time does for the latter, reflection can do for the former: namely, prevent the re-adoption of an abandoned point of view (an ethical point of view (...) in the one case, a temporal point of view in the other). In the final section the author says a little about how reflection might do this. Footnotes1 This essay is derived from a lecture entitled ‘Bernard Williams’, delivered at Oxford University in 2000, in the series ‘Oxford Philosophers on Oxford Philosophers’, organized by Peter Hacker and David Wiggins. I am grateful to those who attended the lecture, and to Bernard Williams, for helpful comments. (shrink)

The study of sport is characterised by its inter-disciplinarity, with researchers drawing on apparently incompatible research traditions and ethical benchmarks in the natural sciences and the social sciences, depending on their area of specialisation. In this groundbreaking study, Graham McFee argues that sound high-level research into sport requires a sound rationale for one’s methodological choices, and that such a rationale requires an understanding of the connection between the practicalities of researching sport and the philosophical assumptions which underpin them. By (...) examining touchstone principles in research methodology, such as the contested ‘gold standard’ of voluntary informed consent in the natural sciences and the postmodern denial of ‘truth’ in the social sciences, McFee demonstrates that epistemology and ethics are inextricably linked. Drawing on a wide range of examples, from the laboratory to the sports field, McFee explores the concepts of ‘knowledge’ and ‘truth’ in sports research and makes a powerful case for a philosophical deepening of our approach to method and methodology in sport. This book is important reading for all advanced students and researchers working in sport, exercise and related disciplines. (shrink)

Background Medical ethics deals with the ethical obligations of doctors to their patients, colleagues and society. The annual reports of Sri Lanka Medical Council indicate that the number of complaints against doctors has increased over the years. We aimed to assess the level of knowledge, attitude and practice regarding medical ethics among doctors in three teaching hospitals in Sri Lanka. Methods A hospital-based cross-sectional study was conducted among doctors using a pre-tested self-administered, anonymous questionnaire. Chi Squared test, and (...) ANOVA test were used to identify the significance of association between level of knowledge and selected factors. Results Most doctors had a poor level of knowledge on medical ethics, with postgraduate trainees showing significantly higher level of knowledge. The average knowledge on medical ethics among doctors was significantly different between the three hospitals. Over 95% had a favourable attitude towards gaining knowledge and advocated the need for training. The majority indicated awareness of unethical practices. 24.6% of respondents stated that they get a chaperone ‘sometimes’ during patient examination while 3.5% never do. The majority responded that they never accept gifts from pharmaceutical companies in recognition of their prescribing pattern. 12–41% of doctors participated in the study acknowledged that they ‘sometime’ engaged in unethical practices related to prescribing drugs, accepting gifts from pharmaceutical companies and when obtaining leave. Conclusion Most doctors had a poor level of knowledge of medical ethics. Postgraduate trainees had a higher level of knowledge than other doctors. The majority showed a favourable attitude towards gaining knowledge and the need of training. Regular in-service training on medical ethics for doctors would help to improve their knowledge on medical ethics, as well as attitudes and ethical conduct. (shrink)

BackgroundPediatricians in developing countries face different ethical dilemmas than do doctors working in settings with more resources. There are very few studies from developing countries analyzing pediatricians’ knowledge and attitudes regarding the ethical dilemmas that arise in such settings. To address this gap, we explored the clinical ethical knowledge, attitude and experience of physicians who are working in the Department of Pediatrics and Child Health of St Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia.Study populationAll (...) pediatric resident doctors and pediatric consultants who were working in the DPCH of SPHMMC in December, 2020.MethodA structured pretested self-administered questionnaire was distributed to all 79 of the residents and consultants in the department during the period December 15–27, 2020. The questionnaire assessed the knowledge, attitude and experiences of the study participants regarding a variety of bioethical issues. Data were analyzed using SPSS version 20.0 for windows. The mean, median, standard deviation, and interquartile range of respondents’ scores were determined and compared using Fisher’s exact test.ResultA total of 59/79 physicians completed the questionnaire. The mean age of the participants was 30.7 ± 4.1 years. Thirty six were female. At the time of data collection, more than half served < 5 years as a physician. The mean ethics knowledge score of the respondents was 12.3 ± 2.34 out of 23 knowledge questions. The lowest and highest knowledge scores were 8 and 19 respectively. Scores were highest on questions about confidentiality and lowest on questions about genetic testing and diagnosis. Only 13 physicians agreed with the practice of children should never be treated without consent of the parent. ConclusionTertiary care pediatricians at one hospital in Ethiopia lack knowledge about current standards in bioethics. There is a need for more ethics education in this setting. (shrink)

This volume is a comprehensive collection of critical essays on The Taming of the Shrew, and includes extensive discussions of the play's various printed versions and its theatrical productions. Aspinall has included only those essays that offer the most influential and controversial arguments surrounding the play. The issues discussed include gender, authority, female autonomy and unruliness, courtship and marriage, language and speech, and performance and theatricality.

ObjectiveTo evaluate the relationship between recently trained paediatricians' ethics knowledge and exposure to a formal ethics or professionalism curriculum during residency.MethodsWe conducted a cross-sectional survey of recently trained paediatricians which included a validated 23-item instrument called the Test of Residents' Ethics Knowledge for Pediatrics. The sample included paediatricians who completed medical school in 2006–2008, whose primary specialty was paediatrics or a paediatric subspecialty, and who completed paediatric residency training in 2010–2011. This sample was stratified based on residency programme (...) variables: presence of a formal curriculum in ethics or professionalism, programme size and American Board of Pediatrics certifying exam passage rate. Paediatricians were randomly selected from each stratum for survey participation.ResultsAmong the 370 responding paediatricians (55%), the mean knowledge score was 17.3 (SD 2.2) out of a possible 23. Presence of a formal curriculum in ethics and/or professionalism was not significantly associated with knowledge. Knowledge was lowest on items about parental requests for a child to undergo genetic testing (2 items, 44% and 85% incorrect), preserving patient confidentiality over email (55% incorrect), decision-making regarding life-sustaining technologies (61% incorrect), and decision-making principles such as assent and parental permission (2 items, 47% and 49% incorrect).ConclusionsThis study highlights several areas in which paediatricians' knowledge may be low and that are amenable to targeted educational interventions. These findings should prompt discussion and research among ethicists and educators about how ethics and professionalism curricula can more consistently influence paediatricians' knowledge. (shrink)

In the contemporary metaethical debate, expressivist (Blackburn, Gibbard) and constructivist (Korsgaard, Street) views can be viewed as inspired by irrealist ideas from Hume and Kant respectively. One realist response to these contemporary irrealist views is to argue that they are inconsistent with obvious surface-level appearances of ordinary ethical thought and discourse, especially the fact that we talk and act as if there is ethical knowledge . In this paper, I explore some constructivist and expressivist options for responding (...) to this objection. My conclusion is that, although both constructivists and expressivists can capture other surface-level features of ethical thought and discourse, the possibility of ethical knowledge causes special problems for these versions of irrealism. I end with some comments about where I think irrealists should begin to look for a response to these special problems, which points, somewhat surprisingly, towards an alternative inferentialist form of irrealism about epistemic and ethical thought and discourse, which is inspired by Sellars. (shrink)

How is ethical knowledge possible? One of the most promising answers is the moral sense view: we can acquire ethical knowledge through emotional experience. But this view faces a serious problem. Emotions are unreliable guides to ethical truth, frequently failing to fit the ethical status of their objects. This threatens to render the habit of basing ethical beliefs on emotions too unreliable to yield knowledge. I offer a new solution to this problem, (...) with practical implications for how we approach ethical decision-making. I argue that an agent can have a reliable belief-forming habit despite having unreliable emotions, so long as she is suitably attentive to defeaters. In moderately virtuous agents, unfitting ethical emotions are frequently accompanied by warning signs, such as negative metaemotions, epistemic feelings, moods, and social cues. An agent who cultivates the attentional skill of noticing these signs can prevent many of her unfitting emotions from translating into false beliefs. For a moderately virtuous agent with this skill, the habit of basing ethical beliefs on emotions will be reliable. The upshot is that emotion-based ethical knowledge is possible even for people whose emotions are unreliable, but only if we cultivate the skill of spotting defeaters. (shrink)

Starting from a pragmatist point of view the paper dismisses the argument that ethical conduct is always based on knowledge of justifying and applying rules. In a first section I show that Plato and Kant already claimed that the originality of the ethical can’t be represented as either propositional knowledge or a norm, but is instead given to us in a way that is never fully available for our rational grasp. In a second section, I will (...) address the ethical conclusions James and Dewey draw from the fact that ethical demands can’t be translated into forms of knowledge. In a third section, I conclude with an argument for the originality of the ethical based on the thoughts of Stanley Cavell, stating that it is always something more than a mere competence in the sense of a knowledge of rules. (shrink)

An old question, still much discussed in moral philosophy, is whether there is any ethical knowledge. It is closely related, by simple etymology, to the question of cognitivism in ethics. Despite the fact that the terms ‘cognitivism’ and ‘objectivism’ seem sometimes to be used interchangeably, I take it that the question whether there can be ethical knowledge is not the same as the question whether ethical outlooks can be objective. A sufficient reason for this is (...) that an ethical outlook might be taken to consist of rules or principles, which do not admit of truth or falsehood and so cannot be objects of knowledge, but which can be seen as having an objective basis. (shrink)

Die Wissensvermittlung in Gesundheitsethik ermöglicht es Auszubildenden der Pflege, sich in ihrer zukünftigen Tätigkeit bei Entscheidungsprozessen des Behandlungsteams hinsichtlich pflegeethischer Fragestellungen einzubringen. Vor diesem Hintergrund wurde anhand der vorliegenden Studie die Entwicklung moralischer Positionen sowie pflegeethischer Kenntnisse von Pflegeauszubildenden sichtbar gemacht. An zwei Krankenpflegeschulen (Berlin und Fürth) wurden im Rahmen einer Panelstudie von August 2010 bis März 2011 Daten einer ersten Querschnittserhebung von Auszubildenden in der Pflege erhoben. Für die Studie wurde ein strukturierter Fragebogen verwendet. Die Studienteilnahme erfolgte freiwillig. Alle (...) Auszubildenden hatten vor der Befragung in unterschiedlichem Umfang Unterricht in Gesundheitsethik erhalten. An beiden Standorten zeigten die Teilnehmenden einen Zuwachs an pflegeethischen Kenntnissen. Auszubildende, die bislang keine praktische Erfahrung mit Sterbehilfe gemacht hatten, zeigten Schwierigkeiten in der theoretischen Handhabung dieser Maßnahmen. Für alle Auszubildenden zeigte sich ein allgemeiner Trend zu einer Befürwortung des partizipativen Interaktionsmodells und damit zu einer Förderung der Patientenselbstbestimmung. Zugleich schätzten die Studienteilnehmenden die Fähigkeiten von Patienten, medizinisch richtige Therapieentscheidungen zu treffen, als gering ein. Die Ausbildung in Gesundheitsethik besitzt ein großes Potential, Kenntnisse zu vermitteln und dadurch die ethische Kompetenzentwicklung zu befördern. Unsere Ergebnisse werfen die Frage auf, inwieweit es einer Integration praktischer Erfahrungen mit Fragestellungen der Gesundheitsethik bedarf, um eine praxisrelevante und wissenschaftlich fundierte Wissensvermittlung zu gewährleisten. (shrink)

This essay is concerned with Bernard Williams’ contention in Ethics and the Limits of Philosophy that, in ethics, reflection can destroy knowledge. I attempt to defend this contention from the charge of incoherence. I do this by taking seriously the idea that ethical knowledge is knowledge from an ethical point of view. There nevertheless remains an issue about whether the contention is consistent with ideas elsewhere in Williams’ own work, in particular with what he says (...) about knowledge in Descartes. In an earlier essay I argued that it is not. In a subsequent essay I indicated that I had changed my mind and gave a more sympathetic account of Williams’ contention. In this essay I set out the issues and say some more about my change of mind. (shrink)

This article analyses reflective practice by exploring ethical knowledge-in-use and the influence of context on professional nursing practice. Is ethical knowledge used in an appropriate context? The author identifies and discusses the theoretical underpinnings of reflective practice and offers an alternative paradigm to the generation and use of ethical knowledge in practice. The message to teachers and practitioners is decoded to facilitate teaching and learning.

Background:Neonatal nurse practitioners have become the frontline staff exposed to a myriad of ethical issues that arise in the day-to-day environment of the neonatal intensive care unit. However, ethics competency at the time of graduation and after years of practice has not been described.Research aim:To examine the ethics knowledge base of neonatal nurse practitioners as this knowledge relates to decision making in the neonatal intensive care unit and to determine whether this knowledge is reflected in attitudes (...) toward ethical dilemmas in the neonatal intensive care unit.Research design:This was a prospective cohort study that examined decision making at the threshold of viability, life-sustaining therapies for sick neonates, and a ranking of the five most impactful ethical issues.Participants and research context:All 47 neonatal nurse practitioners who had an active license in the State of Mississippi were contacted via e-mail. Surveys were completed online using Survey Monkey software.Ethical considerations:The study was approved by the University of Mississippi Medical Center Institutional Review Board (IRB; #2015-0189).Findings:Of the neonatal nurse practitioners who completed the survey, 87.5% stated that their religious practices affected their ethical decision making and 76% felt that decisions regarding life-sustaining treatment for a neonate should not involve consultation with the hospital’s legal team or risk management. Only 11% indicated that the consent process involved patient understanding of possible procedures. Participating in the continuation or escalation of care for infants at the threshold of viability was the top ethical issue encountered by neonatal nurse practitioners.Discussion:Our findings reflect deficiencies in the neonatal nurse practitioner knowledge base concerning ethical decision making, informed consent/permission, and the continuation/escalation of care.Conclusion:In addition to continuing education highlighting ethics concepts, exploring the influence of religion in making decisions and knowing the most prominent dilemmas faced by neonatal nurse practitioners in the neonatal intensive care unit may lead to insights into potential solutions. (shrink)

The author draws on considerable research in this area to provide an overdue critical evaluation of the limits of the market, and future prospects for non-market socialism.

Introduction The goal of this project was to develop and validate a new tool to evaluate learners' knowledge and skills related to research ethics. Methods A core set of 50 questions from existing computer-based online teaching modules were identified, refined and supplemented to create a set of 74 multiple-choice, true/false and short answer questions. The questions were pilot-tested and item discrimination was calculated for each question. Poorly performing items were eliminated or refined. Two comparable assessment tools were created. These (...) assessment tools were administered as a pre-test and post-test to a cohort of 58 Indian junior health research investigators before and after exposure to a new course on research ethics. Half of the investigators were exposed to the course online, the other half in person. Item discrimination was calculated for each question and Cronbach's α for each assessment tool. A final version of the assessment tool that incorporated the best questions from the pre-/post-test phase was used to assess retention of research ethics knowledge and skills 3 months after course delivery. Results The final version of the REKASA includes 41 items and had a Cronbach's α of 0.837. Conclusion The results illustrate, in one sample of learners, the successful, systematic development and use of a knowledge and skills assessment tool in research ethics capable of not only measuring basic knowledge in research ethics and oversight but also assessing learners' ability to apply ethics knowledge to the analytical task of reasoning through research ethics cases, without reliance on essay or discussion-based examination. These promising preliminary findings should be confirmed with additional groups of learners. (shrink)

This article reflects one scholar's attempt to locate herself within emerging ethical methodologies given a specific concern with cross-cultural women's moral praxis. The field of comparative ethics's debt to past debates over methodology is considered through a typology of three waves of methodological invention. The article goes on to describe a specific research focus on U.S. Catholic and Iranian Shii women that initiated a search for a distinct method. This method of comparative ethics, which focuses on the production of (...) ethical knowledge through the interaction of discursive logics of various moral agents, is described. The conclusion turns to how methodological invention can itself become a constructive project through the way it (1) locates the scholar in relation to her subject of study and (2) allows for isolation of tactics within specific moral discourses. (shrink)

Its preoccupation with ontology presents radical democracy with a thorny dilemma: how to combine commitment and affirmation with a distinctive emphasis on contingency and contestability. The article addresses this dilemma by engaging with three different perspectives. Ernesto Laclau’s work shows the intrinsic constraints of ontology and the inadequacy of a simple distinction between ontology and ethico-political decision. Simon Critchley opposes tying radical politics to ontological prefiguration and argues for a particular ethico-political orientation. But ethics and politics come entwined with ontological (...) assumptions, and the ethical direction of politics can be as restrictive as its ontological framing. William Connolly weds ontology and ethics to a sharp awareness of their contestability. But his approach does not reach deep enough. It is not alive to the contestability of the very recognition of contestability. To enhance openness and reflexivity, projects of radical democracy should combine a dimension of substantive, detailed accounts with a reflexive commitment to contestability, which disrupts, questions and renews the thicker descriptions in the name of democracy and truth. (shrink)

This multidisciplinary book brings together a series of critical engagements regarding the notion of ethical practice. As a whole, the book explores the question of how the current neo-liberal socio-political moment, and its relationship to the historical legacies of colonialism, white settlement, and racism, informs and shapes our practices, pedagogies, and understanding of encounters in diverse settings. Drawing largely on the work of Sara Ahmed’s Strange Encounters: Embodied Others in Post-Coloniality, each chapter in this book takes up a particular (...) encounter and unravels the elements that created these meetings in specific times and spaces. Sites of encounters included in this volume range from the classroom to social work practice and from literary to media interactions, and take place both within Canada and internationally. Paramount to the discussions is a consideration of how relations of power and legacies of oppression shape self and others, and draw boundaries between bodies within an encounter. From a social justice perspective, Unravelling Encounters exposes the political conditions that configure our meetings with one another, and inquires into what it means to care, to respond, and to imagine oneself as an ethical subject. (shrink)

Thomas Hurka presents the first full historical study of an important strand in the development of modern moral philosophy. His subject is a series of British ethical theorists from the late nineteenth century to the mid-twentieth century, who shared key assumptions that made them a unified and distinctive school. The best-known of them are Henry Sidgwick, G. E. Moore, and W. D. Ross; others include Hastings Rashdall, H. A. Prichard, C. D. Broad, and A. C. Ewing. They disagreed on (...) some important topics, especially in normative ethics. Thus some were consequentialists and others deontologists: Sidgwick thought only pleasure is good while others emphasized perfectionist goods such as knowledge, aesthetic appreciation, and virtue. But all were non-naturalists and intuitionists in metaethics, holding that moral judgements can be objectively true, have a distinctive subject-matter, and are known by direct insight. They also had similar views about how ethical theory should proceed and what are relevant arguments in it; their disagreements therefore took place on common ground. -/- Hurka recovers the history of this under-appreciated group by showing what its members thought, how they influenced each other, and how their ideas changed through time. He also identifies the shared assumptions that made their school unified and distinctive, and assesses their contributions critically, both when they debated each other and when they agreed. One of his themes is that that their general approach to ethics was more fruitful philosophically than many better-known ones of both earlier and later times. (shrink)

The idea of dignity seems indissociable from that of humanity, whether in its universal dimension of ‘human dignity’, or in the individual ‘dignity of the person’. This paper provides an outlook on the ethics governing the sciences and technology, in particular the biological sciences and biotechnology, and recalls the notion of ‘glory’, both human and divine, as it infuses a great part of the Middle Ages and the Renaissance cultures, just before the scientific revolution in Europe.

This book defends a form of ethical intuitionism, according to which (i) there are objective moral truths; (ii) we know some of these truths through a kind of immediate, intellectual awareness, or "intuition"; and (iii) our knowledge of moral truths gives us reasons for action independent of our desires. The author rebuts all the major objections to this theory and shows that the alternative theories about the nature of ethics all face grave difficulties.

Der Unterricht in Medizinethik soll Medizinstudierenden die Grundlagen dafür vermitteln, in ihrer zukünftigen ärztlichen Tätigkeit gute Entscheidungen treffen zu können. Im Rahmen einer Panelstudie wird derzeit die Entwicklung moralischer Positionen, medizinethischer Kenntnisse und Motivationen von Medizinstudierenden der Ludwig-Maximilians-Universität München über den Verlauf des Studiums untersucht. Für die Datenerhebung wurde ein Fragebogen entwickelt, der medizinethische Positionen und Kenntnisse sowie Motivationen erfasst. Im Wintersemester 2009/10 wurde die erste Querschnittsuntersuchung mit Studierenden im 1., 3. und 8. Semester sowie im Praktischen Jahr durchgeführt. Die (...) Mehrzahl der Befragten verfügte über einen geringen Kenntnisstand in verschiedenen Themenbereichen des Unterrichtsfachs GTE. Rechtliche Grundlagen und praktische Umsetzung von Therapiebegrenzungsmaßnahmen waren bis ins PJ-Semester vielen Studierenden nicht bekannt. Im Verlauf des Studiums veränderten sich die Motivationen weg von der Motivation, Menschen helfen zu wollen, hin zu Wissenserwerb und dem Ergreifen eines sicheren Berufs. Obwohl viele Befragte ein hohes Interesse an medizinethischen Fragestellungen und Unterricht im Bereich GTE angaben, zeigte sich kein nachhaltiger Zuwachs an medizinethischen Kenntnissen im Laufe des Studiums. In der Zusammenschau werfen die Ergebnisse die Frage auf, inwieweit verschiedene Ausbildungskonzepte Einfluss auf die individuelle ethische Entwicklung Medizinstudierender nehmen können. Eine Untersuchung dieser Fragestellung bleibt Gegenstand weitergehender Forschung. (shrink)

Excerpt: 1. Introduction This chapter provides insight into the diverse ethical debates on genetics and epigenetics. Much controversy surrounds debates about intervening into the germline genome of human embryos, with catchwords such as genome editing, designer baby, and CRISPR/Cas. The idea that it is possible to design a child according to one’s personal preferences is, however, a quite distorted view of what is actually possible with new gene technologies and gene therapies. These are much more limited than the editing (...) and design metaphors suggest. Such metaphors are therefore highly problematic phrases in the context of new gene technologies, for two reasons. On one hand, to design a child of choice by modifying the genome would require modifying any gene of choice, which is more than can be done with current gene technologies, such as CRISPR/Cas. On the other hand, a modification of genes would need to be enough to create any characteristic of choice in the future child. The latter presupposes the assumption of genetic determinism. Moreover, the CRISPR/Cas technology can not only be used in a potentially therapeutic manner at the germline level. In addition, there is the (more likely) scenario of a future clinical therapeutic use of these new gene technologies for modifying the DNA sequence of other cells of the body (somatic genome editing). There is also the option of modifying the epigenome, that is, the spatial configuration of DNA (epigenome editing) (see table 1). Like genetics and genome editing, epigenetics has been at the center of recent popular scientific and ethical discourse as well as scientific debates. The concept of epigenetics has given rise to very different notions of inheritability and responsibility for health, which, however, are oftentimes based on scientifically controversial basic assumptions. That there continues to be covert genetic determinism in the form of epigenetic determinism (see table 2) in debates about epigenetics has been pointed out in ethical analyses of epigenetics. Neither genetic determinism nor epigenetic determinism has been confirmed scientifically. It is therefore important to recognize the concepts that are discussed (and sometimes harshly criticized) in debates about genome editing and epigenetics—for example, concepts about the causal role of DNA for our own life course. This importance is based on the fact that if we understand such controversial concepts, we will be able to remain critical when evaluating scientific knowledge and ethical arguments about genome editing and epigenetics. This chapter, therefore, explains some of these concepts. For an ethical analysis of epigenetics as well as of genome editing, it is necessary to understand and critically reflect upon the underlying concepts of genetic determinism and other, related -isms. The following section offers a detailed introduction to these -isms (section 2; see also table 2). Section 3 provides an ethical analysis of genome editing and epigenetics based on the explanations in section 2. Section 3 focuses on inheritability and responsibility, justice, safety, the problem of consent, and the effects of genome editing and epigenetics on embryos and future generations. This section does not discuss in detail further points that can be found in ethical debates about epigenetics as well as in ethical debates about genome editing. These points include (among others): • fear that the findings of epigenetics and that the methods of genome editing are misused—this also with respect to eugenics and enhancement; • naturalness—an issue we mention in passing a few times in the following analysis; • a possible connection between the genome/epigenome and the concept of human dignity, and the derived danger of instrumentalization and infringement of autonomy when intervening in the genome or epigenome. Since current discourse about ethical issues associated with genome editing focuses mainly on germline interventions, which are, for instance, interventions into a human embryo’s genome, we mainly focus on germline interventions when comparing the debates on genome editing and on epigenetics in section 3. (shrink)

Jurgen Habermas' construction of a critical social theory of society grounded in communicative reason is one of the very few real philosophical inventions of recent times that demands and repays extended engagement. In this elaborate and sympathetic study which places Habermas' project in the context of critical theory as a whole past and future, J. M. Bernstein argues that despite its undoubted achievements, it contributes to the very problems of ethical dislocation and meaninglessness it aims to diagnose and remedy. (...) Bernstein further argues that the precise character of the failures of Habermas' program demonstrate the necessity for a return to the first generation critical theory of Adorno. Reading across nearly the whole range of Habermas' corpus, Recovering Ethical Life traces the development of the theory of communicative reason from its inception in Knowledge and Human Interests through its elaboration in The Theory of Communicative Action and into its defense against postmodernism in The Philosophical Discourse of Modernity . In separate chapters Habermas' readings of Freud, Durkheim amd Mead, Adorno and Foucault, Castoriadis and Taylor are critically examined. The focus of Bernstein's analyses, however, is always problem centered and thematic rather than textual psychoanalytic theory as an account of self knowledge, the competing claims of ethical identity and moral reason, the place of judgment in practical reason, and the debate between philosophies of language based communities versus those oriented towards world-disclosure. Critical theory is unique among current philosophies in engaging with the problems of social injustice and nihilism by siding with an abstract moral reason that forfeits the processes of intersubjective recognition it intended to salvage. Even in the fine grain of Habermas' account of performative contradictions and the theory of discourses of application, Bernstein perceives a squandering of the resources of an ethical life in need of transfiguration. (shrink)

This paper critically assesses John Danaher’s ‘ethical behaviourism’, a theory on how the moral status of robots should be determined. The basic idea of this theory is that a robot’s moral status is determined decisively on the basis of its observable behaviour. If it behaves sufficiently similar to some entity that has moral status, such as a human or an animal, then we should ascribe the same moral status to the robot as we do to this human or animal. (...) The paper argues against ethical behaviourism by making four main points. First, it is argued that the strongest version of ethical behaviourism understands the theory as relying on inferences to the best explanation when inferring moral status. Second, as a consequence, ethical behaviourism cannot stick with merely looking at the robot’s behaviour, while remaining neutral with regard to the difficult question of which property grounds moral status. Third, not only behavioural evidence ought to play a role in inferring a robot’s moral status, but knowledge of the design process of the robot and of its designer’s intention ought to be taken into account as well. Fourth, knowledge of a robot’s ontology and how that relates to human biology often is epistemically relevant for inferring moral status as well. The paper closes with some concluding observations. (shrink)

This article analyses reflective practice by exploring ethical knowledge-in-use and the influence of context on professional nursing practice. Is ethical knowledge used in an appropriate context? The author identifies and discusses the theoretical underpinnings of reflective practice and offers an alternative paradigm to the generation and use of ethical knowledge in practice. The message to teachers and practitioners is decoded to facilitate teaching and learning.

In this essay, I consider whether the alleged demise of metaphysical realism does actually provide a better way for defending the cognitive status of ethical judgments. I argue that the rejection of a realist ontology and epistemology does not help to establish the claim that ethical knowledge is possible. More specifically, I argue that Hilary Putnam's argument does not succeed in making a case for ethical knowledge. In fact, his account of the procedures by which (...) our valuations are warranted—the criteria of idealized inquiry—ultimately begs the question in a number of crucial ways. Moreover, it prejudices the moral and political discussion in certain ideological respects. Finally, though Putnam has apparently modified to some extent his approach to the issue of realism in recent years, I will point out that these modifications are not fundamental and do not help to advance the case for ethical knowledge. I note also that Martha C. Nussbaum's appeal to Putnam’s argument actually works against her attempt to make a case for an Aristotelian conception of human flourishing. Ultimately, I conclude that metaphysical realism is vital for ethical knowledge. (shrink)

Open peer commentary on the article “Ethics: A Radical-constructivist Approach” by Andreas Quale. Upshot: The first of my two main goals in this commentary is to establish thinking of ethics as concepts rather than as non-cognitive knowledge. The second is to argue that establishing models of individuals’ ethical concepts is a scientific enterprise that is quite similar to establishing models of individuals’ mathematical concepts. To accomplish these two primary goals, I draw from my experience of working scientifically with (...) von Glasersfeld for 25 years while he was developing radical constructivism as a coherent model of knowing, and appeal to several of his basic insights to establish constructing models of ethical concepts as a scientific enterprise. (shrink)

To determine the knowledge, attitude, and ethical concerns of medical students and graduates with regard to Embryonic Stem Cell (ESC) research. This questionnaire based descriptive study was conducted at the Civil Hospital Karachi (CHK), Pakistan from February to July 2008. A well structured questionnaire was administered to medical students and graduate doctors, which included their demographic profile as well as questions in line with the study objective. Informed consent was taken and full confidentiality was assured to the participants. (...) Data were entered in a Statistical Package for Social Sciences (SPSS version.12) and analyzed. A total of 204 male and 216 female medical students and doctors were administered questionnaires out of which 105 males (51.4%) and 108 females (50%) were aware of the embryonic stem cell research and its ethical implications. Forty percent males and 47% of females were of the opinion that life begins at conception. Forty-six percent males and 39% females were in favor of stem cell research while only 31% males and 28% females supported the ESC research. Less than 1/3 of students supported using frozen embryos for research purposes while more than 2/3 indicated that they were unlikely to support abortion for stem cell research purposes. The majority of the students were in favor of stem cell research with some reservations regarding ESC research. A sizeable number of students withheld their views, reflecting their poor understanding of medical ethics. The result of the study indicates a need for incorporating bioethics into the medical curriculum. (shrink)

This paper builds on existing research investigating CSR and ethical consumption within luxury contexts, and makes several contributions to the literature. First, it addresses existing knowledge gaps by exploring the ways in which consumers perform ethical luxury purchases of fine jewellery through interpretive research. Second, the paper is the first to examine such issues of consumer ethics by extending the application of theories of practice to a luxury product context, and by building on Magaudda’s :15–36, 2011) circuit (...) of practice framework. This is significant in that, to date, consumer research using practice theories has focused mainly on routine and habitual practices. Our findings and discussion provide an analysis of intentional and less intentional ethical consumer performances within the interconnected nexus of activities of consumers’ fine jewellery consumption practice, where meanings, understandings and intelligibility of social phenomena are worked through the various activities that shape such a practice. Finally, the paper concludes with significant managerial and policy-related implications, as our extended circuit of practice analysis conveys that if ethics and sustainability dimensions are to be embedded in fine jewellery consumption practice, they must first be made an intrinsic part of the nexus of the social and material environment of trading and consumption places. (shrink)

Clinical trials of stem cell transplantation raise ethical issues that are intertwined with scientific and design issues, including choice of control group and intervention, background interventions, endpoints, and selection of subjects. We recommend that the review and IRB oversight of stem cell clinical trials should be strengthened. Scientific and ethics review should be integrated in order to better assess risks and potential benefits. Informed consent should be enhanced by assuring that participants comprehend key aspects of the trial. For the (...) trial to yield generalizable knowledge, negative findings and serious adverse events must be reported. (shrink)

BackgroundOne of the next frontiers in HIV research is focused on finding a cure. A new priority includes people with HIV (PWH) with non-AIDS terminal illnesses who are willing to donate their bodies at the end-of-life (EOL) to advance the search towards an HIV cure. We endeavored to understand perceptions of this research and to identify ethical and practical considerations relevant to implementing it.MethodsWe conducted 20 in-depth interviews and 3 virtual focus groups among four types of key stakeholders in (...) the United States (PWH, biomedical HIV cure researchers, HIV clinicians, and bioethicists) to obtain triangulated viewpoints because little was known about the ethics of this topic. Each group was queried as to ethical considerations, safeguards, and protections for conducting HIV cure-related research at the EOL to ensure this research remains acceptable.ResultsAll four key stakeholder groups generally supported HIV cure-related research conducted at the EOL because of the history of altruism within the PWH community and the potential for substantial scientific knowledge to be gained. Our informants expressed that: (1) Strong stakeholder and community involvement are integral to the ethical and effective implementation, as well as the social acceptability of this research; (2) PWH approaching the EOL should not inherently be considered a vulnerable class and their autonomy must be respected when choosing to participate in HIV cure-related research at the EOL; (3) Greater diversity among study participants, as well as multi-disciplinary research teams, is necessitated by HIV cure-related research at the EOL; (4) The sensitive nature of this research warrants robust oversight to ensure a favorable risk/benefit balance and to minimize the possibility of therapeutic misconception or undue influence; and (5) Research protocols should remain flexible to accommodate participants’ comfort and needs at the EOL.ConclusionBecause of the ethical issues presented by HIV cure-related research at the EOL, robust ethical safeguards are of utmost importance. The proposed ethical and practical considerations presented herein is a first step in determining the best way to maximize this research’s impact and social value. More much inquiry will need to be directed towards understanding context-specific and cultural considerations for implementing EOL HIV cure research in diverse settings. (shrink)

Technology moves us to a better world. We contend that through technology people can simplify and solve moral tasks when they are in presence of incomplete information and possess a diminished capacity to act morally. Many external things, usually inert from the moral point of view, can be transformed into the so-called moral mediators. Hence, not all of the moral tools are inside the head, many of them are shared and distributed in “external” objects and structures which function as (...) class='Hi'>ethical devices. (shrink)

Targeted modifications of the human epigenome, epigenome editing (EE), are around the corner. For EE, techniques similar to genome editing (GE) techniques are used. While in GE the genetic information is changed by directly modifying DNA, intervening in the epigenome requires modifying the configuration of DNA, for example, how it is folded. This does not come with alterations in the base sequence (‘genetic code’). To date, there is almost no ethical debate about EE, whereas the discussions about GE are (...) voluminous. Our article introduces EE into bioethics by translating knowledge from science to ethics and by comparing the risks of EE with those of GE. We, first (I), make the case that a broader ethical debate on EE is due, provide scientific background on EE, compile potential use-cases and recap previous debates. We then (II) compare EE and GE and suggest that the severity of risks of novel gene technologies depends on three factors: (i) the choice of an ex vivo versus an in vivo editing approach, (ii) the time of intervention and intervention windows and (iii) the targeted diseases. Moreover, we show why germline EE is not effective and reject the position of strong epigenetic determinism. We conclude that EE is not always ethically preferable to GE in terms of risks, and end with suggestions for next steps in the current ethical debate on EE by briefly introducing ethical challenges of new areas of preventive applications of EE (III). (shrink)

Targeted modifications of the human epigenome, epigenome editing (EE), are around the corner. For EE, techniques similar to genome editing (GE) techniques are used. While in GE the genetic information is changed by directly modifying DNA, intervening in the epigenome requires modifying the configuration of DNA, for example, how it is folded. This does not come with alterations in the base sequence (‘genetic code’). To date, there is almost no ethical debate about EE, whereas the discussions about GE are (...) voluminous. Our article introduces EE into bioethics by translating knowledge from science to ethics and by comparing the risks of EE with those of GE. We, first (I), make the case that a broader ethical debate on EE is due, provide scientific background on EE, compile potential use-cases and recap previous debates. We then (II) compare EE and GE and suggest that the severity of risks of novel gene technologies depends on three factors: (i) the choice of an ex vivo versus an in vivo editing approach, (ii) the time of intervention and intervention windows and (iii) the targeted diseases. Moreover, we show why germline EE is not effective and reject the position of strong epigenetic determinism. We conclude that EE is not always ethically preferable to GE in terms of risks, and end with suggestions for next steps in the current ethical debate on EE by briefly introducing ethical challenges of new areas of preventive applications of EE (III). (shrink)

Background: Ethics consultants (ECs) are increasingly expected to possess core knowledge and skills. Few data address whether ECs actually possess recommended core knowledge. We aimed to measure pediatric ECs’ understanding of ethical principles, identify knowledge gaps, and explore associations between experience/training and knowledge in pediatric ethics consultations. Methods: We identified the 2 ECs most knowledgeable in pediatric ethics from each of 45 freestanding children's hospitals and an equal number of general teaching hospitals in the United (...) States. This yielded a sample of 159 eligible pediatric ECs. Pediatric ECs were sent a survey measuring ethics training, characteristics of the ethics consultation service, and EC knowledge, as assessed by a previously validated scale entitled the Test of Residents’ Ethics Knowledge for Pediatrics (TREK-P). Of 102 completed surveys received, 99 were used in the analysis. Results: Seventy-three percent of ECs had completed ≥1 formal training modality, most commonly bioethics mini-courses, master's degrees, or certificate programs (20–30% each). Respondents infrequently received salary support (32%) or had a budget (28%) to support ethics work. The median TREK-P score was 19 (interquartile range [IQR] 17–21). Forty percent of subjects scored ≥20, surpassing the threshold of adequate performance proposed in previous work. Median scores were significantly higher among ECs with formal training in ethics but did not differ significantly by other variables. In secondary analyses, high scores (≥20) were significantly more common among ECs receiving salary support (55% vs. 33%, p = 0.04) and who had formal ethics training (47% vs. 22%, p = 0.02). Items pertaining to privacy, genetic testing, and assent, were answered incorrectly by >33% of ECs. Conclusions: High scores on a validated ethics knowledge scale were more common among ECs with salary support or formal ethics training. The study highlights knowledge gaps that warrant consideration as EC becomes a professionalized endeavor. (shrink)

Background:Healthcare organizations are now challenged to retain nurses’ generation and understand why they are leaving their nursing career prematurely. Acquiring knowledge about the effect of ethical work climate and level of perceived organizational support can help organizational leaders to deal effectively with dysfunctional behaviors and make a difference in enhancing nurses’ dedication, commitment, satisfaction, and loyalty to their organization.Purpose:This study aims to determine the relationship between ethical work climate, and perceived organizational support and nurses’ organizational commitment, job (...) satisfaction, and turnover intention.Methods:A descriptive correlational research design was conducted in all inpatient care units at three major hospitals affiliated to different health sectors at Alexandria governorate. All nurses working in these previous hospitals were included in the study (N = 500). Ethical Climate Questionnaire, Survey of Perceived Organizational Support, Organizational Commitment Questionnaire, Index of Job Satisfaction, and Intention to Turnover scale were used to measure study variables.Ethical considerations:Approval was obtained from Ethics Committee at Faculty of Nursing, Alexandria University. Privacy and confidentiality of data were maintained and assured by obtaining subjects’ informed consent to participate in the research before data collection.Findings:The result revealed positive significant correlations between nurses’ perception of overall ethical work climate and each of perceived organizational support, commitment, as well as their job satisfaction. However, negative significant correlations were found between nurses’ turnover intention and each of these variables. Also, approximately 33% of the explained variance of turnover intention is accounted by ethical work climate, organizational support, organizational commitment, and job satisfaction, and these variables independently contributed significantly in the prediction of turnover intention.Recommendation:Strategies to foster and enhance ethical and supportive work climates as well as job-related benefits are considered significant factors in increasing nurses’ commitment and satisfaction and decreasing their turnover intention. (shrink)

The sudden emergence of the COVID-19 pandemic brought global disruption to every aspect of society including healthcare, supply chain, the economy, and social interaction. Among the many emergent considerations were the safety and public health of the public, patients, essential workers, and healthcare professionals. In certain locations, clinical research was halted—or terminated—in deference to the immediate needs of patient care, and clinical trials focusing on the treatment and prevention of coronavirus infection were prioritized over studies focusing on other diseases. Difficult (...) decisions were made rapidly; flexibility and reconsideration were necessary not only because the intensity and severity of infection varied over time and by locale but also because knowledge of the disease and understanding of its treatment grew. Here we discuss the ethical challenges in decision-making and competing ethical tensions during the pandemic in an effort to advance future preparedness. (shrink)

Leadership studies on corporate ethical behavior and practices have grown considerably, contributing significant knowledge on ethical leadership challenges that are organizational and industry focused. However, complex socio-ecological systems are placing pressure on organizational culture and old patterns of leadership behavior that play a role in organizational justice. In this study, we argue that scholars of business ethics must consider the role of organizational justice and use person-organization fit (P–O fit). To address this, our study investigates the mediating (...) effect of organizational justice on the relationship between ethical leadership and employees’ ethical behavior. We also examine the moderating role of P–O fit on the relationship between organizational justice and employee’s ethical behavior. The study survey focused on 295 employees belonging to organizations in Iraq. We show that ethical leadership positively influences employees’ ethical behavior, and this relationship is shaped by organizational justice. The findings reflect the positive impact of organizational justice on ethical behavior, and this relationship is more pronounced in employees with high rather than low P–O fit. This study clarifies the importance of employee’s P–O fit and its impact on organizational processes for creating a positive impact on ethical behavior in the workplace. We also share practical implications of the study and recommend systemic research that explores this area. (shrink)