This chapter contains sections titled: Weighing the Value of Meat Stalking the Essence of Hunting Same As It Ever Was The End of Hunting Notes.

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Loopholes, Gaps, and What Is Held Fast”Lorraine Code (bio)Keywordsepistemology, incredulity, knowing other people, memory, testimonyNancy Potter’s compelling essay points to some of the limitations of the theoretical apparatus that the post-positivist empiricist epistemologies of the Anglo-American mainstream make available for evaluating experiential memory claims in general, and “false memory syndrome” in particular. The loopholes and gaps in these theories of knowledge push urgent questions about testimony, trust, (...) and the politics of knowledge into a prominent place on the agendas of successor epistemology projects. These politics are enacted in societies whose dominant rhetoric privileges eye-witness evidence and “knowledge by acquaintance” as sources of objective knowledge, yet whose practices of incredulity—of granting and withholding acknowledgement to testimonial knowledge claims—expose power-saturated structures of dominance and subordination and of arbitrarily uneven distributions of epistemic authority. 1For classical empiricists and their successors, perception, memory and testimony, hierarchically ordered with perception on top, count as the principal sources of empirical knowledge. This ordering maps the relative reliability of the processes, with perception ranking as most stable, reliable and secure, memory coming second on all of these scores, and testimony ranking a poor third, closer to opinion, hearsay and rumor than to the other more respectable sources. Perception, for these theories, is “immediate” in that it is direct, bare, uncontaminated either by the particularities of the perceiving subject or of the perceptual event: from its presumed (but contestable) immediacy, all the rest follows. Memory counts as perception at one remove, its reliability a function of the relative “vividness” of the perceptions it commemorates. The esteem commonly claimed for eye-witness testimony derives from this conception of memory, which is believed to ground the testimony because of its presumed proximity to “immediate” perception. Yet testimony, even in its restricted “knowledge by description” form, tends by contrast with perception and memory to be a shaky affair; and as the temporal distance between event and testimony increases, so knowledge of matters unavailable to direct observation fares less and less well in classical and post-positivist epistemologies. A distrust of testimony is at once understandable and odd, because so small a proportion both of communal and of “individual” knowledge indeed derives from first-hand observations and experiences: most of it comes from testimony in an extended sense that encompasses books, teachings, media reports, all of the sources and resources on which both secular and scholarly knowledge relies for much of its substance. This expanded construction of the term runs alongside [End Page 255] the first-personal “testimonial” sense that is more plainly operative in discussions of false memory syndrome which, despite its experiential source, is often likewise contested on grounds that discredit the “privileged access” status that these same epistemologies claim for experience at first hand.Epistemologists commonly assimilate testimony to monologic, observational knowledge, deriving its constitutive features from instances where a testimonial utterance can pose as another perception—this time an auditory one—in a personal set of knowledge-producing observations (e.g., Fricker 1987). Because the speaker may be lying or mistaken, the process may fail to transmit knowledge; but this failure can be read as a simple perceptual error or a misremembering. Such approaches ignore the constitutive function of an interpreter/listener in fostering or thwarting testimonial knowledge to subsume it, too, much under an observational model. Indeed, not only do they separate the knower from the known and the process of knowing, as Potter observes, they also separate the knower from other knowers to guard against their influencing (= contaminating) the knowledge-production process. Experiences where an interlocutor actually enables the production of knowledge do not figure in such analyses, 2 whose effect is to suggest that giving or hearing testimony invokes no more significant moral-political issues than do acts of perceiving tables and chairs: that hearing, like seeing, is believing. (Norman Malcolm’s analysis of memory, which Potter cites, would also underwrite such a view of testimony.) Yet standard empiricist and post-positivist epistemologies generate an inquisitorial model of eliciting testimony in which the more generalized “testimony” in the knowledge that people acquire from books, media reports, conversation, reference sources recedes from... (shrink)

In this book, I will discuss three main topics: the roots and aims of scientific knowledge, scientific knowledge in society, and science and values I understand scientific knowledge as being a planned and continuous production of the general and common knowledge of scientific communities. I begin my discussion with a brief analysis of the main differences between sciences, on the one hand, and everyday experience, philosophies, religions, and ideologies, on the other. I define the concept of science as a (...) set of family resemblances (in Wittgenstein's sense). The sciences can be distinguished along three lines, in terms of the difference between empirical and non-empirical sciences, differences in degrees of theoretical and methodological structure among individual sciences and scientific disciplines. Scientific knowledge is based upon some grounds, paradigmatic knowledge bases. Scientific knowledge is founded on a unified paradigmatic knowledge base. The latter includes fundamental theories, basic facts, generally accepted empirical regularities (laws), scientific research methods, scientific explanations, and established relations to other sciences. Scientific knowledge in general is defined well in classical terms by the definition that knowledge is a true and rationally-justified belief. In this connection, scientific truth is relative, depending on the given paradigmatic knowledge base and on the precision and accessibility of the measurements and observations involved. In the book's first part, I consider the production and testing of scientific hypotheses, scientific explanations, the structure of scientific theories, and the problem of scientific realism. I consider explanation an integral part of a wider nexus of heuristic and theoretical activities in science like giving reasons, understanding, clarification, and founding. Continuous production of scientific explanations is a necessary condition for the systematic reproduction of scientific knowledge. Accordingly, it does not suffice to describe them in terms of the logical structure of the arguments on which they are based, but rather, scientific explanations ought to be given complete with an epistemic and pragmatic context of the explanation. I consider especially deductive-nomological, inductive-statistical, dispositional, teleological-functional, and genetic explanations. I emphasize the ever-increasing importance of explanations by analogy and by model. Orthogonal to these distinctions lies the distinction between causal and epistemic explanation. Epistemic explanations relate scientific discoveries to epistemic progress, and causal explanations are these epistemic explanations that relate scientific discoveries to reality too. Causal explanations inform us that certain changes occur in the world as agents of other changes, or rather, that certain changes are real consequences of other changes. Thus, by having explanations of causes, we can intervene in the world to induce by design certain changes in some course of phenomena. I consider scientific theories as logically and epistemically ordered wholeness of scientific knowledge in a realm of research that enables us to construct useful models of reality. After the discussion of different 'statement' views on theories and different interpretations of the theory-experience relation, I introduce the 'model' theoretical (non-statement) views on theories, especially the structural theory of science. The model views on theories transcend the realism-antirealism dualism by introducing models between theory and reality. Therefore, the question of scientific realism is not merely whether and, if so, which element(s), of scientific theories represent reality, but rather which conditions suffice to infer from a theory that one of its models truly expresses reality. In other words, under which conditions do models of a theory represent models of reality? Generally, models are just as much images of reality in a theory as they are images of a theory in reality. The actual problem of scientific realism doesn't originate in the observable-unobservable distinction (even if this distinction is otherwise theoretically loaded), but rather in ontological quandaries, of the sort especially encountered in modern physical theories such as quantum mechanics, relativity theory, and cosmological theories, although they are known to arise in other sciences as well. Scientific theories may be real, even if they describe nothing about the world. However, such theories can be given this status only if their formal, mathematical postulates exhibit some formal homology between reality and mathematical forms. The very fact that it is possible to describe reality with the help of mathematics even in cases, where every (representational, conceptual) language and thought fall short, would indicate that even mathematics itself is, in some sense, a part of reality, although 'outside' of the empirical world. It follows we have to distinguish the non-empirical reality and the empirical world. Formal objectivity and non-arbitrariness of theories do not emerge from either our language or thoughts, or from the world of facts, causes, and effects, but rather from non-empirical reality, which frames the world as some kind of objective transcendental condition for the possibility of the existence of the world, thoughts, and language. In the second part of the book, I consider the incorporation of scientific work and scientific knowledge into modern society and its relations to values and ethics. Production of scientific knowledge goes on as a parallel distributed process of a special kind of social (shared) cognition. The central part of this cognition is the presentation of parts of the world by scientific (theoretical) models which are warranted by the shared and public practice of justification, and in reflective acting in the world as it would. I consider various formal concepts of collective propositional knowledge (distributed, mutual, common knowledge). Scientific knowledge is an achievement to be ascribed to a scientific community or, indirectly, to all those who apply or expand it, rather than to individuals per se. It presents the continuous and partially planned production of non-trivial common knowledge of the research communities in modern societies. However, besides common knowledge, shared dispositional knowledge (knowledge how of scientific teams) and shared knowledge by acquiring (knowledge of fundamental similarities and differences in scientific teams) are parts of the real body of scientific knowledge. Scientific common knowledge implies the projection into idealized universal knowledge of all real or potentially rational and well-informed individuals. The respect of scientific knowledge thus presents the norm of rationality. Science as the intensively shared and socially distributed kind of cognition enters into modern society as a special kind of work (general work), as a productive force (social invention drive), and as a form of capital (human, social, cultural, informational, etc.). However any of these categories can adequately represent the socio-economical role of science in modern societies, and we are still waiting for a more adequate general concept that would theoretically cover the 'scientification' of modern societies. My thesis is that the most important general effect of scientification is (and will be) the growth of social processes that structurally resemble parallel distributed shared social cognition of science, and not so much the rise of the use of scientific knowledge and scientifically based information in all kinds of production. Scientification of modern societies inevitably includes a much stronger need for moral and social responsibility of scientists for their work and its effects in their local society and the global world. This need comes in contradiction with the quite large accepted idea (and even the 'norm') on value-free research. I discuss to some degree different arguments for the absence of non-epistemic values and ethical reasoning from science and find them non-convincing. The sound idea of value-free research lies in the need for the absence of categorical value statements from scientific explanations and theoretical deductions. Values and ethical judgment have, and sometimes they even have to play an important role in another part of research and its application in science or outside it. Not the value-loudness of research is a danger for science but its blind, non-reflective use. It leads to the ideologization and politicization of science. A similar danger lies in the purely value-neutrality of research. It leads to the instrumentalization of science to the technical or bureaucratic means for 'any' aims. (shrink)

Theoretical and empirical research in bioethics frequently focuses on ethical dilemmas or problems. This paper draws on anthropological and phenomenological sources to develop an alternative framework for bioethical enquiry that allows examination of a broader range of how the moral is experienced in the everyday lives of individuals and groups. Our account of moral experience is subjective and hermeneutic. We define moral experience as “Encompassing a person's sense that values that he or she deem important are being realised or thwarted (...) in everyday life. This includes a person's interpretations of a lived encounter, or a set of lived encounters, that fall on spectrums of right-wrong, good-bad or just-unjust”. In our conceptualisation, moral experience is not limited to situations that are heavily freighted with ethically-troubling ramifications or are sources of debate and disagreement. Important aspects of moral experience are played out in mundane and everyday settings. Moral experience provides a research framework, the scope of which extends beyond the evaluation of ethical dilemmas, processes of moral justification and decision-making, and moral distress. This broad research focus is consistent with views expressed by commentators within and beyond bioethics who have called for deeper and more sustained attention in bioethics scholarship to a wider set of concerns, experiences and issues that better captures what is ethically at stake for individuals and communities. In this paper we present our conceptualisation of moral experience, articulate its epistemological and ontological foundations and discuss opportunities for empirical bioethics research using this framework. (shrink)

Since its origin bioethics has been a specialized, academic discipline, focussing on moral issues, using a vast set of globalized principles and rational techniques to evaluate and guide healthcare practices. With the emergence of a plural society, the loss of faith in experts and authorities and the decline of overarching grand narratives and shared moralities, a new approach to bioethics is needed. This approach implies a shift from an external critique of practices towards embedded ethics and interactive practice (...) improvement, and from a legal defence of rights towards fostering interdependent practices of responsibility. This article describes these transitions within bioethics in relation to the broader societal and cultural dynamics within Western societies, and traces the implications for the methodologies and changing roles of the bioethicist. The bioethicist we foresee is not just a clever expert but also a relationally sensitive person who engages stakeholders in reciprocal dialogues about their practice of responsibility and helps to integrate various sorts of knowledge (embodied, experiential, visual, and cognitive-scientific). In order to illustrate this new approach, we present a case study. It concerns a project focusing on an innovation in elderly care, based on the participation of various stakeholders, especially older people themselves. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Thus Spake Howard Roark:Nietzschean Ideas in The FountainheadLester H. HuntIThe position I will be taking here will seem very peculiar to many people. I will be treating a novel as a discussion of the work of a philosopher—namely, Friedrich Nietzsche. Worse yet, I will be treating it as a discussion that is philosophically penetrating and deserves to be taken seriously. Still worse, the novel is Ayn Rand's early novel (...) The Fountainhead. I think it is safe to say that her reputation, among academics who discuss the works of philosophers, is very low. If the reader will only bear with me, though, I think I can make a case that Rand opens a line of inquiry about Nietzsche's ideas and values that is not only quite interesting in itself but one that ought to be pursued further by others.There has always been ample reason to associate Nietzsche with The Fountainhead.1 He is after all, the only philosopher who is more or less directly quoted in the book.2 Beyond that, Rand's novel has many other passages that students of Nietzsche instantly recognize as conscious references to him or deliberate echoes of his style. In addition, she revealed, in an introduction written for the twenty-fifth anniversary edition, that the following quotation from Beyond Good and Evil had originally stood at the head of the book when it was still in manuscript:It is not the works, but the belief which is here decisive and determines the order of rank to—employ once more an old religious formula with a new and deeper meaning—it is some fundamental certainty which a noble soul has about itself, something which is not to be sought, is not [End Page 79] to be found, and perhaps, also, is not to be lost—The noble soul has reverence for itself.—3She said, in the same introduction, that she removed the quotation (evidently, immediately before publication) for philosophical reasons, because of her "profound disagreement with the philosophy of its author." Nietzsche, she says, was fundamentally "a mystic and irrationalist," and even in this quotation, chosen for its content, insinuates a philosophical position that she regards as erroneous (namely, determinism). Even her statement of what she likes about this passage is rather constrained: "as a poet [ie., not as a philosopher], he projects at times (not consistently) a magnificent feeling for man's greatness, expressed in emotional, not intellectual terms."4It is of course true enough that Rand does disagree with Nietzsche, and for more or less the reasons that she suggests here, but it is also true that the passage she has quoted expresses some ethical themes—nobility, order of rank, the "pathos of distance," and (most obviously) the idea of self-reverence as a characteristic of the ethically good—which are at least as important in The Fountainhead as they are in Nietzsche's writings. Though Rand's spirited disclaimer serves to remind us of her deep differences with Nietzsche, the quotation itself suggests that there might be an interesting philosophical, not merely literary or emotional, connection between The Fountainhead and Nietzsche's ideas. What I would like to show here is that this connection merits a much closer look than it has ever been given heretofore. Not only is the presence of Nietzschean themes in Rand's novel deep and pervasive, but the book actually contains a very interesting and powerful internal critique of one of Nietzsche's most characteristic ideas, a criticism based in large part on values and assumptions that he shares. Before I can set out this critique, I will need to explore some of the positive thematic and philosophical connections.IIOne evening, rather late in the novel, Gail Wynand, the corrupt newspaper publisher and financier, surprises his wife, Dominique, with a present: he has had an architect design a house for them. The architect, she realizes with shock as she sees the drawings for the house, is her former lover, Howard Roark, a man with whom she is still in love. None of this is known to her husband, who innocently tells her that [End Page 80] Roark... (shrink)

It is a popular view thatpractical deliberation excludes foreknowledge of one's choice. Wolfgang Spohn and Isaac Levi have argued that not even a purely probabilistic self-predictionis available to thedeliberator, if one takes subjective probabilities to be conceptually linked to betting rates. It makes no sense to have a betting rate for an option, for one's willingness to bet on the option depends on the net gain from the bet, in combination with the option's antecedent utility, rather than on the (...) offered odds. And even apart from this consideration, assigning probabilities to the options among which one is choosing is futile since such probabilities could be of no possible use in choice. The paper subjects these arguments to critical examination and suggests that, appearances notwithstanding, practical deliberation need not crowd outself-prediction. (shrink)

UNTIL RECENT YEARS moral traditions have not been an important topic for moral philosophy. With few exceptions, attention has been directed to the problem of moral justification, to the search for universal criteria for the assessment of moral beliefs or judgments regardless of their traditional provenance. Generally, philosophers aspire to formulate "the view from nowhere." Since the publication of Alasdair MacIntyre's After Virtue there has been a revival of interest in the concept of a living, moral tradition, especially among (...) moral philosophers concerned with the possibility of an ethics of virtue or character as a viable alternative to the ethics of principle or, say, to deontological, utilitarian, or contractarian ethics. We must observe here that in the three decades prior to 1981, some moral philosophers displayed similar concern with tradition, although terms other than "tradition" were used, for example, "forms of life," "ways of life," "moral practices," and "moral community." Rawls's conception of reflective equilibrium is also developed with an eye on the notion of tradition. Indeed, Rawls has been quite explicit about his tradition-oriented approach to moral theory: "What justifies a conception of justice is not its being true to an order antecedent to and given to us, but its congruence with our deeper understanding of ourselves and our aspirations, and our realization that, given our history and the traditions embedded in our public life, it is the most reasonable doctrine.". (shrink)

Background: The search for genetic variants between racial/ethnic groups to explain differential disease susceptibility and drug response has provoked sharp criticisms, challenging the appropriateness of using race/ethnicity as a variable in genetics research, because such categories are social constructs and not biological classifications.Objectives: To gain insight into how a group of genetic scientists conceptualise and use racial/ethnic variables in their work and their strategies for managing the ethical issues and consequences of this practice.Methods: In-depth semi-structured interviews were conducted with (...) a purposive sample of 30 genetic researchers who use racial/ethnic variables in their research. Standard qualitative methods of content analysis were used.Results: Most of the genetic researchers viewed racial/ethnic variables as arbitrary and very poorly defined, and in turn as scientifically inadequate. However, most defended their use, describing them as useful proxy variables on a road to “imminent medical progress”. None had developed overt strategies for addressing these inadequacies, with many instead asserting that science will inevitably correct itself and saying that meanwhile researchers should “be careful” in the language chosen for reporting findings.Conclusions: While the legitimacy and consequences of using racial/ethnic variables in genetics research has been widely criticised, ethical oversight is left to genetic researchers themselves. Given the general vagueness and imprecision we found amongst these researchers regarding their use of these variables, they do not seem well equipped for such an undertaking. It would seem imperative that research ethicist move forward to develop specific policies and practices to assure the scientific integrity of genetic research on biological differences between population groups. (shrink)

Modern, science-centered naturalisms can be charged with a certain moral laxity, according to S. T. Coleridge. This fault reflectsnbsp; a devitalizing, materialistic metaphysics informed by a narrow and self-serving conception of reason. Thus seeking a remedy that can bring justice to the spiritual as well as the physical aspects of experience, Coleridge envisages a lsquo;true naturalismrsquo; that will not only address the question lsquo;What is Life?rsquo; but also frame a lsquo;true realismrsquo; that includes what might be called a lsquo;true (...) moralismrsquo;. This calls, however, for a Heraclitean metaphysics capable of linking lsquo;goodnessrsquo; in both thinking and acting to a *Logos*mdash;that is, an essentially nonmodern theory of actuality that can do justice at once to the quicknesses and the uniformities of both Life and Thought. Coleridgersquo;s thus presents an outline of how one might respond to a challenge that can be best met, I argue, with the help of certain insights of Maurice Merleau-Ponty, A. N. Whitehead, Gilles Deleuze, and C. S. Peirce. By enlisting Hannah Arendtrsquo;s individual-centered conception of morality, which ties ethics to public concerns, it is also possible to sketch a metaphysically grounded response to Friedrich Nietzschersquo;s call for a lsquo;healthy moralityrsquo; capable of overturning the nihilistic values entrenched in modern thought. br /. (shrink)

This volume, Applied Social Sciences: Philosophy and Theology, provides the reader with an important set of essays related to the two aforementioned fields of study. Aesthetics plays a key role in contemporary philosophy and several authors examine its various aspects, such as the question of identification of works of art; the concept of â oesocial aestheticsâ ; the social therapeutic function that art can have; and the relationships among hermeneutics, aesthetics and communication sciences. Other papers deal with ethical (...) issues, such as the role of human values in applied ethics and moral determinations in public life. The meaning and role of postmodernism in philosophy and society is examined at length in various contributions to the volume, and the same is true for phenomenology at large. Even the theoretical seduction and practical failure of Marxism is addressed, while anthropological issues are studied with reference to truth and other key philosophical concepts. John Searleâ (TM)s theory of intentionality is seen as a factor for creating social institutions, and the real meaning of â oeglobalizationâ is investigated in another article. Many essays deal directly with theological and religious topics. For instance the alleged â oeillusionâ of religion versus its persistency is analyzed, along with the current relations between Church and civil government in Romania, the presence of different forms of Christianity in the Romanian nation, the dialogue between social theology and anthropological research, and the antinomic nature of the Church. All papers included in the volume are original and open new perspectives on the many issues addressed by the authors. Even the philosophical styles are different: hermeneutics, analytic philosophy, historical approach, postmodernism, communication theory and linguistic approach. Some papers are theoretical and others have a more empirical or historical flavour. There is however an underlying unity because they all purport to provide new ideas to professionals involved in the socio-humanistic field. The information is divided into chapters in order to help readers to form by themselves an image of the issues that are studied. However, the volume is not addressed only to specialists, and is accessible to a wider public interested in an interdisciplinary approach. (shrink)

Moral Case Deliberations are reflective dialogues with a group of participants on their own moral dilemmas. Although MCD is successful as clinical ethics support, it also has limitations. 1. Lessons learned from individual MCDs are not shared in order to be used in other contexts 2. Moral learning stays limited to the participants of the MCD; 3. MCD requires quite some organisational effort, 4. MCD deals with one individual concrete case. It does not address other, similar cases. (...) These limitations warrant research into complementary ways of providing CES to healthcare professionals. Our research objective was therefore to develop a low threshold CES tool based on a series of MCDs on autonomy in long-term care. We used a qualitative research design in which we analyzed the process and content of a series of MCDs, combined with reflections on the theoretical background of MCD. In total 28 MCDs were analyzed by means of a thematic content analysis. In various rounds of development, the results of the analysis were combined with theoretical reflections on CES. Consequently, the tool was evaluated in three focus groups and adjusted. The CES tool, called ‘moral compass’, guides the users through a series of six subsequent questions in order to methodically reflect on their concrete moral dilemma, in the form of a booklet of 23 pages. It combines a methodical element that encourages and structures a reflection process with a substantive element, including norms, values, options, strategies, and insights regarding dealing with client autonomy. By using data from a series of MCDs, combined with theoretical reflections on MCD, ethics support and moral learning, we developed a thematic, low-threshold CES tool that supports healthcare professionals in daily practice in dealing with moral questions regarding client autonomy. It integrates examples and insights from earlier MCDs on the same topic. The moral compass is not a replacement of, but can be used complementary to MCD. The feasibility and impact of the moral compass need to be investigated in an evaluative follow-up study. The methodology presented in this paper may be used to develop moral compasses on different topics in various healthcare organizations. (shrink)

Health care providers (HCPs) are routinely placed into morally challenging situations that have the potential to cause moral distress. This is especially true for HCPs working in the military, whether they are on deployment outside their typical contexts of practice such as in disaster relief (e.g., Haiti and the Ebola missions in West Africa), or in more typically military settings such as peace keeping or armed conflicts (e.g., Afghanistan, Syria). Moral distress refers to “painful feelings and/or psychological disequilibrium” (Nilsson, Sjöberg, (...) Kallenberg, & Larsson, 2011, p. 50) that occur when an individual is aware of a morally appropriate action in a moral dilemma but obstruction prevents them from carrying it out, or when in a situation where they must choose between upholding equally treasured but conflicting moral values. Similarly, moral distress can occur when faced with a ‘tragic choice’ where all available courses of action require something of moral significance to be given up, such as surgical triage in a mass casualty event (Hunt, Sinding, & Schwartz, 2012). In the literature, moral distress has been connected to negative psychological effects and even stress related mental health issues including compassion fatigue, burnout, and post-traumatic stress disorder (Owen & Wanzer, 2014; Gustafsson, Eriksson, Strandberg, & Norberg, 2010; Litz, et al., 2009). (shrink)

In this article, we present an ethics framework for health practice in humanitarian and development work: the ethics of engaged presence. The ethics of engaged presence framework aims to articulate in a systematic fashion approaches and orientations that support the engagement of expatriate health care professionals in ways that align with diverse obligations and responsibilities, and promote respectful and effective action and relationships. Drawn from a range of sources, the framework provides a vocabulary and narrative structure (...) for examining the moral dimensions of providing development or humanitarian health assistance to individuals and communities, and working with and alongside local and international actors. The elements also help minimize or avoid certain miscalculations and harms. Emphasis is placed on the shared humanity of those who provide and those who receive assistance, acknowledgement of limits and risks related to the contributions of expatriate health care professionals, and the importance of providing skillful and relevant assistance. These elements articulate a moral posture for expatriate health care professionals that contributes to orienting the practice of clinicians in ways that reflect respect, humility, and solidarity. Health care professionals whose understanding and actions are consistent with the ethics of engaged presence will be oriented toward introspection and reflective practice and toward developing, sustaining and promoting collaborative partnerships. (shrink)

It has been claimed that there are certain acts that nurses as people practising nursing must never do because they are nurses and this is regardless of what the same agent should do; that certain actions are not part of proper nursing practice. The concept of an internal morality has been discussed in relation to medicine and has been used to ground the actions proper to medicine in a realist tradition. Although the concept of an internal morality of (...) nursing is not explicitly mentioned in the literature the underpinning ideas about the proper practice of nursing based on philosophical realism I argue equate with it and a discussion of the method of an internal morality can help to understand how arguments against euthanasia related to the profession of nursing are far from clear. Ultimately, although the idea of particular acts proper to nurses qua nurses is not clear, the concept of an internal morality can help to get practitioners to see how the profession is tightly linked to moral actions, even so the hard problems in bioethics such as the morality of euthanasia remain hard for all and the easy ones easy for all. (shrink)

In this essay I will discuss the relationship between two of the most basic ideas in political and legal philosophy: the justification of the state and state legitimacy. I plainly cannot aspire here to a complete account of these matters; but I hope to be able to say enough to motivate a way of thinking about the relation between these notions that is, I believe, superior to the approach which seems to be dominant in contemporary political philosophy. Today showing that (...) a state is justified and showing that it is legitimate are typically taken to require the very same arguments. I will argue that this contemporary stance obscures the difference between two central ways in which we should morally evaluate states, and it generates confusions about other serious practical issues, such as those surrounding our moral obligations to comply with law. I begin with brief discussions of the ideas of justification and legitimacy and with an attempt to capture what ought to be most central in our concerns about these ideas. I turn then to two basic ways of thinking about the relation between justification and legitimacy that I want to distinguish: what I will call the Lockean and the Kantian approaches. Next, I argue that the minority Lockean approach to this issue captures essential features of institutional evaluation that the majority Kantian approach does not; and I add brief mention of one further complication facing any adequate account of political evaluation. (shrink)

In this article we address the social value of bioethics research and show how a participatory approach can achieve social impact for a wide audience of stakeholders, involving them in a process of joint moral learning. Participatory bioethics recognizes that research co-produced with stakeholders is more likely to have impact on healthcare practice. These approaches aim to engage multiple stakeholders and interested partners throughout the whole research process, including the framing of ideas and research questions, so that outcomes are (...) tailored to the interests and context, and the type of impact stakeholders envisage. There is an emphasis on realizing social change through the conduct of the research, and it is believed that the engagement of stakeholders in the research process will promote their intrinsic motivation to change their practice. Another distinctive feature of participatory bioethics research is that its central normative commitment is to reflection and dialogue, not to a particular substantive ethical approach. In reflection and dialogue there is an emphasis on inclusion and the co-production of knowledge. Furthermore, empirical and normative research are combined, and there is a deliberate attempt to give voice to otherwise marginalized positions. This provides a model of social impact which is relevant not only for bioethics research, but also for other areas of health care research. We will show the merits of a participatory approach to bioethics research with a case example. It concerns the reduction of coercion and in particular seclusion in Dutch mental healthcare. (shrink)

A traditional approach to teaching medical ethics aims to provide knowledge about ethics. This is in line with an epistemological view on ethics in which moral expertise is assumed to be located in theoretical knowledge and not in the moral experience of healthcare professionals. The aim of this paper is to present an alternative, contextual approach to teaching ethics, which is grounded in a pragmatic-hermeneutical and dialogical ethics. This approach is called moral case deliberation. (...) Within moral case deliberation, healthcare professionals bring in their actual moral questions during a structured dialogue. The ethicist facilitates the learning process by using various conversation methods in order to find answers to the case and to develop moral competencies. The case deliberations are not unique events, but are a structural part of the professional training on the work floor within healthcare institutions. This article presents the underlying theory on ethics and illustrates this approach with an example of a moral case deliberation project in a Dutch psychiatric hospital. The project was evaluated using the method of responsive evaluation. This method provided us with rich information about the implementation process and effects the research process itself also lent support to the process of implementation. (shrink)

This book is the result of a three-year study undertaken by a multidisciplinary working party of the Institute of Medical Ethic (UK). The group was chaired by a moral theologian, and its members included biological and ethological scientists, toxicologists, physicians, veterinary surgeons, an expert in alternatives to animal use, officers of animal welfare organizations, a Home Office Inspector, philosophers, and a lawyer. Coming from these different backgrounds, and holding a diversity of moral views, the members produced the agreed report as (...) a result of detailed and rigorous discussions. The book sets out facts about animal experiments and about animal abilities to experience pain, distress and anxiety. There is a detailed examination of the moral claims related to the benefits likely to accrue from animal research, and of strategies for weighing these benefits against the harm caused to animals, in order to decide whether particular research projects ought or ought not to proceed. This leads to consideration of the statutory and non-statutory controls which safeguard standards in such research. The final section explores a variety of philosophical arguments about the use of animals in research, and offers a philosophical justification for the Working Party's more practical conclusions. Written in clear, nontechnical language, this book is accessible to lay people as well as to scientists. It is the first such document to emerge from a meeting of people with such widely differing views on this highly controversial subject, and represents a major contribution towards informing and raising the quality of contemporary debate. The book is unique in drawing together material and ideas never before found in one volume. It will interest a broad spectrum of readers, from ethicists and animal rights advocates to scientific researchers and laboratory administrators, along with general readers concerned about this compelling issue. (shrink)

Ethical Engineering: A Practical Guide with Case Studies provides detailed and practical guidance in making decisions about the many ethical issues practicing engineers may face in their professional lives. It outlines a decision-making procedure and helps engineers construct an ethics toolkit consisting of professional models, a comprehensive set of ethical considerations and factors that help in weighing those considerations, and analyses of particular issues, such as reverse engineering a patented process. Illustrating case studies, both brief and detailed, are (...) provided. Features: Introduces the nature of ethical decision making as applied to engineering values and issues. Helps readers develop a detailed ethics toolkit that identifies options and solutions and allows them to monitor and adjust as necessary. Features topics such as safety, sustainability, bioethics, diversity and equality, information technology and AI, as well as critical areas often overlooked in engineering texts, such as mentoring, advertising (for consulting firms), engineering sales, and much more. Includes more than 50 case studies to illustrate a variety of scenarios. Offers an international perspective with codes of ethics from around the world, including Saudi Arabia, India, New Zealand, Chile, and Japan. Adds further cases and samples for discussion and a summary of key ideas. Emphasizing the importance of the moral life and of engineering as an occupation with high ideals, this book helps readers navigate a variety of real-world ethical issues they are likely to face in this increasingly interdisciplinary, global, and diverse profession. (shrink)

In this article, we present an ethics framework for health practice in humanitarian and development work: the ethics of engaged presence. The ethics of engaged presence framework aims to articulate in a systematic fashion approaches and orientations that support the engagement of expatriate health care professionals in ways that align with diverse obligations and responsibilities, and promote respectful and effective action and relationships. Drawn from a range of sources, the framework provides a vocabulary and narrative structure (...) for examining the moral dimensions of providing development or humanitarian health assistance to individuals and communities, and working with and alongside local and international actors. The elements also help minimize or avoid certain miscalculations and harms. Emphasis is placed on the shared humanity of those who provide and those who receive assistance, acknowledgement of limits and risks related to the contributions of expatriate health care professionals, and the importance of providing skillful and relevant assistance. These elements articulate a moral posture for expatriate health care professionals that contributes to orienting the practice of clinicians in ways that reflect respect, humility, and solidarity. Health care professionals whose understanding and actions are consistent with the ethics of engaged presence will be oriented toward introspection and reflective practice and toward developing, sustaining and promoting collaborative partnerships. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Women Philosophers: Genre and the Boundaries of PhilosophyLorraine CodeCatherine Villanueva Gardner. Women Philosophers: Genre and the Boundaries of Philosophy. Boulder, CO: Westview, 2003. Pp. xv + 198. Paper, $22.00.In a tradition which "trains us to read purely for content" (xii), Catherine Gardner wonders how to read the philosophy of five women who write in "non-standard philosophical forms" (xiii): Mechthild of Magdeburg's poetry, Christine de Pisan's allegory, Catharine Macaulay's (...) epistolary form, and Mary Wollstonecraft's and George Eliot's fiction. Asking how these authors' gender and their works' genre bear on their exclusion from canonical philosophy with its reliance on rigorous argument unsullied by stylistic considerations, she argues that form is integral to understanding philosophy, and can impede its recognition as philosophy. Specifically, she wonders what these historical writings can offer present-day feminist ethics?Gardner's readings and her thesis about style and genre as conditions of philosophical legitimacy are provocative. She urges "reading past" forms deemed inhospitable to moral truth—such as Macaulay's epistolary style (44-45)—to encounter the author as moral philosopher, and explain her invisibility as such. Eliot's philosophy "demands the form of a novel" (123), she proposes, and Wollstonecraft's principles of style "are ultimately principles of morality as well" (92). More complex is the poetically articulated moral epistemology in Mechthild's The Flowing Light, with God, speaking through Mechthild, as its author (154-56). Because these forms—epistolary, allegorical, mystical-poetic, fictional—have been most accessible to women, Gardner urges feminists to consider how these authors' gender bears on their exclusion from moral philosophy. Owing to women's "greater capacity for emotion and... weaker capacity for reason" (155), mystics such as Mechthild were deemed well-suited to write as they did; yet works attributed to God stand immune to philosophical argument. Macaulay's thoughts on government and social reform were judged secondary to her "feminine" ones about educating women for marriage and domesticity (26-27). Gardner is persuaded and persuasive about the philosophical stature of the works she discusses. Yet if a thinker's gender denies her philosophical status, how can she bypass those exclusionary structures—even if, like Eliot, she chooses a male name? If a work's genre removes it from the sustained argumentative debate that is the hallmark of western philosophy, how can it claim a place there?There are no easy answers, but the questions spark numerous others. Perplexing is Gardner's contention that these women are ignored because they defy norms of style and method. But how would she classify Plato's dialogues, Voltaire's Candide, Pascal's and Nietzsche's aphorisms, Wittgenstein's numbered propositions,or Sartre's, Camus' (and Beauvoir's) philosophical novels, given their maverick styles? Style alone cannot effect or explain the exclusions she deplores. More puzzling are Gardner's conceptions of standard method and dominant form (e.g., 24, 120, 175), since she does not elaborate, apart from indicating that both require rigorous prose argument. But formal and methodological orthodoxy varies historically, as in the influence of scholasticism, for Christine, which receives no mention, or Gardner's ahistorical suggestion that the absence of a "normative subject as an independent, autonomous individual" (171) is a lacuna in Mechthild's work. Why would a thirteenth-century writer presuppose an Enlightenment subject? These issues demand attention in a work of historical scholarship.A different question troubles the method discussion. The author regrets certain women's exclusion from the canon despite the philosophical nature of their work, maintaining that [End Page 215] works whose styles/forms diverge from the standard count, nonetheless, as philosophy. These women demonstrate that philosophy need not be couched in formal argument: poetry, allegory, novels can also articulate philosophical theories. But—if my reading is correct—here Gardner is inconsistent. She commends the philosophy in Macaulay's Letters, claiming it "can and does contain the sort of sustained argument... uncontroversially identifiable as... philosophical" (44), and makes similar claims for Wollstonecraft and Eliot. But in legitimating these works by received standards of argument after all, Gardner weakens the force of her claims that philosophy—good philosophy—need not be presented in orthodox form, thus... (shrink)

Following the trend of sharing, and associating being on-line with being 'on-life', many people are now demanding the ownership and control of their data across all processing phases, including the erasure of their presence on the web. In Europe, recent proposals for regulation include an explicit 'Right to be Forgotten'; this right stated in the European Commission Proposal for Regulation COM 2011/12 does not emerge without controversy. It is being criticised on several grounds, including clashing with other rights, (...) such as freedom of expression, as well as setting the terrain for censorship. Besides the purely legal aspects of the proposed provisions, the chapters of this volume discuss how those legal provisions correspond in practice to worldviews and how individual and collective memory must be governed. They look into the deeper consequences of such provisions to construction of identity, culture and community formation, and how such a right affects how, what and why individuals, groups and societies remember and forget. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Thus Spake Howard Roark:Nietzschean Ideas in The FountainheadLester H. HuntIThe position I will be taking here will seem very peculiar to many people. I will be treating a novel as a discussion of the work of a philosopher—namely, Friedrich Nietzsche. Worse yet, I will be treating it as a discussion that is philosophically penetrating and deserves to be taken seriously. Still worse, the novel is Ayn Rand's early novel (...) The Fountainhead. I think it is safe to say that her reputation, among academics who discuss the works of philosophers, is very low. If the reader will only bear with me, though, I think I can make a case that Rand opens a line of inquiry about Nietzsche's ideas and values that is not only quite interesting in itself but one that ought to be pursued further by others.There has always been ample reason to associate Nietzsche with The Fountainhead.1 He is after all, the only philosopher who is more or less directly quoted in the book.2 Beyond that, Rand's novel has many other passages that students of Nietzsche instantly recognize as conscious references to him or deliberate echoes of his style. In addition, she revealed, in an introduction written for the twenty-fifth anniversary edition, that the following quotation from Beyond Good and Evil had originally stood at the head of the book when it was still in manuscript:It is not the works, but the belief which is here decisive and determines the order of rank to—employ once more an old religious formula with a new and deeper meaning—it is some fundamental certainty which a noble soul has about itself, something which is not to be sought, is not [End Page 79] to be found, and perhaps, also, is not to be lost—The noble soul has reverence for itself.—3She said, in the same introduction, that she removed the quotation (evidently, immediately before publication) for philosophical reasons, because of her "profound disagreement with the philosophy of its author." Nietzsche, she says, was fundamentally "a mystic and irrationalist," and even in this quotation, chosen for its content, insinuates a philosophical position that she regards as erroneous (namely, determinism). Even her statement of what she likes about this passage is rather constrained: "as a poet [ie., not as a philosopher], he projects at times (not consistently) a magnificent feeling for man's greatness, expressed in emotional, not intellectual terms."4It is of course true enough that Rand does disagree with Nietzsche, and for more or less the reasons that she suggests here, but it is also true that the passage she has quoted expresses some ethical themes—nobility, order of rank, the "pathos of distance," and (most obviously) the idea of self-reverence as a characteristic of the ethically good—which are at least as important in The Fountainhead as they are in Nietzsche's writings. Though Rand's spirited disclaimer serves to remind us of her deep differences with Nietzsche, the quotation itself suggests that there might be an interesting philosophical, not merely literary or emotional, connection between The Fountainhead and Nietzsche's ideas. What I would like to show here is that this connection merits a much closer look than it has ever been given heretofore. Not only is the presence of Nietzschean themes in Rand's novel deep and pervasive, but the book actually contains a very interesting and powerful internal critique of one of Nietzsche's most characteristic ideas, a criticism based in large part on values and assumptions that he shares. Before I can set out this critique, I will need to explore some of the positive thematic and philosophical connections.IIOne evening, rather late in the novel, Gail Wynand, the corrupt newspaper publisher and financier, surprises his wife, Dominique, with a present: he has had an architect design a house for them. The architect, she realizes with shock as she sees the drawings for the house, is her former lover, Howard Roark, a man with whom she is still in love. None of this is known to her husband, who innocently tells her that [End Page 80] Roark... (shrink)

There has been an increase in recent years in the use of empirical methods in healthcare ethics. Appeals to empirical data cannot answer moral questions, but insights into the knowledge, attitudes, experience, preferences and practice of interested parties can play an important part in the development of healthcare ethics. In particular, while we may establish a general ethical principle to provide explanatory and normative guidance for healthcare professionals, the interpretation and application of such general principles to actual practice (...) still requires interpretation and judgement. And many situations in healthcare practice are complex and may involve a variety of principles, each of which may conflict with the others. Simple surveys or interview studies may not be sufficient if we wish to develop a nuanced approach to ethical practice that can be set out in guidelines, codes or directives. We do not resolve moral questions by plebiscite. In this paper, the authors argue for the use of consensus methods to develop shared understanding of ethical practice, and they argue further for the combination of the Delphi method with the use of vignettes to illustrate the kind of situations that may occur in practice. They develop their argument in part by reference to their experience of using this approach in their recent research. (shrink)

Philosophical inquiry strives to be the unencumbered exploration of ideas. That is, unlike scientific research which is subject to ethical oversight, it is commonly thought that it would either be inappropriate, or that it would undermine what philosophy fundamentally is, if philosophical research were subject to similar ethical oversight. Against this, I argue that philosophy is in need of a reckoning. Philosophical inquiry is a morally hazardous practice with its own risks. There are risks present in the methods we (...) employ, risks inherent in the content of the views under consideration, and risks to the subjects of our inquiry. Likely, there are more risks still. However, by starting with the identification of these three risks we can demonstrate not only why an ethics of practice is needed but also which avenues are the most promising for developing an ethics for philosophical practice. Although we might be in the business of asking questions, we do not absolve ourselves of responsibility for the risks that inquiry incurs. (shrink)

The determination of death by neurological criteria remains controversial scientifically, culturally, and legally, worldwide. In the United Kingdom, although the determination of death by neurological criteria is not legally codified, the Code of Practice of the Academy of Medical Royal Colleges is customarily used for neurological death determination and treatment withdrawal. Unlike some states in the US, however, there are no provisions under the law requiring accommodation of and respect for residents' religious rights and commitments when secular conceptions of death (...) based on medical codes and practices conflict with a traditional concept well-grounded in religious and cultural values and practices. In this article, we analyse the medical, ethical, and legal issues that were generated by the recent judgement of the High Court of England and Wales in Re: A [2015] EWHC 443. Mechanical ventilation was withdrawn in this case despite parental religious objection to a determination of death based on the code of practice. We outline contemporary evidence that has refuted the reliability of tests of brainstem function to ascertain the two conjunctive clinical criteria for the determination of death that are stipulated in the code of practice: irreversible loss of capacity for consciousness and somatic integration of bodily biological functions. We argue that: the tests of brainstem function were not properly undertaken in this case; the two conjunctive clinical criteria set forth in the code of practice cannot be reliably confirmed by these tests in any event; and absent authentication of the clinical criteria of death, the code of practice wrongly invokes a secular definition of death based on the loss of personhood. Consequently, the moral obligation of a pluralistic society to honor and respect diverse religious convictions to the greatest extent possible is being violated. Re A is contrasted with the US case of Jahi McMath in which the court accommodated parental religious objection to the determination of neurological death codified in the Uniform Determination of Death Act. We conclude that the legal system in the United Kingdom should not favour a secular definition of death over a definition of death that is respectful of religious values about the inviolability and sanctity of life. We recommend the legal recognition of religious accommodation in death determination to facilitate cultural sensitivity and compassionate care to patients and families in a pluralistic society. (shrink)

The paper begins with a description of a grey seal performing conspecific infanticide. The paper then gives an account of “nobleness” and “brutishness.” Roughly, a behavioural-disposition is noble/brutish if it is one that would be a moral virtue/vice if the possessor of the behavioural-disposition were a moral agent. The paper then advances two pairs of axiological claims. The first pair of claims is that nobleness is good and that brutishness is bad. The second pair of claims is about an (...) axiological interaction between nobleness/brutishness and well-being. That any non-human animal lacks well-being is bad. Yet, it is worse that a noble non-human animal lacks well-being, and not so bad that a brutish non-human animal lacks well-being. Lastly, the paper discusses some potential moral implications of these axiological claims, for instance that factory farming is especially wrong because it causes noble non-human animals to lack well-being. (shrink)

The idea of moral reform requires that morality be more than a description of what people do value, for there has to be some measure against which to assess progress. Otherwise, any change is not reform, but simply difference. Therefore, I discuss moral reform in relation to two prescriptive approaches to common morality, which I distinguish as the foundational and the pragmatic. A foundational approach to common morality (e.g., Bernard Gert’s) suggests that there is no reform of (...) morality , but of beliefs, values, customs, and practices so as to conform with an unchanging, foundational morality. If, however, there were revision in its foundation (e.g., in rationality), then reform in morality itself would be possible. On a pragmatic view, on the other hand, common morality is relative to human flourishing, and its justification consists in its effectiveness in promoting flourishing. Morality is dependent on what in fact does promote human flourishing and therefore, could be reformed. However, a pragmatic approach, which appears more open to the possibility of moral reform, would need a more robust account of norms by which reform is measured. (shrink)

The determination of death by neurological criteria remains controversial scientifically, culturally, and legally, worldwide. In the United Kingdom, although the determination of death by neurological criteria is not legally codified, the Code of Practice of the Academy of Medical Royal Colleges is customarily used for neurological death determination and treatment withdrawal. Unlike some states in the US, however, there are no provisions under the law requiring accommodation of and respect for residents' religious rights and commitments when secular conceptions of death (...) based on medical codes and practices conflict with a traditional concept well-grounded in religious and cultural values and practices. In this article, we analyse the medical, ethical, and legal issues that were generated by the recent judgement of the High Court of England and Wales in Re: A [2015] EWHC 443. Mechanical ventilation was withdrawn in this case despite parental religious objection to a determination of death based on the code of practice. We outline contemporary evidence that has refuted the reliability of tests of brainstem function to ascertain the two conjunctive clinical criteria for the determination of death that are stipulated in the code of practice: irreversible loss of capacity for consciousness and somatic integration of bodily biological functions. We argue that: the tests of brainstem function were not properly undertaken in this case; the two conjunctive clinical criteria set forth in the code of practice cannot be reliably confirmed by these tests in any event; and absent authentication of the clinical criteria of death, the code of practice wrongly invokes a secular definition of death based on the loss of personhood. Consequently, the moral obligation of a pluralistic society to honor and respect diverse religious convictions to the greatest extent possible is being violated. Re A is contrasted with the US case of Jahi McMath in which the court accommodated parental religious objection to the determination of neurological death codified in the Uniform Determination of Death Act. We conclude that the legal system in the United Kingdom should not favour a secular definition of death over a definition of death that is respectful of religious values about the inviolability and sanctity of life. We recommend the legal recognition of religious accommodation in death determination to facilitate cultural sensitivity and compassionate care to patients and families in a pluralistic society. (shrink)

Human risk (the risk of people doing things they shouldn't, or not doing things they should') is the largest single risk facing all organisations -- when things go wrong, there's always a human component, either causing the problem or making it worse. Collectively, companies spend billions trying to manage human risk via functions like Compliance, InfoSec, Risk, Audit, Legal, Human Resources and Internal Comms -- it is people in these functions, as well as those tasked with managing people, that (...) is the target audience for the book. Technology exacerbates the problem by providing each of us with weapons of mass destruction' from a human risk perspective -- even the most junior employee can cause huge damage via their keyboard, either in the work environment or via their personal social media account -- and by taking over basic, repetitive tasks, which mean people are spending more time in human risk sensitive' activities. Traditional approaches to mitigating human risk rely heavily on the idealised presumption that because people are employed, they can simply be told what to do -- this works well in safety-critical environments, where the black & white' parameters of desired outcomes are easy to predict, but is much harder when it comes to grey', less codifiable, areas like ethics which are often difficult to monitor until it's too late and rely on employees being positively engaged. If we want to mitigate the risks posed by human decision-making, then we need to base our approach on an understanding of how humans actually make decisions, which is where Behavioural Science -- a discipline based on academic research and field-tested on real' humans by advertisers, governments and transport authorities -- can help achieve better outcomes. This book is designed to help all those involved in managing human risk to achieve compliance' with a small -- in other words, getting their desired outcome -- and explores how organisations can get the best out of their people by designing frameworks that work with, rather than against, the grain of human thinking. Readers will learn to challenge their existing presumptions about managing human risk and discover practical techniques and examples they can deploy in their work environment. (shrink)

Recent discourses about the legitimacy of homeopathy have focused on its scientific plausibility, mechanism of action, and evidence base. These, frequently, conclude not only that homeopathy is scientifically baseless, but that it is “unethical.” They have also diminished patients’ perspectives, values, and preferences. We contend that these critics confuse epistemic questions with questions of ethics, misconstrue the moral status of homeopaths, and have an impoverished idea of ethics—one that fails to account either for the moral worth of (...) care and of relationships or for the perspectives, values, and preferences of patients. Utilitarian critics, in particular, endeavour to present an objective evaluation—a type of moral calculus—quantifying the utilities and disutilities of homeopathy as a justification for the exclusion of homeopathy from research and health care. But these critiques are built upon a narrow formulation of evidence and care and a diminished episteme that excludes the values and preferences of researchers, homeopaths, and patients engaged in the practice of homeopathy. We suggest that homeopathy is ethical as it fulfils the needs and expectations of many patients; may be practiced safely and prudentially; values care and the virtues of the therapeutic relationship; and provides important benefits for patients. (shrink)

Disaster research has grown in scope and frequency. Research in the wake of disasters and during humanitarian crises – particularly in resource-poor settings – is likely to raise profound and unique ethical challenges for local communities, crisis responders, researchers, and research ethics committees. Given the ethical challenges, many have questioned how best to provide research ethics review and oversight. We contribute to the conversation concerning how best to ensure appropriate ethical oversight in disaster research and argue that ethical (...) disaster research requires of researchers and RECs a particular sort of ongoing, critical engagement which may not be warranted in less exceptional research. We present two cases that typify the concerns disaster researchers and RECs may confront, and elaborate upon what this ongoing engagement might look like – how it might be conceptualized and utilized – using the concept of real-time responsiveness. The central aim of RTR, understood here as both an ethical ideal and practice, is to lessen the potential for research conducted in the wake of disasters to create, perpetuate, or exacerbate vulnerabilities and contribute to injustices suffered by disaster-affected populations. Well cultivated and deployed, we believe that RTR may enhance the moral capacities of researchers and REC members, and RECs as institutions where moral agency is nurtured and sustained. (shrink)

This study used experimental and correlational techniques to examine perceptions that university faculty hold regarding the practice of professorial selling of examination textbooks to wholesalers. Faculty members (n = 236) from 14 universities and community colleges and a wide variety of academic disciplines responded to a web-based survey. We presented hypothetical selling situations to respondents with manipulated variables consisting of solicitation status (unsolicited versus solicited) and use of money (for faculty or for student activities). Both main effects and the (...) interaction effect were significant such that respondents perceived it to be more ethical to sell an examination book when the book was unsolicited and when the money was being used to fund student activities. The variable most correlated with faculty members' beliefs that book selling is ethical and the faculty members' self-reports of whether or not they have engaged in bookselling was how widespread the practice appeared to be on campus. About 30 percent of faculty members sold textbooks over the past year at a dollar value of about $80 per professor. About 38 percent of respondents reported they believed the practice to be generally ethical. Implications for business ethics theory, students' moral development, and advancement of on-campus codes of ethics policies are discussed along with avenues for future research. (shrink)

ART and, in particular, IVF and ICSI, are essentially a laboratory experiment, but which, due to its specificity, goes beyond the disciplinary boundaries, explicitly acquiring an ethical-axiological dimension in the interaction zone of the members of a particular community involved in child-bearing. At the same time, it is noted that the activity and choice of a way to solve problems with childbirth has a characteristic severity, due to the traditions and level of civil and social maturity of a country, (...) due, among other things, to the level and achievements of technical equipment in this industry of knowledge and practice. According to foreign studies, about half of all subfertile people in developed countries are trying to overcome their infertility with the help of medicine, and research data indicate that the proportion of such individuals is growing. The most difficult problems of reproduction are associated with low quality of oocytes or low ovarian reserve ; aspermia and deep teratozoospermia, can not give hope to a couple to have genetically related offspring. However, donor programs create additional opportunities for social motherhood / paternity. Donation of oocytes is found in ART programs at least 3 times more often than donation of spermatozoa. At the moment, donation of gametes and embryos raises a number of ethical, legal, medical and socio-psychological issues that require competent support from experts of a wide range of specialists, as well as competent, non-commercial, primarily due to the interaction between donors and recipients. The analysis of possible modifications of family and kinship ties is based on the idea of transforming social relations, in which assisted reproductive technologies play a fundamental role, building a system of “new kinship and new family.” By entering into the intimate process of the birth of life and acting as a regulator of the composition of participants in this process through the stimulation of responsibility to present and future relatives, reproductive technologies affect the initial moral requirements in the community, redefining universal values based on the specific situation. Scenarios of childbearing through ART with the involvement of additional participants are possible in the context of the legal field, but legally fixed anonymity of the donor leaves many unresolved issues related to the problems of hereditary diseases, genetic abnormalities and epigenetic changes; in addition, there is a problem associated with the possibility of unintentional incest, as well as the difficulties of the child’s self-identification and the closeness of his genealogy. Solutions to these issues are postponed until later, thereby initiating future dramatic situations, ethical conflicts and dilemmas with a poorly predictable positive outcome. (shrink)

Ethics support staff help others to deal with moral challenges. However, they themselves can also experience moral challenges such as issues regarding (breaching) confidentiality when practicing ethics support. Currently there is no insight in these confidentiality issues and also no professional guidance for dealing with them. To gain insight into moral challenges related to Moral Case Deliberation (MCD), we studied a) beliefs and experiences of MCD facilitators regarding breaching confidentiality, b) considerations for (not) breaching confidentiality, and (...) c) needs for an ethics support tool. Data collection consisted of qualitative research methods: six semi-structured interviews; analyses of a) two recorded MCD sessions, and b) a focus group with MCD facilitators. Findings: MCD facilitators mention different conceptions and interpretations of confidentiality and various moral challenges. Questions concerning confidentiality ultimately cause reflections on roles and responsibilities of facilitators. Needs for ethics support vary from seeking advice to procedural and sometimes normative guidance for MCD facilitators. Education for MCD facilitators should focus on developing a concrete tool that stimulates awareness and reflection(skills). (shrink)

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)

Contemporary medical diagnostics has a dynamic moral landscape, which includes a variety of agents, factors, and components. A significant part of this landscape is composed of information technologies that play a vital role in doctors’ decision-making. This paper focuses on the so-called Intelligent Decision-Support System that is widely implemented in the domain of contemporary medical diagnosis. The purpose of this article is twofold. First, I will show that the IDSS may be considered a moral agent in the practice of medicine (...) today. To develop this idea I will introduce the approach to artificial agency provided by Luciano Floridi. Simultaneously, I will situate this approach in the context of contemporary discussions regarding the nature of artificial agency. It is argued here that the IDSS possesses a specific sort of agency, includes several agent features (e.g. autonomy, interactivity, adaptability), and hence, performs an autonomous behavior, which may have a substantial moral impact on the patient’s well-being. It follows that, through the technology of artificial neural networks combined with ‘deep learning’ mechanisms, the IDSS tool achieves a specific sort of independence (autonomy) and may possess a certain type of moral agency. Second, I will provide a conceptual framework for the ethical evaluation of the moral impact that the IDSS may have on the doctor’s decision-making and, consequently, on the patient’s wellbeing. This framework is the Object-Oriented Model of Moral Action developed by Luciano Floridi. Although this model appears in many contemporary discussions in the field of information and computer ethics, it has not yet been applied to the medical domain. This paper addresses this gap and seeks to reveal the hidden potentialities of the OOP model for the field of medical diagnosis. (shrink)

This highly original book_ _explores the idea and potential of psychology in the context of ethical theory, and the idea of ethics in the context of psychology. In so doing, it not only interrogates how we come to understand ethics and notions of right behaviour, but also questions the discipline of psychology and how it functions in the 21 st century. Neill turns psychology inside out, controversially suggesting that psychology no longer exists as we know it. He proposes (...) a rebirth of psychology based on an intricate and detailed examination of _who_ we really are, and how we come to structure this idea of ourselves. Taking the idea of ethics seriously, Neill allows us to see psychology in a totally new light, addressing key points, such as: The inadequacy of psychology to address the question of ethics throughout history. Why thinking through the question of ethics necessarily brings us into confrontation with a question of psychology. What we actually do when we do psychology and how, via a serious consideration of ethics we might do this differently and better. Ethics and Psychology presents readers with a new and potentially productive understanding of both ethics and psychology and will appeal to anyone active within and critically engaged with the field. (shrink)

This book argues that the institutions of law, and the structures of legal thought, are to be understood by reference to a moral ideal of freedom or independence from the power of others. The moral value and justificatory force of law are not contingent upon circumstance, but intrinsic to its character. Doctrinal legal arguments are shaped by rival conceptions of the conditions for realization of the idea of law. In making these claims, the author rejects the viewpoint of much contemporary (...) legal theory, and seeks to move jurisprudence closer to an older tradition of philosophical reflection upon law, exemplified by Hobbes and Kant. Modern analytical jurisprudence has tended to view these older philosophies as confused precisely in so far as they equate an understanding of law's nature with a revelation of its moral basis. According to most contemporary legal theorists, the understanding and analysis of existing institutions is quite distinct from any enterprise of moral reflection, but the relationship between ideals and practices is much more intimate than this approach would suggest. Some institutions can be properly understood only when they are viewed as imperfect attempts to realize moral or political ideals; and some ideals can be conceived only by reference to their expression in institutions. (shrink)

The aim of this article is to provide a preliminary ethical evaluation of the effect of telesurgery on patient care. In order to accomplish this task we give a broad description of the state of the art in telesurgery and analyse it using Joan Tronto’s articulation of care as a structured process. This structure illuminates the significance of the patient-physician relationship as the buttress for establishing and preserving practices of care in the healthcare context, with the ultimate goal of (...) safeguarding patient dignity. The process of care combined with the moral aim of medicine—to fulfil the good of the patient—provides the ethical foundation for assessing telesurgery. By exploring various telesurgical scenarios we may assess its potential role in augmenting or diminishing patient care within the frame of the patient-physician relationship. The significance of conducting this evaluation lies in the fact that the practice of telesurgery may very shortly become routine and an evaluation has not yet been attempted. (shrink)

This paper takes a virtuist approach to medical ethics to explore, from an empirical angle, ideas about settled ways of living a good life. Qualitative research methods were used to analyse the ways in which a group of 15 general practitioners articulated notions of good doctoring and the virtues in their work. I argue that the GPs, whose talk is analysed here, defined good general practice in terms of the ideals of accessibility, comprehensiveness, and continuity. They regarded these ideals (...) significant both for the way they dealt with morally problematic situations and for how they conducted their professional lives more generally. In addition, I argue that the GPs who articulated these ideals most clearly were able to, in part, because they shared the experience of working in rural areas. This experience helped them to develop an understanding of the nature of general practice that their urban colleagues were less able to draw on. In that sense, the structural and organisational framework of general practice in rural areas provided the context for their understanding of ideals in general practice. (shrink)

Many of us are all too familiar with the experience of taking pleasure in things we feel we ought not, and of finding it frustratingly hard to bring our pleasures into line with our moral judgements. As a value dualist, Kant draws a sharp contrast between the two sources of practical motivation: pleasure in the agreeable and respect for the moral law. His ethics might thus seem to be an unpromising source for help in thinking about how (...) we can bring our agreeable pleasures into line with our moral values. But I argue that a careful reading of Kant’s texts reveals a helpfully realistic view about the extent to which we can modify our agreeable pleasures. On my interpretation, Kant shows us how to hold together two seemingly incompatible ideas: on the one hand, that pleasure in the agreeable is resistant to rational direction, and on the other hand, that we can cultivate these pleasures with a view to ethical self-transformation. (shrink)

At the 1992 Women in the History of Philosophy Conference at Cambridge, the contestability of the title "philosopher" was a major item of discussion. Historically, it seemed, women could claim the title only if there was no doubt that their work was original, where originality had everything to do with producing writings that did not "merely" derive from, comment upon, contribute to, or critique the works of male philosophers. The requirement is odd in an intellectual discipline shaped and sustained (...) by critical-constructive debate that constitutes both its history and its substance, many of whose canonical participants have directed their major efforts to corroborating, refuting, and/or extending the ideas of their semblables elsewhere or in other times. The "merely derivative" criterion is difficult to credit when it merely confirms fixed assumptions about women's place in a social order where they had no audible public voice and achieved minimal wider acknowledgement for their private utterances. For, although no simple conspiracy theory could account for women's philosophical silence, the original-versus-derivative distinction has often functioned as a double standard, recognizing many men as philosophers because of their engagement with topics that preoccupied other, already established philosophers, denying women recognition because of equivalent engagements. The injustice of these practices prompts Linda McAlister's project of collecting these eighteen articles, which span the time period from the work of Hypatia in the fourth century BC to the late-twentieth-century work of Hannah Arendt and Angela Davis. Many of the essays first appeared in Hypatia: A Journal of Feminist Philosophy, some of them are reprinted from other journals, and five appear here for the first time. In presenting detailed, engaged philosophical analyses of the work of women philosophers, the essays begin to address the belief that women, "denied the opportunity to stand on the shoulders of their foremothers", have frequently had to enter philosophical discourse through the auspices of men. They attest to the contingencies of canon formation in determining who can claim a place in the lineage of the fathers. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Recovering Aquinas's Common-Good-Oriented Right of RebellionNathaniel A. MoatsIntroductionAs recent events have woefully displayed, armed rebellion is not a topic of merely theoretical interest.1 While theory seemingly has very little impact on the citizens participating in armed rebellions, theory still remains of paramount importance, providing crucial criteria to evaluate, restrain, apply, and respond to such force. Criteria such as legitimate authority, just cause, right intention, necessity, proportionality, and likelihood of (...) success have been offered by thinkers advocating "just war" theory from across diverse political, philosophical, and religious backgrounds, garnering widespread agreement over the centuries. Contemporary scholars who identify as "historically oriented" just war thinkers have continued to defend that historical tradition as a sufficient and substantial guide for contemporary practice.2 Yet some have questioned whether the it can provide useful aid for dealing with contexts of political tyranny. In a 2013 article, Valeria Morkevičius describes [End Page 175] Western culture as divided over the moral permissibility of armed rebellion, with advocates basing their views on the Enlightenment ideas found in John Locke and Jean-Jacques Rousseau, whereas traditional just war theorists have generally denied a right to armed rebellion.3 In Morkevičius's perspective, she argues that there can be justified use of armed force against tyranny and calls upon other scholars to help create a "just rebellion theory" that would "radically reimagine" traditional just war thinking.4 She claims that there is a "lack of a systematic and rigorous ethical framework for evaluating the justness of rebellions"5 and that "a new theory of just rebellion—a systematic way of evaluating the justness of real world rebellions, of determining appropriate state responses to domestic rebellions, and of weighing the pros and cons of intervention" is needed.6In line with Morkevičius' sentiments, the last ten years has seen the increasing rise of self-proclaimed just war revisionists.7 Jeff McMahan, the figurehead for this movement, claims that the classical just war criteria "can no longer stand."8 McMahan argues that traditional just war theory has [End Page 176] depicted war as a morally sui generis category of violence in which unique moral principles apply.9 The moral asymmetry of war is also reinforced by a "statist" and "collectivist" orientation that overrides the importance of individuals and their rights of life, liberty, property, and other fundamental goods. Instead of seeing war as a distinct category of violence, McMahan argues that war and self-defense are morally symmetrical. Further, he argues that combatants should be depicted as individuals distinct from their political or collective identity.10 In other words, McMahan offers a theory of war oriented around individuals and their rights based in the concept of justified self-defense.11 Extending McMahan's theory, Cécile Fabre has particularly targeted the criterion of legitimate authority as morally problematic.12 Rejecting the exclusive authorization of armed force by political authorities, she argues in favor of an individual's right to war, and by extension the right to rebellion.13 Therefore, given the historical just war tradition's emphasis on the criterion of legitimate authority (i.e., the restriction of armed force [End Page 177] to established authorities) and resistance to support armed rebellions due to the lack of recognized political leaders, revisionists conclude that traditional just war thinking is inadequate for providing contemporary guidance in the context of rebellion.14To challenge revisionist claims, I analyze Thomas Aquinas's ingenuity and relevance for future "just rebellion" thinking. First, I argue that classical just war thinking is not as antithetical to armed rebellion as suggested.15 One just rebellion theory has coexisted alongside the classical formation of just war theory, albeit often neglected or ignored by contemporary thinkers.16 It is well known that Aquinas formalized the Augustinian classical just war theory revolving around the criteria of legitimate authority, just cause, and right intention. Much less known, however, is the fact that Aquinas also crafted criteria for justified armed rebellions. While Aquinas's just war thinking rearticulates Augustine's perspective, Aquinas appropriated his mentor's views to allow for justified armed rebellions. Aquinas's originality was displayed not only in allowing justified armed... (shrink)

PurposeThe purpose of this paper is to study the ethical behaviour of Muslim IT professionals in an attempt to stop many unethical practices such as software piracy, software intellectual property violations and general software development.Design/methodology/approachThis study examines the computer ethical principles presented in the Association for Computing Machinery code of conduct from an Islamic point of view through studying some relevant verses of The Holy Quran and Hadiths of Prophet Mohammed. An evaluation of the benefits of this newly proposed Islamic (...) computer code of ethics is presented by surveying how IT students, IT professionals and software house owners would adhere to it. The evaluation was carried out by teaching different groups of participants aspects of the ACM code of conduct and the proposed Islamic computer ethics code and then surveying their opinions by a questionnaire.FindingsThe study demonstrates that teaching computer ethics in general, and computer ethics from an Islamic point of view in particular, clearly contributes to ethical behaviour of Muslim IT professionals with regards to software development issues.Research limitations/implicationsIt is not possible to put participants through real life scenarios and practically observe how they would react to different ethical situations. The empirical research thus relies on what participants said they would do.Practical implicationsThe newly developed Islamic code of computer ethics and its proposed implementation method can be utilised by organisations for their benefit.Originality/valueThe study is the first to address the issue of computer ethics and Islam for IT professionals. This paper presents a first Islamic computer code of ethics and presents a methodology for applying it. It also reports a study undertaken in Bahrain of how attitudes might be influenced by teaching computer ethics in general, and computer ethics from an Islamic point of view in particular. (shrink)

A persistent problem in the dominant agricultural development model is the imposition of technologies without regard to local processes and cultures. Even with the recent shift towards sustainability and agroecology, initiatives continue to overlook local knowledge. In this article we provide analysis of agroecological soil management in the Maya-Achi territory of Guatemala. The Achí, subject to five decades of interventions and development, present an interesting case study for assessing the complementarities and tensions between traditional, generally preventative practices and external (...) initiatives which tend to be curative. Our findings reveal a complex farming system that continues to rely on ancestral knowledge and practices, many of which display a high potential for sustainability and are deeply embedded in local culture. While some new practices have been incorporated into the traditional system, abandonment rates are high, and some extension methods have been paternalistic. The Achí are thirsty for new ideas to help them confront their current, unprecedented challenges. However, future collaborations should be built on existing local knowledge, which has contributed to the development of preventative and restorative practices still in use. Introduced technologies must coincide with local needs and socioecological context in a manner that encourages beneficial synergies, as well as horizontal learning/teaching processes. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Buddhist Literature as Philosophy and Buddhist Philosophy as Literature ed. by Rafael K. StepienVesna A. Wallace (bio)Buddhist Literature as Philosophy and Buddhist Philosophy as Literature. Edited by Rafael K. Stepien. Albany, NY: State University of New York Press, 2020. Pp. xi + 381. Paperback $26.95, isbn 978-1-4383-8070-1.The editor of the Buddhist Literature as Philosophy and Buddhist Philosophy as Literature should be commended for bringing together an excellent collection (...) of essays and producing the first comprehensive volume that offers a coherent study of the relationship between Buddhist literature and philosophy. This book is an ambitious and praiseworthy project, which covers a wide range of Buddhist literary genres produced in India, Tibet, and East Asia over two millennia. As a whole, the volume invites the reader to reexamine a centuries-long binary division between the categories of literature and philosophy, which have been often approached in academic studies as mutually exclusive. It does so by demonstrating that in the context of Buddhism, philosophy and literature continuously converge, diminishing the overarching binary and broadening their scopes. Most contributions to this volume demonstrate that Buddhist philosophy as presented and enacted in Buddhist literature is not limited to what some would consider a "pure philosophy." The volume is divided into the two, mutually mirroring sections, with each section containing six chapters. Chapters forming the section one, "Buddhist Literature as Philosophy," aim at broadening our perspective about literary forms, such as tales, novels, hymns, and court poetry, which have not been usually explored as the means of articulating Buddhist philosophical views. Chapters grouped in the section "Buddhist Philosophy as Literature" focus on Buddhist literary theories as philosophy of language and introduce the Buddhist biographical and autobiographical genres characterized by practical philosophy to further challenge our preconceptions of what it is that constitutes literature and philosophy. While some contributors endeavor to demonstrate the presence of rational, analytical reasoning in unexpected literary forms, other contributors problematize a strict distinction between literature and philosophy as inapplicable to Buddhism, which is undeniably cross-disciplinary.The first two chapters in section one, authored by Amber Carpenter and Sarah Shaw respectively, draw examples from jātaka stories to show us how Buddhist ethical lessons work in the narrative tales of the Buddha's former births. These two chapters also draw our attention to an accessible and engaging, [End Page 1] narrative manner that presents the Bodhisattva's philosophical exercises to the audience, a manner that stands in contrast to the a priori reasoning characteristic of philosophical treatises. In the first chapter, titled "Transformative Vision: Coming to See the Buddha's Reality," Carpenter analyzes two jātaka stories--"Bodhi the Wandering Ascetic" and "The Man Without an Heir"--taken from Āryaśūra's Jātakamālā. In the first story, a renunciant Bodhi, while repudiating the king's ministers who are intent on disqualifying him as a king's advisor on morality, makes metaphysical claims regarding the nature of reality, causation, and the universe, and provides the reasons and arguments. According to Shaw, by offering an insight into the Buddhist worldview and morality, jātaka tales have a transformative power not only with regard to ethics but also in transforming the reader's vision of reality. In the chapter "Jātakas and the Abhidhamma: Practical Compassion and Kusala Citta," Shaw suggests that a reason why jātaka stories are rarely discussed seriously in the way that they were intended is their literary format based in narrative and mundane situations. Analyzing the concepts of momentariness and kusala citta ("virtuous consciousness") in these stories, Shaw shows that by communicating the technical and insight-based Buddhist doctrinal elements, jātaka tales significantly contribute to Buddhist practical ethics. The Pāli Javanahaṃsa-jātaka, a tale about the friendship between a goose and a king, introduces the reader to some of the most complex Buddhist ideas such as impermanence, momentariness, and mental states, expounded in the Abhidhamma in extraction. Through her analysis of the Kurudhamma-jātaka and Mahosaddha-jātaka, Shaw further shows the integration of narrative literature and Buddhist philosophical tenets, of Buddhist tales and the Abhidhamma, of the relationship between the intention and consciousness... (shrink)

In their daily practices, many ethical vegans choose what to eat, wear, and buy among a range that is limited to the exclusion of animal products. Rather than considering and then rejecting the idea of using such products, doing so often does not occur to them as a possibility at all. In other cases, when confronted with the possibility of consuming animal products, vegans have claimed to reject it by saying that it would be impossible for them to do (...) so. I refer to this phenomenon as ‘moral impossibility’. An analysis of moral impossibility in animal ethics shows that it arises when one’s conception of ‘what animals are’ shifts—say through encounter with other animals. It also arises when individuals learn more about animals and what happens to them in production facilities. This establishes a link between increased knowledge, understanding, and imaginative exploration on the one hand, and the exclusion of the possibility of using animals as resources on the other. Taking moral impossibility in veganism seriously has two important consequences: one is that the debate around veganism needs to shift from choice and decision, to a prior analysis of concepts and moral framing; the other is that moral psychology is no longer seen as empirical psychology plus ethical analysis, but the contents of psychological findings are understood as being influenced and framed by moral reflection. (shrink)

BackgroundVulnerability is a key concept in traditional and contemporary bioethics. In the philosophical literature, vulnerability is understood not only to be an ontological condition of humanity, but also to be a consequence of contingent factors. Within bioethics debates, vulnerable populations are defined in relation to compromised capacity to consent, increased susceptibility to harm, and/or exploitation. Although vulnerability has historically been associated with older adults, to date, no comprehensive or systematic work exists on the meaning of their vulnerability. To fill (...) this gap, we analysed the literature on aged care for the meaning, foundations, and uses of vulnerability as an ethical concept.MethodsUsing PRISMA guidelines, we conducted a systematic review of argument-based ethics literature in four major databases: PubMed, Embase®, Web of Science™, and Philosopher’s Index. These covered biomedical, philosophy, bioethical, and anthropological literature. Titles, abstracts, and full texts of identified papers were screened for relevance. The snowball technique and citation tracking were used to identify relevant publications. Data analysis and synthesis followed the preparatory steps of the coding process detailed in the QUAGOL methodology.ResultsThirty-eight publications met our criteria and were included. Publication dates ranged from 1984 to 2020, with 17 publications appearing between 2015 and 2020. Publications originated from all five major continents, as indicated by the affiliation of the first author. Our analyses revealed that the concept of vulnerability could be distinguished in terms of basic human and situational vulnerability. Six dimensions of older adults’ vulnerability were identified: physical; psychological; relational/interpersonal; moral; sociocultural, political, and economic; and existential/spiritual. This analysis suggested three ways to relate to older adults’ vulnerability: understanding older adults’ vulnerability, taking care of vulnerable older adults, and intervening through socio-political-economic measures.ConclusionsThe way in which vulnerability was conceptualised in the included publications overlaps with distinctions used within contemporary bioethics literature. Dimensions of aged care vulnerability map onto defining features of humans, giving weight to the claim that vulnerability represents an inherent characteristic of humans. Vulnerability is mostly a value-laden concept, endowed with positive and negative connotations. Most publications focused on and promoted aged care, strengthening the idea that care is a defining practice of being human. (shrink)