This chapter contains sections titled: On Ethical Choices Aristotle on Character Will‐to‐Power Caring and Justice Stacking the Deck.

Ideal for students with little or no background in philosophy, Ethical Choices: An Introduction to Moral Philosophy with Cases provides a concise, balanced, and highly accessible introduction to ethics. Featuring an especially lucid and engaging writing style, the text surveys a wide range of ethical theories and perspectives including consequentialist ethics, deontological ethics, natural and virtue ethics, the ethics of care, and ethics and religion. Each chapter of Ethical Choices also includes compelling case studies that are (...) carefully matched with the theoretical material. Many of these cases address issues that students can relate directly to their own lives: the drinking age, student credit card debt, zero tolerance policies, grade inflation, and video games. Other cases discuss current topics like living wills, obesity, human trafficking, torture "lite," universal health care, and just-war theory. The cases provide students with practice in addressing real-life moral choices, as well as opportunities to evaluate the usefulness and applicability of each ethical theory. Every case study concludes with a set of Thought Questions to guide students as they reflect upon the issues raised by that case. Ethical Choices is enhanced by several pedagogical features. These include summaries at the end of each section, lists of key terms, questions For Reflection and Discussion at the end of each chapter, Guidelines for a Case Study Analysis, and suggestions For Further Reading that include Internet sources. Starred sections indicate more advanced material that may be included at the instructor's discretion. A companion website at www.oup.com/us/burnor contains additional resources for both students and instructors: chapter outlines, flashcards of key terms, sets of Helpful Hints to further aid students in mastering the material, and an additional chapter on our Moral Obligations Towards the Future. (shrink)

Ideal for students with little or no background in philosophy, Ethical Choices: An Introduction to Moral Philosophy with Cases provides a concise, balanced, and highly accessible introduction to ethics. Featuring an especially lucid and engaging writing style, the text surveys a wide range of ethical theories and perspectives including consequentialist ethics, deontological ethics, natural and virtue ethics, the ethics of care, and ethics and religion.Each chapter of Ethical Choices also includes compelling case studies that are carefully (...) matched with the theoretical material. Many of these cases address issues that students can relate directly to their own lives: the drinking age, student credit card debt, zero tolerance policies, grade inflation, and video games. Other cases discuss current topics like living wills, obesity, human trafficking, torture "lite," universal health care, and just-war theory. The cases provide students with practice in addressing real-life moral choices, as well as opportunities to evaluate the usefulness and applicability of each ethical theory. Every case study concludes with a set of Thought Questions to guide students as they reflect upon the issues raised by that case.Ethical Choices is enhanced by several pedagogical features. These include summaries at the end of each section, lists of key terms, questions For Reflection and Discussion at the end of each chapter, Guidelines for a Case Study Analysis, and suggestions For Further Reading that include Internet sources. Starred sections indicate more advanced material that may be included at the instructor's discretion. A companion website at www.oup.com/us/burnor contains additional resources for both students and instructors: chapter outlines, flashcards of key terms, sets of Helpful Hints to further aid students in mastering the material, and an additional chapter on our Moral Obligations Towards the Future. (shrink)

Ethics is of vital importance to the Swedish educational system, as in many other educational systems around the world.Yet, it is unclear how ethics should be dealt with in school, and prior research and evaluations have found serious problems regarding ethics in education.The field of moral education lacks clear and widely accepted definitions of key concepts, and these ambiguities negatively impact both research and educational practice. This thesis draws a distinction between three approaches to ethics in school – the (...) descriptive ethics approach, the value transmission approach, and the inquiry ethics approach – and studies in what way (if at all) they are prescribed by the national curriculum for the Swedish compulsory school, how they relate to students’ moral reasoning about technology choices and online behaviour, and what pedagogical merits and disadvantages they have. Hopefully, this both contributes to reducing the ambiguities of the field, and to answering the question of how ethics should be dealt with in education. The descriptive ethics approach asserts that school should teach students empirical facts about ethics, such as what views and opinions people have. The value transmission approach holds that school should mediate some set of predefined values to the students and make sure the students come to accept these values.The inquiry ethics approach is the view that school should teach students to reason and think critically about ethics and to engage in ethical inquiry. The role of ethics in the curriculum has not been studied in light of the above distinction, in prior research,and such an investigation is undertaken here.The results suggest that ethics has a prominent, but complicated, role in the Swedish national curriculum. Although no explicit distinction is drawn or acknowledged in the curriculum, all three approaches are prescribed throughout the curriculum, albeit to different degrees. In the general section of the curriculum, the value transmission and inquiry ethics approaches are more extensively prescribed than the descriptive ethics approach. It was found that most of the syllabi contained explicit references to ethics, while some only contained implicit references to ethics, and two syllabi lacked references to ethics altogether. In the syllabi, the inquiry ethics approach is the most dominant, both in the sense of being present in the most syllabi, and in the sense of being more strongly prescribed in many of the syllabi where several approaches occur.The value transmission approach has the weakest role in the syllabi. In total, the inquiry ethics approach is the approach most strongly prescribed by the curriculum. But prior research has shown that inquiry ethics is very rarely implemented in the classroom. In this thesis, it is found that the inquiry ethics and the value transmission approaches are incompatible, given certain reasonable interpretations, which makes the finding that inquiry ethics is rarely implemented less surprising, since value transmission is practiced in schools. Some possible causes, and some consequences, of this is discussed. The students, in their moral reasoning about technology choices, reasoned in accordance with several classical normative theories – including consequentialism, deontological ethics and virtue ethics – and in doing so, they expressed reasoning that in the discussion is found to be in conflict with the values of the value foundation in the curriculum. These findings complement earlier findings, for example that students in their actions contradict the value foundation, by adding that such conflicts also exist in their reasoning. The existence of these conflicts is found to be problematic for a value transmission approach. Many of the students defended very restrictive views on disclosing personal information online, and prior research as well as the present data has shown that adults typically hold views that are very similar to these, concerning how they think that young people ought to act online. On the other hand, youths’ actual online behaviour, as reported in earlier studies, differs considerably from this. In line with this, the students also seemed to endorse a form of private morals view, according to which moral choices are simply up to one’s own taste, which would yield an escape exit from the restrictive views mentioned above, and permit any behaviour. In the discussion, it is argued that this is the result of an attempt at value transmission from the grown-up community, probably including teachers, which might seem to work, since the students claim to hold certain views, but which likely instead constitutes a false security, since these values are not actually accepted, but only paid lip service to, and the adults are therefore wrong in their belief that the students are protected by a certain set of values (that they think the students are upholding), since the students in fact do not uphold, and therefore do not act based upon, these values. This situation risks making the students more vulnerable than had no value transmission attempt been taken in the first place. Hence, the attempted value transmission runs the risk of counteracting its purpose of helping the students acquire a safe online behaviour. Throughout the moral reasoning mentioned above, extensive variations in the students’ reasoning were found, both interpersonally and intrapersonally, both in the decision method and in the rightness criterion dimensions, as well as in between the dimensions.The existence of such variations is a novel finding, and while possible applications in future research are discussed, it is also noted that this existence constitutes a reason to question the successfulness of both the value transmission and the inquiry ethics endeavours of the educational system. The results and discussions described above highlight the importance of investigating the merits of the different approaches. Several arguments that arise from the material of this thesis are presented, evaluated and discussed. The ability of each approach to fulfil some alleged key aims of ethics education is scrutinised; their abilities to educate for good citizenship, to educate for quality of life of the individual, and to facilitate better educational results in other subjects are all investigated, as well as the ability of each approach to help counteract the influence from online extremist propaganda aimed at young people and to promote safe online behaviour in general. It is concluded that the inquiry ethics approach has the strongest support from the material of this thesis. Some consequences for school practice are discussed, and it is concluded that changing the role of ethics in the curriculum would be beneficial, downplaying the role of value transmission and further increasing, and making more explicit and clear, the role of inquiry ethics. It is also shown that there are strong reasons for the inclusion of a new subject in the Swedish compulsory education with special focus on ethics. 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Adult education has long been the Cinderella of the education system. This is not helped by the fact that there is currently an impasse between employers, government and individuals over who should finance such training. So what, if anything, can philosophers do to help resolve the normative question of who ought to pay, setting aside for the moment the practical question of how this might be put into effect? An important strand of contemporary egalitarian philosophy argues that equality of (...) opportunity for education should be implemented in such a way that children with the same level of talent and the same willingness to make an effort have the same opportunity to attain skills and qualifications such that they are each able (at the onset of adult life) to compete effectively with others for advantageous positions and rewards in society. But what about children or teenagers who drop out of education or make such little effort that they achieve wholly inadequate exam results? Should they be offered second and third chances for free education as adults funded by the state? A case is made for lifelong as opposed to one-off equality of opportunity for education on a number of grounds, including efficiency, utility, the value of choice, the social bases of self-respect and responsibility-catering prioritarianism. This last view supports lifelong access to education (for reasons of priority) but with the additional (responsibility-catering) stipulation that adults should contribute at least some of the costs themselves in so far as they are accountable for not making enough effort the first time around. (shrink)

Adult education has long been the Cinderella of the education system. This is not helped by the fact that there is currently an impasse between employers, government and individuals over who should finance such training. So what, if anything, can philosophers do to help resolve the normative question of who ought to pay, setting aside for the moment the practical question of how this might be put into effect? An important strand of contemporary egalitarian philosophy argues that equality of (...) opportunity for education should be implemented in such a way that children with the same level of talent and the same willingness to make an effort have the same opportunity to attain skills and qualifications such that they are each able (at the onset of adult life) to compete effectively with others for advantageous positions and rewards in society. But what about children or teenagers who drop out of education or make such little effort that they achieve wholly inadequate exam results? Should they be offered second and third chances for free education as adults funded by the state? A case is made for lifelong as opposed to one-off equality of opportunity for education on a number of grounds, including efficiency, utility, the value of choice, the social bases of self-respect and responsibility-catering prioritarianism. This last view supports lifelong access to education (for reasons of priority) but with the additional (responsibility-catering) stipulation that adults should contribute at least some of the costs themselves in so far as they are accountable for not making enough effort the first time around. (shrink)

Adult education has long been the Cinderella of the education system. This is not helped by the fact that there is currently an impasse between employers, government and individuals over who should finance such training. So what, if anything, can philosophers do to help resolve the normative question of who ought to pay, setting aside for the moment the practical question of how this might be put into effect? An important strand of contemporary egalitarian philosophy argues that equality of (...) opportunity for education should be implemented in such a way that children with the same level of talent and the same willingness to make an effort have the same opportunity to attain skills and qualifications such that they are each able (at the onset of adult life) to compete effectively with others for advantageous positions and rewards in society. But what about children or teenagers who drop out of education or make such little effort that they achieve wholly inadequate exam results? Should they be offered second and third chances for free education as adults funded by the state? A case is made for lifelong as opposed to one-off equality of opportunity for education on a number of grounds, including efficiency, utility, the value of choice, the social bases of self-respect and responsibility-catering prioritarianism. This last view supports lifelong access to education (for reasons of priority) but with the additional (responsibility-catering) stipulation that adults should contribute at least some of the costs themselves in so far as they are accountable for not making enough effort the first time around. (shrink)

The preeminence of informed consent in human subjects protections reflects Western democratic societies' ethical and political commitments to secure each citizen against both coercive and paternalistic influences of other people. Society permits adults extensive personal discretion in choices such as where to live, what to eat, how to dress, and whether to be in research. In short, individuals are afforded extensive discretion in choosing what to do and what is in their own best interests. Informed consent to (...) enroll in research is especially important because research necessarily involves procedures such as randomization and blinding that are done to assure that the project will produce generalizable knowledge. (shrink)

Conversations about real-life ethically challenging situations form the core of the book, aimed specifically at business school teachers and students. Conversations on Ethics and Business offers a direct line and insight into workplace ethics for an undergraduate and graduate audience. Each topical 'conversation' is followed by a curated and guided list of additional readings. The book also offers an introduction to business ethics for working professionals who may not have had any formal exposure to ethical examination of (...) the typical problems of running a business. The authors approach business ethics as an integrative part of everyday business decisions, with the aim of promoting better choices, and creating value for various stakeholders. Filled with real-world examples, Conversations on Ethics and Business serves as a primer for all readers interested in business ethics, and applied ethics in general."--Cover page 4. (shrink)

To understand how compliance develops both in everyday and corporate environments, it is crucial to understand how different mechanisms work together to shape individuals’ (non)compliant behavior. Existing compliance studies typically focus on a subset of theories (i.e., rational choice theories, social theories, legitimacy theories, capacity theories, and opportunity theories) to understand how key variables from one or several of these theories shape individual compliance. The present study provides a first integrated understanding of compliance, rooted in complexity science, in which key (...) elements from these theories are considered simultaneously, and their relations to compliance and each other are explored using network analysis. This approach is developed by analyzing online survey data (_N_ = 562) about compliance with COVID-19 mitigation measures. Traditional regression analysis shows that elements from nearly all major compliance theories (except for social theories) are associated with compliance. The network analysis revealed groupings and interconnections of variables that did not track the existing compliance theories and point to a complexity overlooked in existing compliance research. These findings demonstrate a fundamentally different perspective on compliance, which moves away from traditional narrow, non-network approaches. Instead, they showcase a complexity science understanding of compliance, in which compliance is understood as a network of interacting variables derived from different theories that interact with compliance. This points to a new research agenda that is oriented on mapping compliance networks, and testing and modelling how regulatory and management interventions interact with each other and compliance within such networks. (shrink)

In the near future developments in non-invasive prenatal testing may soon provide couples with the opportunity to test for and diagnose a much broader range of heritable and congenital conditions than has previously been possible. Inevitably, this has prompted much ethical debate on the possible implications of NIPT for providing couples with opportunities for reproductive choice by way of routine prenatal screening. In view of the possibility to test for a significantly broader range of genetic conditions with NIPT, (...) the European Society of Human Genetics and American Society of Human Genetics recommend that, pending further debate, prenatal screening for reproductive choice should only be offered where concerning serious congenital conditions and childhood disorders. In support of this recommendation, the ESHG and ASHG discuss a number of ethical issues on which they prompt further debate: the informational privacy of the future child, the trivialization of abortion, the risk of information overload, and issues of distributive justice. This paper responds to this call with further reflection on each ethical issue and how it relates to the moral justification of providing couples with opportunities for meaningful reproductive choice. The paper concludes that whilst there may be good reasons for qualifying the scope of any unsolicited prenatal screening offer to serious congenital conditions and childhood disorders, if prenatal screening is justified for providing couples with opportunities for meaningful reproductive choice, then health services may have obligations to empower couples with the same opportunity where concerning other conditions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Kennedy Institute of Ethics Journal 14.1 (2004) 47-54 [Access article in PDF] Ethical Guidelines for Human Embryonic Stem Cell Research*(A Recommended Manuscript) Adopted on 16 October 2001Revised on 20 August 2002 Ethics Committee of the Chinese National Human Genome Center at Shanghai, Shanghai 201203 Human embryonic stem cell (ES) research is a great project in the frontier of biomedical science for the twenty-first century. Be- cause the research (...) involves the use of human embryos, it triggers serious debate on ethical issues. Opponents consider the embryo to be an early form of human life that should be respected and not destroyed. However, the majority of scientists support embryonic stem cell research, believing that it offers good prospects for the treatment of diseases that have remained incurable until now and so will benefit humankind. The Ethics Committee of the Department of Ethical, Legal, and Social Implications of the Chinese National Human Genome Center at Shanghai seriously discussed the ethical debate initiated by embryonic stem cell research. We concluded that we should support the scientists of our country in actively carrying out human embryonic stem cell research for the noble cause of "medicine being a beneficent art." For the healthy and orderly development of human embryonic stem cell research in our country, we put forward the following recommended Ethical Guidelines for Human Embryonic Stem Cell Research as a reference for leaders, administrative departments, and related scientists. Preface Article 1. Human embryonic stem cells are the primitive cells that play the main role in the growth and development of a human body. These [End Page 47] primitive cells have the potential for infinite proliferation, self-renewal, and multi-directional differentiation. If scientists can discover the mechanism of differentiation of human embryonic stem cells, it will be possible to induce differentiation of human embryonic stem cells to form various types of human cells for clinical cell therapy. If human embryonic stem cell research can be integrated with modern biomedical engineering techniques, it also will be possible to make repair and replacement of human tissues and organs a reality. Article 2. There are two ways to classify human embryonic stem cells. One way is to classify them according to their potential for differentiation. There could be three kinds of stem cells: totipotent stem cells, pluripotent stem cells, and unipotent stem cells.A totipotent stem cell has the potential to develop into a whole individual. It can differentiate into the more than 200 cell types in the whole body, construct any tissue or organ of the body, and finally develop into a whole individual. The fertilized egg and the cleavage cells at the very early stage of embryonic development are totipotent stem cells.A pluripotent stem cell has the potential to differentiate into many cell types derived from the three embryonic layers. However, it has lost the capacity to develop into a complete organism.A unipotent stem cell is derived from the further differentiation of the pluripotent stem cell. It can differentiate only into one cell type such as a hematopoietic stem cell, neural stem cell, and others.The other way is to classify human stem cells according to their source. There could be two kinds of human stem cells: embryonic stem cells and tissue stem cells (also called adult stem cells). The former involves experimentation with embryos, which has serious ethical implications. Ethical issues associated with the latter are mainly expressed in the various opinions regarding the allocation of health resources. Article 3. Human embryonic stem cells are the group of cells called the blastocyst inner cell mass during the early stage of embryonic development. They are the main source of totipotent stem cells, and hence the focal and hot point in stem cell research. Studies on the clinical application of embryonic stem cells probably will involve use of the somatic cell nucleus transfer (SCNT) technique, which destroys the early human embryo. At present, the ethical and moral debate is very serious in human embryonic stem cell research regarding whether the research will develop... (shrink)

There is robust scientific evidence from meta-analyses in psychotherapy research that common factors such as the alliance between patients and therapists, empathy, goal consensus/collaboration, positive regard/affirmation and genuineness have a much greater effect on the overall psychotherapy outcome than the so-called specific factors like particular treatment methods or ingredients of therapy.1 The current evidence base also suggests that the effects of telepsychiatric treatment are comparable with those of face-to-face treatment, not only regarding clinical outcome parameters but also with respect to (...) patient satisfaction, acceptance and adherence—all common factors of psychotherapy.2 According to a comprehensive review of the main ethical arguments for and against different forms of online psychotherapy, the online setting provides several weighty advantages: for example, increased access, availability, flexibility, convenience, satisfaction, acceptance and increased demand.3 Among the arguments against online psychotherapy, privacy, confidentiality and data security issues, emergency issues, as well as communication issues have been mentioned.3 Frittgen and Haltaufderheide 4 are concerned that telepsychiatry could ‘impact ethically relevant aspects of the therapeutic relationship’. They conclude that ‘there is evidence for ethically relevant changes of the therapeutic relationship in video-based telepsychiatric consultations’,4 particularly pertaining to ‘respect for autonomy, lucidity, fidelity, justice and humanity towards each other’.4 Indeed, video-based consultations as technically mediated communication ‘do not only transmit but transform what can be perceived, …. (shrink)

Photo by Jonathan Ford on Unsplash ABSTRACT Since 2008, an average of twenty million people per year have been displaced by weather events. Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. This paper analyzes the idea of expanding a duty to rescue to climate migration. We address who should have (...) the duty and to whom the duty should extend. The paper discusses ways to define and apply the duty to rescue as well as its limitations, arguing that it may take the form of an ethical duty to prepare. INTRODUCTION Climate migration creates a special setting for a duty to rescue. A duty to rescue is a moral rather than legal duty and imposes on a bystander to take an active role in preventing serious harm to someone else. Examples of circumstances range from person-to-person intimate rescue to saving those in poverty, even in distant parts of the world.[1] Since 2008, an average of twenty million people per year have been displaced by weather events.[2] Circumstances like being thrust from homes under the threat of fire, mudslide, and flooding vary greatly from long-term changes like land becoming too arid for crops or temperatures increasing annually gradually pushing up the number of heat-related deaths, with the area slowly becoming uninhabitable. Imminence in fleeing affects resettling and need for rescue with important implications for how the duty to rescue might apply. This paper reevaluates the ethical framing of the duty to rescue and, while it is arguably a stretch, applies it to climate migration. Climate migration has become common and is expected to increase due to rises in sea level, increases in weather events that make areas uninhabitable, and changes to land that preclude farming or other necessary land uses. We argue that a duty to rescue may help highlight who has moral obligations to whom. Because the problem is so large in scope, we suggest a change in the ethical limits to humans' duty to rescue other humans who are in distress. We imagine an expansion or extension of the duty to rescue to meet some of the basic needs created by climate migration. Yet how it should expand, and how much depend on ethical framing and practical limitations. l. Expanding the Geographical Boundaries Two commonly recognized emergencies, Hurricane Katrina in the case of weather events and the current COVID-19 pandemic, provide a historical and current backdrop to evaluate ethical obligations as more disasters displace people. A significant reassessment of the ethical scope of an obligation to rescue in the case of weather events will be limited by the ability to render aid to those in distress in the case of a planet-wide weather catastrophe. The problems may overwhelm the ability to rescue or the reasonableness of attempting rescue. The extent of the moral obligation borne by humans to other humans in the case of a weather event has been largely defined by its locality and limited geographic influence. Whether we are imagining the scope of ethical obligation in the case of hurricane, flood, tornado, drought, or wildfire events, the perceived ethical obligation is significantly defined by the limited impact of these weather events on people outside the zone of the weather event's direct impact, yet close to that zone. A hurricane affecting New Orleans will not have immediate impact on the residents of California or even those on the northeast coast of the United States until a later time. Wildfires in the Pacific Northwest do not impair the ability of those in the rest of the country to come forward with assistance. But as climate migration crosses international borders, and climate events occur simultaneously in many regions, a more expansive duty to rescue may provide the ethical impulse to help those who live afar or migrate long distances. In this respect, the need for help in the event of widespread climate migration due to global warming is more like a pandemic than a weather event. Its broad impact area diminishes the capability of nearly the entire balance of the human population to help due to those populations' awareness that they will, in short order, have the same need for the same resources, from the same cause. Those living near current flood zones may find their historically safe havens are also a flood zone. Those previously best positioned to rescue may find themselves also needing to relocate. Thus, we may observe the need for new rescuers. ll. The Rule of Rescue The Rule of Rescue as defined by Al Jonsen describes the moral impetus or knee jerk reaction to save identifiable people facing death.[3] A duty to rescue has since been expanded beyond imminent death and beyond the near and identifiable. But there are limitations. For example, by most accounts, the ethical duty tends not to require extreme bodily risk or financial depletion. In comparing Good Samaritans to humanitarians, Scott M. James argues the duty to rescue arises from unique dependence, but the ethical obligation to help strangers through humanitarian aid is of a different nature.[4] The wrongness of failing to help is arguably more egregious when one is in a unique position to help. Like in the tragedy of the commons, where there is no unique positioning, when the global community is called upon to help, each individual in it may feel less obliged to do so. Climate migration falls in between—it requires helping strangers, yet it may move forward without anyone seeing themselves as uniquely positioned to help until those strangers become part of communities, at which time, there may be more moral justification to help a community member in need. Generally, arguments about Good Samaritans hinge on extraordinary acts, praiseworthy because they are acts of compassion, not obligation. Now all US states have Good Samaritan laws[5] which protect helpers from liability for help gone wrong or for a failure to succeed once engaged in an act of rescue. Extraordinary help as a moral good is thus somewhat encouraged through legal protection, but not imposed. Conversely, jobs like firefighting, search and rescue, and emergency medical care tend to oblige employees to take on risks that would be extraordinary if undertaken by the average bystander, yet they are rendered ordinary rescue as part of the job. Three states, Minnesota, Rhode Island, and Vermont have a broad duty to rescue, adding legal considerations to an otherwise moral conundrum. The laws do not require bystanders to take on risk for the sake of rescuing strangers.[6] The moral duty will require looking beyond law, but it is unclear how the moral duty to rescue should be distributed in the case of climate migration. A bare minimum would prevent taking advantage of newcomers, paying sub-minimum wage, and discriminating against them. Yet such a minimum is hardly rescue. lll. An Ethical Rather than Legal Duty The difficulty in defining the duty to rescue as a legal obligation is that it is difficult to determine the extent of risk a rescuer ought to be required to take. The nature of this ethical duty is also arguably tied to the experiences of both the rescuer and the rescued. There are subjective aspects like what someone perceives as a danger that make it difficult to write enforceable laws requiring rescue. It is one thing to expect a rescuer to step into several inches of relatively warm water to lift a person lying face down in a pond and enable them to breathe. It is something altogether different to expect that rescuer to dive into frigid water and attempt to extricate someone trapped in a submerged automobile. As the legal philosopher H.L.A. Hart observed, it is always easier to define application of the core intention of any rule, whether law or ethical norm. It is more difficult to create legal certainty about how the law applies to what he described as “penumbra circumstances”. In the case of a hurricane, it is easier to define what surplus resources are available in areas geographically remote from the impact of the storm and demand, as a moral obligation, that those nearby but outside the area provide assistance. It is more difficult to obligate people, organizations, or governments to supply a quantity of medication or some number of ventilators to an adjacent community when they expect to imminently need them for their own community. In the early stages of climate migration, the ethics of extreme weather event assistance, a common application of the duty to rescue, will be useful and appropriate. The rising sea levels first experienced by island nations in the South Pacific[7] will not render those living in other coastal communities, those with greater available “high ground”, unable to supply resources to those in need. But when sea level rise and climate change affect more communities simultaneously, albeit in varying degree, the task of defining what response is ethically obligatory becomes increasingly complicated. Pinpointing the obligations of those communities which are resource rich to those communities which are resource deprived, and of those partly affected to those more severely affected may become necessary. The limitations of the traditional duty to rescue could expand to meet the needs. lV. Contribution to the Problem Many argue that the duty to rescue may depend on any appropriate claim of those needing rescue. One issue is whether preferential claims among those who can identify the source of the harm should call for a greater duty or whether everyone in need should be approached as like candidates for rescue, shaping the duty as equal across those on the receiving end. As climate change does have human-made causes, there are strong arguments to impose a greater ethical duty on any entity that caused the climate-related problems leading to the mass exodus. While the global north is often implicated in pollution that causes migration, industries like energy, transportation, and agriculture are tied to climate change and associated with significant greenhouse gas emissions.[8] Practices like directing agriculture to less sustainable single crop growth generally made land less farmable. Yet it is difficult to place blame and identify specific causal relationships as most migration is due to many factors. A movement toward greater accountability can be reframed as a greater duty to rescue, a duty to engage in the extraordinary. The fossil fuel industry, for example, should have a larger obligation than the average person. Similarly, some may argue anyone unjustly enriching themselves while contributing to climate change or people who over-consume have an elevated duty to rescue.[9] Climate change lawsuits demonstrate an eagerness to hold governments and corporations accountable, despite difficulty proving causation. V. The Most Vulnerable One ethical dimension of climate migration that remains unexplored is how a duty to rescue applies to vulnerable populations who stand to be left behind or unable to migrate without assistance. Researchers from the Global North working across the Global South are increasingly observing the phenomenon of ethics dumping, where the research ethics of some countries are imposed on research subjects in other countries.[10] In that vein, rescuers should be careful not to impose unwelcome cultural standards or exploit people who are in the process of migrating. There is a gap in discussions reflecting voices that have been left out. The duty to rescue is incomplete without an attempt to understand the ethical experiences of those being rescued. The actual people affected by climate migration who are the least likely to have the means to migrate, or to do so without extreme hardship, should have a voice informing the global community including those in a position to carry out rescue. People who have the means and are young and healthy may easily make decisions to avoid the catastrophic consequences that climate migration brings. However, what about those who are left behind? For example, especially recognizing cultural differences, the homeless community, disabled community, refugees, the elderly community, and women[11] and children may suffer differently and call for more attention. In some parts of the world, human rights are severely constrained. An ethical duty to rescue, with many considerations and variables, may be more justified in the case of those most in need. As climate migration continues and increases significantly, it may be reasonable to ask the local and global community to focus on those least well positioned to migrate successfully. In this context, the use of phenomenology to understand the lived experiences of those migrating, sometimes termed “ethical experiences”, may help flesh out how a duty to rescue takes shape. The discussion of duty and obligation requires an articulation of the ethical experiences (how the local community in need of rescue views the proposed rescue). Then, the obligation to interpret the duty as ‘one shall not’ or ‘one must’ can be focused on the migrants’ needs rather than the rescuers’ feelings of obligation.[12] A revised theory of the duty to rescue taking into account the asymmetrical experiences of communities involved could ensure that the needs of people whose living situations, gender, ethnicity, age, or race impact their ability to even begin the migration process are considered. In this discussion, the rescuing is directed toward communities /collectives of persons migrating, whether at once or across a period of time. Often, the climate migrant may not be in a state to articulate the nature of this event when it happens, given its subjective proximity. Yet, when communities are given the space and opportunity to articulate their shared values, the ethical action of rescue derives its meaningfulness from the community rather than the rescuers. In other words, allowing climate migrants to explain their feelings can add complexity to what some see as a binary receiver-giver (of rescue) dynamic. This is necessary because the concept of vulnerable populations is fraught with problematic assumptions. There have been various definitions and criteria to determine what would constitute vulnerable populations.[13] For example, the United Nations Framework Convention on Climate Change[14] identifies and assesses vulnerable populations. These criteria may be helpful. However, they do not provide the full picture. Rather than identifying categorical criteria of vulnerable populations, engaging with people who are experiencing climate migration and listening to their current experiences and concerns helps determine need. Knowing what people need may prevent the kneejerk reaction to label people who are quite resilient yet have appropriate needs “vulnerable”. Proceeding with caution is important because the duty to rescue has hierarchical underpinnings of "us" and "them." Often when people swoop in to save, there are good and bad consequences of the intervention. We should proceed with caution because often the helper misses the actual needs of those in need. The only way to combat this would be to make sure that people are empowered to inform those agencies that are able to help. In addition to more practical approaches, large scale oral histories could allow those who have migrated already to share their experiences. It would be important to capture the lived experiences of people who are already experiencing the consequences of climate migration or of other migration like that due to political or economic extreme events. These experiences could shape our analysis of whether people in fact wish for rescue. If so, further conversations can determine best actions as well as give important insight into what resources might be necessary to empower people now and in the future. Vl. A Duty to Rescue as a Duty to Prepare If we view Good Samaritans as going above and beyond, then a duty to rescue, something ethically compelled, must bring rescue out of the framework of charity and place it in the context of humanity and obligations. Such a view would also support expanding the geographical reach of the otherwise more proximate duty. The duty may be stronger and take shape in a more workable way if it applies to preparing places expecting to see an influx of people due to climate migration and to helping those most in need. The duty may arise out of expectations of what type of community the place welcoming those migrating due to climate should be—does it want to offer good housing, schooling, and medical care as well as economic opportunity to new people? And if so, at what cost, or with which risks? If the newcomers are viewed as community members rather than strangers, a model of acceptance may lead to better preparation. Some considerations like whether the actions will reasonably help the persons in need of rescue[15] will shape the application of a duty to rescue in the context of climate migration. Similarly, ensuring that people have the chance to articulate their values may help communities support the newcomers. New relationships should not be defined as migrant and rescuer. Voluntariness in participation and not forcing any action deemed rescue would help ensure the human rights of those migrating. In the United States, President Biden issued an executive order addressing impending climate migration steeped in a duty to prepare by making plans for resettlement and to address the impact of climate migration.[16] Vll. At What Risk? As we investigate the ethical obligations to meet even basic needs, we must also ask what level of risk is ethically compelled. There is an extraordinary need to integrate newcomers successfully, but it is difficult to stretch an ethical duty to rescue to require all the prerequisites for successful climate migration. Even defining success would create deep ethical arguments. As observed in almost all migrations, extraordinary charitable acts may be the key to success, while an ethical duty to rescue must try to require the important government and community-based basics and ensuring respect for human rights. That is, the migrating people should be rescued from circumstances that contradict basic human rights. Rather than comparing communities to bystanders, mere places where people will arrive and need to hash out how to find housing, jobs, education, and opportunity, a duty of preparation may be the key to rescue those disenfranchised by migration. There are cultural, personal, physical, psycho-social, and geopolitical issues surrounding how to best help those needing to permanently relocate. Ethics arguments will certainly range from “do nothing”, which may fail people, to “do everything”, which could waste taxpayer money in futile over-preparation while failing to actually help. Communities must avoid planning exclusively for one scenario only to have it not take place. Striking the balance, a duty to rescue as it could apply to climate migration should set goals of societal integration, and providing the basics like education, housing, food, health care, and job opportunity, the precursors to flourishing. Recommending the extraordinary, morally preferred but perhaps not compulsory, when charitable actors are participating, or when wrongdoers are compensating, may be more workable than seeing the duty to rescue as compelling people or local governments to take on significant financial and personal risk for newcomers. While humanitarian ethics supports helping everyone, it is likely that people who resettle in advance of a need to flee will find themselves with more choices and opportunities. Help is warranted for those with more dire needs. Preparing for them may do just that. Vlll. Rescue Prior to Migration and Rescue in the Process of Resettlement The duty to enable the migration in the first-place hints to the inadequacy of a duty to prepare. The traditional duty to rescue perhaps steps in if rescue looks like those geographically just out of harm's way rescuing those in danger. That resembles the traditional moral requirement, or duty to rescue according to the Rule of Rescue. Humanitarian aid typically provided by many institutions makes sense and is in place, although financial support for additional humanitarian aid is always needed. Despite having moved to purportedly more capable communities, migrant communities may be able to develop more egalitarian orders of living. Rather than continually being identified as having been rescued, it is important to make sure people keep or make social ties during and after migration. Immigrants often face social isolation.[17] Small shifts in gestural language also have the potential to welcome people and show they are valued. For instance, some migrants may not like questions like “Where are you from?” and “What brings you here?” as they emphasize differences over fitting in. CONCLUSION The ethical duty to rescue should be expanded to better match those in need of relocation with a welcome environment and the resources needed to achieve success and fully integrate socially and culturally. Expanding a dialogue that includes the voices of people who have recently migrated whether due to violence, poverty, or climate, could properly frame the extent of the duty. If we are to apply the duty of rescue to climate migration, rescuers should avoid labeling people vulnerable, dependent, or needy, although there is reason to focus on those whose needs are the most dire. A soft duty to rescue people during the course of climate migration can come in the form of preparation. People will need help finding housing, education, access to food, and employment. Ultimately, to help them help themselves may be the best goal. While the obligations should be borne differently by people, whether due to a special responsibility, or a special relationship that creates a clearer duty, the global community must prepare for its role in rescuing those displaced by climate events. By helping those displaced at the start of the climate migration process according to a more commonly held notion of the duty to rescue, and by preparing to incorporate newcomers successfully according to an expanded duty to rescue, effectively a duty to prepare, countries that take on climate refugees may find themselves rewarded by the cultural diversity and workplace talents that people bring. A duty to those at a distance is a reasonable expansion of the duty to rescue. But what one ought to do in the global community varies somewhat from the traditional Rule of Rescue. - [1] Singer, P. (1972). Famine, Affluence, and Morality. Philosophy and Public Affairs, 1(3): 229-43. [2] Irfan, U. (2022, March 16). Why We Still Don’t Yet Know How Bad Climate Migration Will Get. Vox. https://www.vox.com/2022/3/16/22960468/ipcc-climate-change-migration-migrant-refugee, citing the International Panel on Climate Change (IPCC) (2022). Sixth Assessment Report, Climate Change 2022, Impacts, Adaptation, and Vulnerability. https://www.ipcc.ch/report/ar6/wg2/ [3] McKie, J., Richardson, J. (2003) The Rule of Rescue. Social Science & Medicine, 56(12): 2407-2419. https://doi.org/10.1016/S0277-9536(02)00244-7. [4] James, S.M. (2007). Good Samaritans, Good Humanitarians. Journal of Applied Philosophy, 24(3):238-254. [5] Overview of Good Samaritan laws. https://worldpopulationreview.com/state-rankings/good-samaritan-law-states [6] Fifield, J. (2017, Sept. 19). Why It’s Hard to Punish ‘Bad Samaritans’. Stateline Blog, Pew Charitable Trusts, https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/09/19/why-its-hard-to-punish -bad-samaritans [7] Cassella, C. (2019). There’s a Climate Threat Facing Pacific Islands That’s More Dire Than Losing Land, Science Alert, https://www.sciencealert.com/pacific-islanders-are-in-a-climate-crisis-as-rising-sea-levels-threaten -water; Hassan, H. R., and Cliff, V. (2019). For Small Island Nations, Climate Change is not a Threat. It’s Already Here, World Economic Forum, https://www.weforum.org/agenda/2019/09/island-nations-maldives-climate-change/ [8] For example, Lyons, K. (2019). Australia Coal use is Existential threat to Pacific Islanders, The Guardian. https://www.theguardian.com/world/2019/aug/12/australia-coal-use-is-existential-threat-to-pacific-is lands-says-fiji-pm [9] Cripps, E. (2013). Climate Change and the Moral Agent: Individual Duties in an Interdependent World. Oxford: Oxford University Press. [10] Schroeder, D., Chatfield, K., Singh, M., Chennells, R., and Herissone-Kelly, P.. Ethics Dumping and the Need for a Global Code of Conduct. In Cham. (Ed.)(2019). Equitable Research Partnerships. SpringerBriefs in Research and Innovation Governance. Springer. 2019. https://doi.org/10.1007/978-3-030-15745-6_1 [11] Giudice L.C., Llamas-Clark E.F., DeNicola N., Pandipati, S., Zlatnik, M.G., Decena, D.C.D., Woodruff, T.J., Conry, J.A. (2021). Climate Change, Women’s Health, and the Role of Obstetricians and Gynecologists in Leadership, International J Gynecol Obstet, 155(3), 345-356. 10.1002/ijgo.13958 [12] See Ferrarello, S. and Zapien, N. (2020). Ethical Experience: A Phenomenology, Bloomsbury. (for understanding phenomenological determinants of ethical action). [13] McLeman, R.A., Hunter, L.M., (2010). Migration in the context of vulnerability and adaptation to climate change: insights from analogues. Wiley Interdiscip Rev Clim Change, 1(3): 450-461. [14] Least Developed Countries Expert Group. (2018). Considerations Regarding Vulnerable Groups, Communities and Ecosystems in the Context of the National Adaptation Plans: United Nations Framework Convention on Climate Change. [15] Jecker, N.S. 2013. "The Problem with Rescue Medicine." J Med Philos, 38(1):64-81. [16] White House Report. (February 9, 2021), Executive Order (E.O.) 14013, “Rebuilding and Enhancing Programs to Resettle Refugees and Planning for the Impact of Climate Change on Migration.” (calls on the National Security Advisor to prepare a report on climate change and its impact on migration. “This report marks the first time the U.S. Government is officially reporting on the link between climate change and migration.” https://www.whitehouse.gov/briefing-room/presidential-actions/2021/01/27/executive-order-on-tackling -the-climate-crisis-at-home-and-abroad/ [17] Torres, J.M., Casey, J.A. (2017) The centrality of social ties to climate migration and mental health. BMC Public Health, 17: 600. https://doi.org/10.1186/s12889-017-4508-0. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Introduction to the Special Section on Psychedelics Research and TreatmentDominic SistiAgainst a backdrop of post-pandemic malaise, diseases of despair, and a fragmented mental health care system, psychedelics have enjoyed a resurgence of interest as powerful psychotherapeutic agents and as catalysts of personal growth. The true power of these substances—some of which are considered sacramental by Indigenous peoples—has been shrouded for half a century by cultural mythology, political propaganda, and (...) misuse. From about 1940 to 1970, psychedelics including psilocybin and LSD were studied and used by clinicians to treat a range of psychiatric disorders from alcoholism and depression in adults to "autistic schizophrenia" in children.In June 1971, the Nixon administration's racist and illiberal War on Drugs inaugurated what was essentially a total ban on psychedelics. Society was robbed of half a century of scientific progress, and one can only speculate how differently our society might now function, and how many people might have been spared the trauma of mental illness and incarceration. Thankfully, it appears the time has arrived for psychedelic medicines to be decriminalized and included again in the pharmacopeia.In June 2023, a group of psychedelic researchers, therapists, bioethicists, Indigenous scholars, and advocates met at the Banbury Conference Center at Cold Spring Harbor Laboratory. There, this interdisciplinary group discussed several pressing ethical issues in psychedelics research and treatment that continue to [End Page 114] challenge the field. The aim of this meeting was to develop a bioethical framework for the use of psychedelics in mainstream medical settings. That is, how should psychedelics be employed responsibly by everyday clinicians, including psychiatrists, psychologists, social workers, and other behavioral health-care providers? This special section offers a sampling of three topics in psychedelic bioethics raised by the Banbury group, several of whom appear as coauthors.In our first paper, Logan Neitzke-Spruill and colleagues offer an overview of explanatory models describing the therapeutic mechanisms of psychedelic substances and how each of these models generates unique ethical quandaries. Starting from molecular biology and moving to neural circuitry and networks, neurobiological models now propel contemporary scientific research into psychedelics. Knowing how these substances work on a molecular level may offer promising ways forward in the development of new molecules designed to treat serious mental illnesses and other neurologic conditions. Perhaps neuroplastic mechanisms will be harnessed to develop new therapies without necessitating a psychedelic trip—a controversial premise discussed in our third paper, by Katherine Cheung, Brian Earp, and David Yaden.Such "neuroreductionism" risks ignoring the subjective psychological and spiritual experiences of patients that appear to be pivotal in psychedelic-assisted therapy, often described as mystical and utterly transformative. At the psychological level, these substances engender a kind of vulnerability and suggestibility requiring clear ethical standards to ensure patients' psychological and physical safety. And so too, practitioners will need structural and cultural competency to recognize the spiritual or moral values that inspire patient reactions during and after their psychedelic experiences. Ethically informed psychedelic practitioners will have to navigate between disciplinary silos and explanatory models. One practical upshot is the open question of how best to train psychedelic practitioners who hold this broad set of competencies.To that end, well-trained practitioners will need to be able to disclose in some way the transformative properties of psychedelics to prepare patients for their experiences. But how does one describe the ineffable? This raises the question of how or if it is possible for patients to truly consent to the transformative experience elicited by psychedelics, often described as one of the most important experiences of a person's life. The experience might stimulate significant emotional healing, or it might be horrifying. This sounds like a problem uniquely attached to psychedelics: after all, most pharmaceuticals don't trigger changes in one's fundamental moral values, life choices, and commitments, nor are they intended to. Yet, Brent Kious, Andrew Peterson, and Amy McGuire challenge the view that the psychedelic experience is uniquely transformative and impervious to the disclosure requirements of informed consent, a bedrock of bioethics. Ultimately, the writers show how consent is possible even if the experiences are dramatically different from most medical interventions, endorsing a practical view of consent [End... (shrink)

Comments and reports on synthetic biology often focus on the idea that this field may lead to synthetic life or life forms. Such claims attract general attention because “life” is a basic concept that is understood, interpreted and explained in multiple ways. While these different understandings of life may influence the ethical assessment of synthetic biology by experts and the public, this field might, in turn, influence how academics or the public view life. We (...) suggest in this paper that synthetic biology provides an opportunity to discuss and compare different views and explanations of the world, starting from the concept of life. We argue that a narrow focus on just one interpretation of this concept may be harmful and that people will benefit from being aware of a diversity of understandings of life because they provide answers to different questions. Moreover, the confrontation among views is important for the development of reasoning abilities, and a nuanced view on our world will be useful for integrating scientific findings and their implications into a wider context. At the same time, we should not only consider other understandings of life for our own benefit but also because a moral attitude of respect for and toleration toward others implies permission to express and maintain their views. For these reasons, we suggest that a diversity of views on life should be included in public education and in public engagement events on synthetic biology. Moreover, they should be on the research agenda of technology assessment studies within the ELSA or RRI frameworks. (shrink)

The lack of consistency between people’s engagement in ethical issues and their food choices has received considerable attention. Consumption as “choice” dominates this discourse, understood as decision-making at the point of purchase. But ideas concentrating on individual choice are problematic when trying to understand how social and ethical issues emerge and are dealt with in the practices of buying and eating food. I argue in this paper that “consumer choice” is better understood as a political ideology addressing a (...) particular way in which everyday practices can be directed so as to solve social problems. It is a way that makes questions of power particularly challenging. Some assume consumer sovereignty, emphasizing consumer choice as a reflection of neoliberal deregulation and commercialization. Others worry that ongoing changes increase consumers’ powerlessness. None of these seem to capture that there is active regulation, where public as well as commercial and civil actors are making strong efforts to make people do the right thing—voluntarily. Labeling is the key measure. In practice, the individualized and rationalized model of responsibility depends not only on market opportunities, but even political and social expectations and trust. People may lack concrete capabilities and power to follow up on moral calls, but they may also have a different understanding of who is responsible and what is a “good deed,” or their actions may, in a Foucauldian sense, represent resistance. The paper will, with examples from European empirical studies, discuss how mobilization as well as inertia and disinterest emerge within specific political constellations and practical contexts. (shrink)

Ethics and Business: An integrated approach for business and personal success equips students with business ethics concepts and pragmatic knowledge they need to identify and solve ethical dilemmas, understand their own and others' ethical behavior, promote ethical behavior in their organization, and begin the process of living a life rich in meaning and happiness. Ethics and Business: An integrated approach for business and personal success provides a systematic and logical framework for understanding ethical challenges and (...) thinking about how to respond. The chapters build on each other. Part 1 (chapters 2-4) lay a foundation for a holistic view of individual ethics. Part 2 (chapters 5-7) provide important knowledge and language about organizational realities and how they deal with issues of ethics and compliance. Part 3 (chapters 8-12) offer students the opportunity to apply what they've learned around four common ethical challenges in business: Conflict of Interest, Bribery, Honesty/ Integrity, the Use and Abuse of Power, and Corporate Social Responsibility. Part 4 takes up some larger issues of ethics: the role of ethics in a market-based or planned economy and the ethical challenges that come with technological innovation. (shrink)

_2015 Gradiva Award Winner_ _Clinical Implications of the Psychoanalyst’s Life Experience_ explores how leaders in the fields of psychoanalysis and psychotherapy address the phenomena of the psychoanalyst’s personal life and psychology. In this edited book, each author describes pivotal childhood and adult life events and crises that have contributed to personality formation, personal and professional functioning, choices of theoretical positions, and clinical technique. By expanding psychoanalytic study beyond clinical theory and technique to include a more (...) careful examination of the psychoanalyst’s life events and other subjective phenomena, readers will have an opportunity to focus on specific ways in which these events and crises affect the tenor of the therapist’s presence in the consulting room, and how these occurrences affect clinical choices. Chapters cover a broad range of topics including illness, adoption, sexual identity and experience, trauma, surviving the death of one’s own analyst, working during 9/11, cross cultural issues, growing up in a communist household, and other family dynamics. Throughout, _Steven Kuchuck_ shows how contemporary psychoanalysis teaches that it is only by acknowledging the therapist’s life experience and resulting psychological makeup that analysts can be most effective in helping their patients. However, to date, few articles and fewer books have been entirely devoted to this topic. _Clinical Implications of the Psychoanalyst’s Life Experience_ forges new ground in exploring these under-researched areas. It will be essential reading for practicing psychoanalysts, psychotherapists, psychologists, social workers, those working in other mental health fields and graduate students alike. (shrink)

I appreciate all of the commentaries for their careful and thoughtful engagement with my article. Because of limited space, I can only focus on some criticisms and cannot develop my responses as fully as I would like. This is probably best for the reader anyway. John Keown worries about the ‘dualism’ of the third objection against expressivism. By this I think he means that critics of the expressivist argument at the beginning of life view a certain class of human (...) beings as ‘non-persons’ and therefore not worthy of protection. Obviously, a pro-life stance will take issue with classifying the unborn as non-persons, as defenders of selective abortion and other biotechnologies do, but I did not think it relevant to get into the weeds on this issue. Keown claims that the worrisome dualism views those with intellectual disabilities, whether ‘newborns or adults’, as non-persons who lack a right not to be killed. However, I do not think defenders of either selective abortion or assisted suicide are committed to this. Many would insist that once you are born, you are a person and therefore cannot …. (shrink)

Fulfilling consumer expectations of corporate social responsibility can bring strategic advantage to firms. However, research on the topic is fragmented across disparate disciplines, and a comprehensive framework to connect CSR supply and demand is missing. As a result, firms often supply CSR that does not attract demand, as signified by pessimism about ethical consumerism in recent years and the inconclusive link between corporate financial and social performance. In this study, we propose a framework of strategic CSR management to define (...) how a company’s supply of CSR could meet consumer demand for ethical products by aligning managerial and consumer perspectives. We then investigate empirically whether such a strategic approach, which integrates potential demand in CSR management, would influence consumer choice of products with CSR components. Our hybrid choice modeling allows the inclusion of psychological biases caused by social desirability and cynicism to increase result validity. The findings support the explanatory power of the framework and reveal that consumers prefer some CSR elements while others adversely affect choices. This study advances the understanding of strategic CSR management and its impact on consumer choice and helps managers include the right mix of CSR characteristics in their products to satisfy ethical consumers. (shrink)

Most donated organs in the United States come from brain dead donors, while a small percentage come from patients who die in “controlled,” or expected, circumstances, typically after the family or surrogate makes a decision to withdraw life support. The number of organs available for transplant could be substantially if donations were permitted in “uncontrolled” circumstances–that is, from people who die unexpectedly, often outside the hospital. According to projections from the Institute of Medicine, establishing programs permitting “uncontrolled donation after (...) circulatory determination of death,” or uDCDD, throughout the United States has the potential to provide 22,000 more donation opportunities annually. In contrast, U.S. controlled donation after circulatory determination of death, or cDCDD, cases have increased progressively over the past decade from 87 to 848 donors, but currently account for only 10.6 percent of all deceased donors. Following the IOM recommendations, several projects exploring the feasibility of uDCDD were funded by the federal government, including a grant from the Health Resources and Services Administration that supported a pilot project in New York City in which the authors of this article participated.A key feature of our protocol, and indeed of many uDCDD protocols, is the initiation of preservation methods such as chest compressions and extracorporeal membrane oxygenation shortly after death in order to perfuse and preserve the donor's organs. Critics of uDCDD argue that the means of determining death deviates from generally ascribed principles. They assert that reinstituting circulation in order to preserve organs has the effect of “undoing” the prior determination of death. The result is that cDCDD is widely accepted and practiced routinely even though it only marginally increases the number of organs available for transplantation, and uDCDD is widely considered unacceptable despite being ethically embraced and proven to significantly increase organ donation opportunities in other countries. This article explores the evolution of this counterintuitive state of affairs and calls for a policy that, in line with the IOM report, allows for both cDCDD and uDCDD protocols. (shrink)

The purpose of this study was to explore the views of members of the general public regarding ethical issues in adult predictive genetic testing. The literature pertaining to ethical issues regarding to adult predictive genetic testing is largely restricted to the views of ‘experts’ who have emphasized informed consent, patent issues, and insurance discrimination. Occasionally the views of patients who have undergone genetic counselling and testing have been elicited, adding psychosocial and family issues. However, the general (...) public has not had the opportunity to contribute. In order to explore theatre as a health policy research tool, 1,200 audience members attended the play ‘Sarah’s Daughters’ in seven Canadian cities, following which audience discussions were audiotaped. This study performed a secondary qualitative analysis of the data to identify the ethical issues of adult predictive genetic testing important to members of the general public. The identified issues were: (1) need for public education; (2) choice to undergo genetic counselling and testing; (3) access to genetic counselling and testing; and (4) obligations regarding the handling of genetic information. Audience members emphasized public education and access to information regarding potential choices, which was different from the emphasis on informed consent and other ethical issues prominent in the literature. Members of the general public emphasized ethical issues that were different than those identified by experts and patients. It is essential that members of the public be included in complex and controversial public policy decisions. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:To Recognize the Person: Learning from Narratives of Psychiatric TreatmentLinda J. MorrisonTo know what patients endure at the hands of illness and therefore to be of clinical help requires that doctors enter the worlds of their patients, if only imaginatively, and to see and interpret these worlds from the patient’s point of view(Charon, 2006, p. 9).These narratives of psychiatric hospitalization are rich and evocative. We are fortunate to have (...) twelve descriptions appearing side-by-side, each unique in its focus, outlook, detail and narrative tone. Together their interwoven contexts describe personal and work relationships, internal and external help-seeking, encounters in community and hospital settings, and experiences of the psychiatric (psychiatrized) self as supplicant, victim, recipient, participant, product, and active agent over time (Morrison, 2005).Through their collected narratives, the authors create a distinct counterpoint to the more familiar clinical narratives of psychiatric encounters. Ordinarily the professional narrative drives interpretation of a clinical experience, whether medical or psychiatric. The caregivers populating these narratives would probably tell different stories, and the hospital notes and treatment records yet another (Hinsby & Baker, 2004; VanDerNagel et al., 2009). The disjunction between professional and patient narrative is especially true for psychiatric hospitalizations, in which the inpatient’s active narrative becomes a part of the diagnostic and treatment process (Steslow, 2010).In this symposium, the patient’s narrative is a window for interpretive insights into personal experience of the process. Each is a situated retrospective, in which added dimensions of feeling, thought and interaction provide the reader a fuller and more complex awareness of the experience of psychiatric hospitalization. The narratives provide insights about choice and agency, control and harm, safety and strength, hope and frustration, resilience and recovery, empathy and humanity; they also reveal various ethical issues related to the experience of help-seeking and treatment.It is vital to consider what each person wrote: what choices they made in representing their experience; what aspects they focused on, and what they (we imagine) left out. The authors used their own voices to create their own representations. In each narrative, “the person” provides an important standpoint. Who is this person, what is his or her experience? Where is the person in the situation; in what way does he or she appear to those who provide treatment or care? How, if at all, is the treatment pertinent to the person’s concerns? Does it feel helpful or harmful? How does the person find a way to continue, to push through, with the help of (or in spite of) those we hope are providing care? This is the first sign of agency, of choice, of “dreaming.” [End Page 35]As V. Barnard writes in Dreaming: A Recovery Story, “to make a film, one has to dream it first.” All of the authors in this symposium took the risk and the opportunity to create their own stories: what to include, what to leave out, how to tell what they wanted to say. These choices gave them the power to dream: how it was, how it might have been; how it felt, good and bad; the chance to represent their own reality—to themselves, and to unknown others (Morrison, 2006).Dreaming, Choice and Agency“My psychiatric illness is only one part of me. I am a person with hopes, dreams, love, an artist and a fellow helper of my peers.” V. BarnardV.’s narrative describes the potential for positive action, of dreaming herself as a whole into existence. Her themes of choice and agency emphasize the importance of autonomy and the capacity for autonomous action. On the farm, V. was free to choose and take risks, to take on responsibilities, to be “treated with respect as a human being trying to get better rather than a criminal suffering from something that was optional.” From disconnection, she was able to find connection, on her own terms.The support of peers adds a valuable dimension. Being recognized as a peer, a person who shares similar psychiatric experiences and respects the challenge of everyday life, brings another level to supportive relationships. Negative judgments and stigma are reduced by mutual support and acknowledgement of common goals. Mental health... (shrink)

Adult education has long been the Cinderella of the education system. This is not helped by the fact that there is currently an impasse between employers, government and individuals over who should finance such training. So what, if anything, can philosophers do to help resolve the normative question of who ought to pay, setting aside for the moment the practical question of how this might be put into effect? An important strand of contemporary egalitarian philosophy argues that equality of (...) opportunity for education should be implemented in such a way that children with the same level of talent and the same willingness to make an effort have the same opportunity to attain skills and qualifications such that they are each able to compete effectively with others for advantageous positions and rewards in society. But what about children or teenagers who drop out of education or make such little effort that they achieve wholly inadequate exam results? Should they be offered second and third chances for free education as adults funded by the state? A case is made for lifelong as opposed to one‐off equality of opportunity for education on a number of grounds, including efficiency, utility, the value of choice, the social bases of self‐respect and responsibility‐catering prioritarianism. This last view supports lifelong access to education but with the additional stipulation that adults should contribute at least some of the costs themselves in so far as they are accountable for not making enough effort the first time around. (shrink)

The question of the ethical life is arguably one of the most compelling, and urgent, questions of our time. As Peter Singer, among others, has pointed out, almost 10 million children die each year due to poverty, some of whom would not die if the amount of aid that we now offer increases significantly. As Singer has also pointed out, the exploitation of human beings and other animals is a major ethical and practical concern. There (...) can be little reasonable doubt that pain and suffering abound, in the world today, due to many causes such as poverty, disease, environmental degradation and destruction and anthropocentrism among others, just as there can be little reasonable doubt that some of the pain and suffering is preventable. So, what does it mean to live ethically today? Does it mean taking the point of view of the universe, as Sidgwick put it, memorably, rather than a narrow anthropocentric or speciesist view? Does it mean living in accordance with duties or obligations, or in light of recognised virtues, or with the minimisation of pain and suffering primarily in mind? Does it entail a consideration of the interests of other species and a rejection of the principle of the sanctity of human life? Does it mean not eating animals when other healthy alternatives are available, especially when those animals have been treated in ways that are inconsistent with their interests, whatever they may be? Does it mean taking active steps to reduce poverty on our part on a day to day basis? Is ethics exhausted in some sense today? And if we could reach some consensus on these questions, what difference would the ethical life make? Some argue that speciesism and the exploitation of human beings and other animals might diminish; that pain and suffering, especially gratuitous pain and suffering, would decrease, or at the very least, not increase; or that we will become more aware of the limitations of things such as "the traditional ethic of the sanctity of life", as Singer calls it. Some argue that the ethical life is closely related to a life of relationships, reflection and deliberation, all of which deepen our understanding and enrich us personally. Others argue that the ethical life is closely related to our search for a meaningful life - that the ethical life can help us to find meaning in a world in which "meaning", defined broadly, can seem elusive, enigmatic or unsubstantial. These and related issues and questions are explored in this collection, which illustrates the relevance, vitality and dynamism of ethics today. (shrink)

Business ethics as a field of academic endeavour has made significant progress over the past two or three decades. It now boasts a substantial body of scholarly literature, which is a major resource in which much time and effort have been invested and from which much can be gained. However, there is still much work to be done, and the dynamic nature of both academic life and the world beyond it ensures that new issues and opportunities will continue (...) to emerge. Business ethicists, individually and collectively, through the allocation of their limited research resources, will govern how well the field progresses and meets future challenges over the years to come. In particular, through our decisions about what we do or do not study and write about, we will determine the future shape of the scholarly literature – what it addresses successfully and on what it remains silent or inadequate. Implicitly or explicitly, individually and collectively, choices are made, and some are presumably better than others. This paper is a reflection on the progress of business ethics as an academic enterprise. Of course, the development of business ethics as a focus of academic interest has been marked by several review papers already, some reflecting underlying concerns consistent with Enderle’s comment that “in its present stage of development, business ethics appears to be far from being an established academic discipline”. Some might question whether something like business ethics can ever be an academic discipline as such, and for the purposes of this paper it will be helpful to distinguish between disciplines – such as philosophy, economics and psychology – and fields to which the concepts and methods of academic disciplines can be applied. Nevertheless, whatever kind of academic activity business ethics is taken to be, there are significant issues relating to its academic status. (shrink)

Spinoza's ethics is founded on the idea that we are egoists who should do nothing but search our own advantage , but that in doing so, this is when we are most virtuous, most moral, and most social . Community, taken in any sense stronger than a mere collection of things, only occurs, then, when each is drawn to seek his self-interest. ;Spinoza would hold that no study of ethics can be done in a metaphysical vacuum . To discuss (...) the ethics of an individual existing in community, one must first address the metaphysical foundations of the individual, its rights, and its place in community. To this end, the greater part of this work examines just those metaphysical bases which define an individual and how it relates in community. The analysis is textually based; focusing on how Spinoza uses certain terms , we attempt to understand what Spinoza understood to be an individual, community, right, etc. Then, because society affects an individual and the individual in turn affects society, the study looks at human individuals and their affects, that is, how humans affect and are affected by other humans. Just as a group of rocks makes only a pile and not what might be called a community, so too a group of human individuals does not necessarily make a society. The move from many individuals to one community is examined. ;Finally, after the metaphysical and psychological considerations are established, the study addresses its main question, that is, the value that should be accorded to a particular human life vis-a-vis the society in which the person lives. The study touches, therefore, questions concerning capital punishment, euthanasia, assisted suicide, and even abortion. The surprising conclusion is that Spinoza's ethics do allow for and can support what could be called a consistent human life ethic in which the right to life remains primary. (shrink)

Book reviewed in this article: Practical Medical Ethics. By Alastair Campbell, Grant Gillett, and Gareth Jones. If I Were a Rich Man Could I Buy a Pancreas? and Other Essays on the Ethics of Health Care. By Arthur L. Caplan. Bloomington Ethics on Call: A Medical Ethicist Shows How to Take Charge of Life and Death Choices in Today's Health Care System. By Nancy Dubler and David Nimmons.

Photo by Thought Catalog on Unsplash INTRODUCTION The coronavirus pandemic is a challenge to educators, policy makers, and ordinary people. In facing the threat from COVID-19, school systems and global institutions need “to address the essential matter of each human being and how they are interacting with, and affected by, a much wider set of biological and technical conditions.”[1] Educators must grapple with the societal issues that come with the intent of ensuring the safety of the public. To some, (...) “these are actually as important as the biological concerns of people.”[2] The current global crisis shows that “scientifically, socially, and politically the economy and technosphere are not just related, they are integral to a comprehensive response to major challenges.”[3] In developing these responses, scientists, government leaders, and policy makers need to consider the vulnerabilities of people, especially those in “thrown away” groups.[4] Jerome Ravetz explains that “microscopic viral predators cull our populations, as ever, but with a selection that is not natural but social and political.”[5] Educators must address the underlying vulnerabilities and evaluate the virus as a threat to academic experiences and access to a fair education. ANALYSIS • Critical Pedagogy By definition, the critical approach to teaching is about the problem-posing method of education developed by Paolo Freire. In his Pedagogy of the Oppressed, he proposed a paradigm shift away from the banking method of learning wherein teachers deposit knowledge into the minds of students. Critical pedagogy is an educational approach that challenges students to develop the ability to recognize and criticize dominating theories and evaluate them in their social context. Teachers press students to recognize oppression and try to remedy oppression in their culture.[6] Despite the lack of in-person interaction between the teacher and the students, the effort to use innovative teaching techniques like critical pedagogy should continue. Online learning is not just about the use of technology, although the internet is crucial in the delivery of content. Since human beings are creators of value, they determine the meaning and purpose of technology. In this way, the set of values people have will influence online learning. Teachers cannot be more concerned about outcomes than about the process itself. The process is crucial since the ability of the student to think critically is developed in the exchange between the student and the teacher. The teacher cannot simply dump loads of information (deposit knowledge) but must pose problems to test the analytical and critical skills of students.[7] Education is about how people humanize the world. Policy makers miss the point when they focus on the delivery but do not pay attention to the substantive aspect of learning, which is human empowerment. Education is meant to expand the freedom of people. Education should be seen as an integrative activity. Learning is a formative process that aims to develop the human person. Without the face-to-face encounter between teacher and students, the challenge is finding ways to make learning an effective means to mold the values of young people. • Online Critical Pedagogy & the Role of Technology Physical distance appears to be an impediment in realizing the ideals of learning. The lack of contact between the teacher and the students may prevent a more meaningful interaction since online instruction is impersonal. It can be argued that there is no alternative to some classroom activities, especially laboratory experiments in science courses. The total classroom environment naturally influences the behavior of students when it comes to academic work: the look in the eyes of the professor, the caring ways of a teacher, or the pressure while taking exams contribute to an experience that only a classroom setting can provide. If implemented properly, technology can facilitate the personal relationships between teachers and students while providing meaningful experiences. With the current need for online learning during the COVID-19 pandemic, gadgets are indispensable. Some would even consider gadgets an extension of the human body. A mobile phone is not just any instrument; it has evolved into a novel way of being in the world. Our gadgets are a means of seeing how the outside world unfolds. Modern technological tools allow the interface of people in many fields of experience in a globalized environment. Computers and other digital devices extend the meaning and value of human freedom. For example, a laptop provided to a poor child can redefine the meaning of and what the future might hold for that child. The device is crucial to the whole learning process. Modern tools are critical to self-discovery and greater freedom. The values that people embrace will matter in the new normal. The internet has provided a new democratic space that empowers groups and individuals to express themselves and to understand the world.[8] In an online class, students and teachers alike need to analyze big picture questions and layers of information. For example, the student in an ethics or philosophy class can reflect on the realities of life. With the proper guidance, online education should help define the meaning of moral commitment and human responsibility. CONCLUSION Before the pandemic, policy makers had been pursuing the goals of a globalized economy. They had been fashioning and promoting programs that cater to the interests of a consumer-driven world that has deprived the poor of opportunity. When the pandemic struck, globalization suddenly came to a halt and people realized the things that truly matter in life – family, love, and life itself. The new normal must now emphasize the role of education as a source of inner strength that can empower the person to live well reinforcing values based on a social consciousness. Critical pedagogy is possible under the new normal. The distance between the teacher and student does not make the educational process less real and in the absence of a vaccine, online learning is the safest strategy. Governments cannot freeze an entire school year since education is the only way out from poverty for millions. The COVID-19 pandemic provides a reason to re-imagine teaching using technology to encourage all students to question systems of oppression or greed, as the persistent pursuit of the truth is what education is all about. [1] Hartsell, Layne, Krabbe, Alexander, & Pastreich, Emmanuel. “Covid-19, Global Justice, and a New Biopolitics of the Anthropocene.” Social Ethics Society Journal of Applied Philosophy 6, no. 2 (2020), 3. [2] Ravetz, Jerome. “Science for a Proper Recovery: Post-Normal, not New Normal.” Issues in Science and Technology [Internet] July 15, 2020. https://issues.org/post-normal-science-for-pandemic-recovery/ [3] Hartsell, et al. “Covid-19, Global Justice, and a New Biopolitics of the Anthropocene,” 6. [4] Ravetz, “Science for a Proper Recovery: Post-Normal, not New Normal.” [5] Ibid. [6] Freire, Paolo. Pedagogy of the Oppressed. (New York: Continuum Books, 1993). [7] Freire writes that in such a situation “instead of communicating, the teacher issues communiqués and makes deposits which the students patiently receive, memorize, and repeat.” See his Pedagogy of the Oppressed. [8] Bakardjieva, Maria. Internet Society. (London: Sage Publications, 2005). (shrink)

Using philosophical guidelines--and applying these guidelines throughout a patient's lifespan--this text assists readers in making ethically sound choices in nursing. It explores both traditional and contemporary ethical theories and acknowledges changing trends in the health field, incorporating issues such as managed care. Includes clinical case studies within each chapter. Incorporates a new organization in Part Two, in three sections entitled "Developmental Highlights," "Issues and Problems," and "Morally Reasoned Nursing Interventions." Provides new "What if?" questions throughout to help apply (...) theory to real events. Offers extensive analysis of euthanasia and assisted suicide. Includes thorough coverage of the HIV/AIDS epidemic and its moral complexities. Discusses organ transplantation and experimental medical treatments in ethical context. Ideal for practicing nurses looking for a reference on professional ethics. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Evil as the Good?A Reply to Brook ZiporynDavid R. LoyI was surprised to receive this lengthy response to my short review—yet not displeased, for the important question is, of course, how much Professor Ziporyn's reply helps to clarify the issues at stake, which we agree deserve to be pursued. One of the many admirable aspects of his Evil and/or/as the Good is that, in addition to presenting the Tiantai (...) ethical position in its historical context, it argues forcefully for the validity and relevance of that approach today. Moreover, I am pleased at the way Ziporyn's response focuses the argument of his rich and dense book, so I welcome this opportunity to continue the discussion. And perhaps those who have read this far will also be pleased that I am able to present my main concerns somewhat more concisely.Ziporyn begins with the relationship between ultimate and provisional truth, usually the crux of the matter from a Mahāyāna perspective. In response to a point I make—that ethically the nondual 'ultimate' point of view needs to be supplemented by a provisional 'lower truth' that distinguishes between good and evil—he emphasizes that according to Tiantai "conventional truth and ultimate truth are actually identical" (his italics) and that the conventional truth embraces all possible assertions, beliefs, and positions. Later, he elaborates that "provisional truth is a portion of ultimate truth, in a peculiar omnicentric sort of whole/part relation in which each part in fact contains the whole." The important term remains identity, for according to Tiantai "the idea that two entities might be mutually implicative and dependent, not adventitiously but in their nature, and yet not identical, is logically impossible." Ethically, of course, this means something more than the interdependence of good and evil: it is not only that "the most horrible evils are ineradicable, built into the absolute unchangeable nature of all existence, and fully and eternally present even in Buddhahood," but that "greed, anger, and delusion would be seen to be identical with Buddhahood, in accordance with precisely this Tiantai doctrine of the interpenetration of good and evil."As in the original review, my main point is that this emphasis on the identity of conventional truth and ultimate truth is an important insight, but one that turns out to be quite problematic ethically. Its value is mostly epistemological and metaphysical: it helps us escape from the kind of dualism that often postulates some 'higher' transcendental reality corresponding to a 'higher' ultimate truth. Instead, the 'higher' is not separate from the provisional and conventional, but the truth (whether realized or not) is that the whole 'ultimate' is completely contained within each conventional part or provisional position.Dōgen somewhere makes the point that the goal is not to eradicate concepts (which is a dualistic approach to practice, seeking a purified mind that transcends language) but to liberate concepts. What becomes important is our ability to move [End Page 348] (and play) freely among the multiplicity of linguistic possibilities—in Ziporyn's terms, to 'recontextualize' without getting stuck in any particular context or conceptual system. Nothing is lacking in any of these possibilities; in terms of Indra's Net, each node manifests the whole. We are not liberated from language, except in the sense that we are not trapped in any particular language game; rather, we are liberated in language. We should not blame the victim: the problem is not language itself, but our tendencies to cling to some concepts, et cetera, more than others- including, for example, our dualistic tendency to discriminate between 'good' and 'evil' in order to identify with the former by annihilating the latter (a very timely topic, unfortunately).But good and evil for Ziporyn are more than interdependent. He claims that they are identical, and that is where difficulties arise. The epistemological point about the identity of the two truths becomes more problematical when we move into ethics, where the 'cash value' is somewhat more obvious and immediate, in the sense that we need ethics to help us cope with moral choices that we find ourselves required to make in daily life, in circumstances not always... (shrink)

This thesis provides an ethical analysis of imprisonment as a mode of punishment. Consisting in an introduction and four papers the thesis addresses several important questions concerning imprisonment from a number of different perspectives and theoretical starting points. One overall conclusion of this thesis is that imprisonment, as a mode of punishment, deserves more attention from moral and legal philosophers. It is also concluded that a more complete ethical assessment of prison conditions and prison management requires a broader (...) focus. It must include an explicit discussion of both how imprisonment directly affects prison inmates and its negative side-effects on third parties. Another conclusion is that ethical discussions on prison conditions should not be too easily reduced to a question about how harsh or lenient is should be. Paper 1 argues that prisoners have a right to privacy. It is argued that respect for inmates’ privacy is related to respect for them as moral agents. Consequently, respect for inmates’ privacy is called for by different established philosophical theories about the justification of legal punishment. Practical implications of this argument are discussed and it is argued that invasion of privacy should be minimized to the greatest extent possible, without compromising other important values or the rights to safety and security. It is also proposed that respect for privacy should be part of the objective of creating and upholding a secure environment. Paper 2 discusses whether the collateral harm of imprisonment to the children and other close family members of prison inmates may give rise to special moral obligations towards them. Several collateral harms, including decreased psychological wellbeing, financial costs, loss of economic opportunities, and intrusion and control over their private lives, are identified. Two perspectives in moral philosophy, consequentialism and deontology, are then applied in order to assess whether these harms are permissible. It is argued that from either perspective it is hard to defend the claim that allowing for these harms are morally permissible. Consequently, imprisonment should be used only as a last resort. Where it is deemed necessary, it gives rise to special moral obligations. Using the notion of residual obligation, these obligations are then categorized and clarified. Paper 3 focuses on an argument that has figured in the philosophical debate on felon disenfranchisement. This argument states that as a matter of democratic self-determination, a legitimate democratic collective has the collective right to decide whether to disenfranchise felons as a way of defining their political identity. Yet, such a collective’s right to self-determination is limited, since the choice to disenfranchise anyone must be connected to normative considerations of political significance. This paper defends this argument against three charges that has been raised to it. In doing so it also explores under what circumstances felon disenfranchisement can be permissible. Paper 4 explores the question of whether prison inmates suffering from ADHD should be administered psychopharmacological intervention for their condition. The theoretical starting point for the discussion is the communicative theory of punishment, which understands criminal punishment as a form of secular penance. Viewed through the lens of the communicative theory it is argued that the provision of pharmacological treatment to offenders with ADHD need not necessarily be conceived of as an alternative to punishment, but as an aid to achieving the penological ends of secular penance. Thus, in this view offenders diagnosed with ADHD should have the option to undergo pharmacological treatment. (shrink)

Freud justified his extensive theorizing about dreams by the observation that they were “the royal road” to something much more general: namely, our unconscious mental life. The current preoccupation with the theory of excuse in criminal law scholarship (including my own) can be given a similar justification, for the excuses are the royal road to theories of responsibility generally. The thought is that if we understand why we excuse in certain situations but not others, we will have also gained (...) a much more general insight into the nature of responsibility itself. Nowhere has this thought been more evident than in the century-old focus of criminal law theoreticians on the excuse of insanity, a focus that could not be justified by the importance of the excuse itself.In this paper I wish to isolate two theories of excuse, each of which instantiates its own distinctive theory of responsibility. One is what I shall call the choice theory of excuse, according to which one is excused for the doing of a wrongful action because and only because at the moment of such action's performance, one did not have sufficient capacity or opportunity to make the choice to do otherwise. Such a choice theory of excuse instantiates a more general theory of responsibility, according to which we are responsible for wrongs we freely choose to do, and not responsible for wrongs we lacked the freedom (capacity and opportunity) to avoid doing. The second I shall call the character theory of excuse, according to which one is excused for the doing of a wrongful action because and only because such action is not determined by (or in some other way expressive of) those enduring attributes of ourselves we call our characters. (shrink)

Most librarians believe that they are part of a profession that is service oriented, democratic and nonjudgmental. Implicit in these principles is a core of professional ethics, allowing librarians to make effective, informed choices in matters affecting the library, its patrons and staff.Many of the ethical dilemmas facing the profession are covered here through a series of case studies. The focus is on librarians' relationships with patrons, colleagues, organizations, resources and vendors. Such issues as parental consent, patrons' rights to (...) privacy, union activities, library endorsements, censorship, and many others are covered. Each case study is followed by questions that highlight the particular ethical problem. (shrink)

A warm, personal guide to building a strong ethical and moral compass in the midst of today's confusing, scary, global problems. The moral challenges of today are unfamiliar in the history of philosophy. Climate change is the paradigm example of what Travis Rieder calls "The Puzzle" in the way your choices can seem at odds with what the planet urgently needs. How do we decide the right thing to do in the face of a massive collective challenge? Should you (...) drink water from a plastic bottle or not? Drive a Tesla? Or is that just what Elon and all the other corporations want you to think? What makes individual ethics difficult to think about in the case of catastrophic climate change makes ethics difficult to think about in many other contexts as well. The Puzzle, as he explains, is everywhere now. The chapters include a lively, meaningful tour of traditional moral reasoning looking at the contributions of Plato, Hegel, and Kant among others. But they could not grasp The Puzzle we now face. Old fashioned exercises like trolley problems involving sacrificing one person on this track for a bunch of people on the other don't address the huge consequential and complex crises our global community faces today. The tools most of us unthinkingly rely on when we try to do the right thing don't help when it comes to reasoning about individual responsibility for large collective problems. Expanding our suite of ethical concepts is now urgently required. Rieder defines exactly how to change our thinking, addressing mundane issues like bottled water to the biggies like whether to have children. This is a way to live a morally decent life in the scary, always complicated world we and our children live in. It's how to build your own Catastrophe Ethics. (shrink)

Today’s students are accustomed to a world where information is available on-demand, anywhere and anytime. They bring this expectation to their academic world where they want to work cooperatively and flexibly, using the modern information processing tools and access with which they are familiar. New hardware platforms such as e-Readers and tablet computers have made substantial inroads in the consumer market. E-Readers are becoming more prevalent in universities – replacing the need for physical textbooks, lecturing notes and other academic (...) documents. Many universities are now running pilot programs, while some are already using e-Readers. Tablet computers, apart from their ability to read, edit or create various types of information documents, also offer additional features such as collaborative and social networking services. This empirical research project investigated student perspectives on the educational use of e-Readers and tablets within the University of Cape Town. A questionnaire was distributed to a significant portion of the student population and stratified according to seniority and faculty. Quantitative data was gathered and analysed on themes ranging from awareness to preferences to facilitating conditions around e-Readers within the academic environment. The students sent a clear signal: that they are keen to embrace these new technologies and the advantages they offer. E-Books can be updated automatically and downloaded to e-Readers instantly from almost anywhere in the world. Students feel they would benefit greatly through the use of e-Readers and many believe they are set to replace books completely. Having access to a portable library of information in their backpacks would benefit both students and the environment. However, there are a number of barriers to the comprehensive introduction of these technologies, including the cost of the devices; cost, rights and file format of e-books; the need for a critical mass of textbooks available in digital format and device characteristics such as battery life, and ubiquitous Wi-Fi access. (shrink)

While the ethics of technology is analyzed across disciplines from science and technology studies, engineering, computer science, critical management studies, and law, less attention is paid to the role that firms and managers play in the design, development, and dissemination of technology across communities and within their firm. Although firms play an important role in the development of technology, and make associated value judgments around its use, it remains open how we should understand the contours of what firms owe society (...) as the rate of technological development accelerates. We focus here on digital technologies: devices that rely on rapidly accelerating digital sensing, storage, and transmission capabilities to intervene in human processes. This symposium focuses on how firms should engage ethical choices in developing and deploying these technologies. In this introduction, we, first, identify themes the symposium articles share and discuss how the set of articles illuminate diverse facets of the intersection of technology and business ethics. Second, we use these themes to explore what business ethics offers to the study of technology and, third, what technology studies offers to the field of business ethics. Each field brings expertise that, together, improves our understanding of the ethical implications of technology. Finally we introduce each of the five papers, suggest future research directions, and interpret their implications for business ethics. (shrink)

The purpose of this article is to describe and reflect ethical challenges in a grounded theory study on the dynamics of hope in HIV-positive adults and their significant others. It concentrates on the justification of a research problem, sensitive research and the relationship between the researcher and the participants in data collection. The basis of ethically sound nursing research on the dynamics of hope in these two vulnerable groups lies in the relationship between the researcher and the participant. However, (...) it is also obvious that the content, the process, the methods used and the ethics of the study cannot be divorced from this relationship. In conducting grounded theory research on the dynamics of hope in this research population, the researcher has to consider the surrounding world, that is, the reality in which these people live in hope or despair. (shrink)

PurposeThis paper aims to demonstrate the relevance of worldviews of the global south to debates of artificial intelligence, enhancing the human rights debate on artificial intelligence (AI) and critically reviewing the paper of UNESCO Commission on the Ethics of Scientific Knowledge and Technology (COMEST) that preceded the drafting of the UNESCO guidelines on AI. Different value systems may lead to different choices in programming and application of AI. Programming languages may acerbate existing biases as a people’s worldview is captured in (...) its language. What are the implications for AI when seen from a collective ontology? Ubuntu (I am a person through other persons) starts from collective morals rather than individual ethics.Design/methodology/approachLiterature overview on the African philosophy of Ubuntu as applied to artificial intelligence. Application of it to the United Nations Educational, Scientific and Cultural Organisation (UNESCO) debates on establishing guidelines to the ethics of artificial intelligence.FindingsMetaphysically, Ubuntu and its conception of social personhood (attained during one’s life) largely rejects transhumanism. When confronted with economic choices, Ubuntu favors sharing above competition and thus an anticapitalist logic of equitable distribution of AI benefits, humaneness and nonexploitation. When confronted with issues of privacy, Ubuntu emphasizes transparency to group members, rather than individual privacy, yet it calls for stronger (group privacy) protection. In democratic terms, it promotes consensus decision-making over representative democracy. Certain applications of AI may be more controversial in Africa than in other parts of the world, like care for the elderly, that deserve the utmost respect and attention, and which builds moral personhood. At the same time, AI may be helpful, as care from the home and community is encouraged from an Ubuntu perspective. The report on AI and ethics of the UNESCO World COMEST formulated principles as input, which are analyzed from the African ontological point of view. COMEST departs from “universal” concepts of individual human rights, sustainability and good governance which are not necessarily fully compatible with relatedness, including future and past generations. Next to rules based approaches, which may hamper diversity, bottom-up approaches are needed with intercultural deep learning algorithms.Research limitations/implicationsThere is very few existing literature on AI and Ubuntu. Therefore, this paper is of an explorative nature.Practical implicationsThe ethics of Ubuntu offers unique vantage points in looking at the organization of society and economics today, which are also relevant for development of AI, especially in its tenet of relatedness rather than individuality (and practical use of AI for individuals), taking responsibility for society as a whole (such as analyzing the benefit of AI for all strata of society), and embodying true inclusiveness. Whether looking at top-down guidelines for the development and implementation of AI or the bottom-up ethical learning process of AI (deep learning), ethics of the Global South can have an important role to play to combat global individualist tendencies and inequity, likely reinforced by AI. This warrants far more research.Social implicationsApplications of AI in Africa are not contextualized, do not address the most pressing needs of the African continent, lead to cybersecurity issues and also do not incorporate African ethics. UNESCO’s work in this regard is important but expert inputs are largely centered around Western “universal” principles and Organisation for Economic Cooperation and Development and EU precedence. African ethics have, so far, a small role to play in global ethics and philosophy and therefore risk to be overlooked in the discussion on AI and ethics. This is why the consultation process of UNESCO on ethics of AI was of paramount importance. However, it does not automatically lead to consultation of African philosophers or sages, as many are educated in Western (ized) education systems. See further details under practical implications.Originality/valueThis is a new area of research in which little work has been done so far. This paper offers the opportunity to widen the debate on AI and ethics beyond the conventional discourse, involving multiple worldviews, of which Ubuntu is just one. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Health Care Ethics: Theological Foundations, Contemporary Issues, and Controversial Cases, revised edition by Michael R. Panicola, David M. Belde, John Paul Slosar, and Mark F. Repenshek, and: On Moral Medicine: Theological Perspectives in Medical Ethics, third edition ed. by M. Therese Lysaught and Joseph J. Kotva Jr. with Stephen E. Lammers and Allen VerheyLindsey EsbensenReview of Health Care Ethics: Theological Foundations, Contemporary Issues, and Controversial Cases, revised edition (...) MICHAEL R. PANICOLA, DAVID M. BELDE, JOHN PAUL SLOSAR, AND MARK F. REPENSHEK Winona, MN: Anselm Academic, 2011. 438 pp. $37.95Review of On Moral Medicine: Theological Perspectives in Medical Ethics, third edition EDITED BY M. THERESE LYSAUGHT AND JOSEPH J. KOTVA JR. WITH STEPHEN E. LAMMERS AND ALLEN VERHEY Grand Rapids, MI: Eerdmans, 2012. 1180 pp. $61.55Health Care Ethics and On Moral Medicine are excellent resources for those studying and teaching in the field of medical ethics. Each text on its own provides a very good initial evaluation of contemporary conversations in health care ethics. Together they provide a thorough foundation for the study of health care ethics that encourages further exploration of topics in the field. They both provide an excellent overview for undergraduate students as well as anyone interested in the field of medical morality.Health Care Ethics is especially helpful for those entering the field of ethics in general and the more particular realm of medical morality. User-friendly, [End Page 211] the book is accessible to beginners while also being relevant to those already well-versed in medical ethics. The book provides case studies culled from the experiences of the authors throughout their careers in the practice of medical ethics. Perhaps even more useful, however, are the other exercises in which readers are given the opportunity to actively engage the text in order to discover and more fully articulate their own moral stance. Although Health Care Ethics approaches the topic from a theological perspective, using scriptural passages as well as broader religious themes and contexts, the book is accessible to those outside of the religious arena as well.The first three chapters lay the framework for general theological and ethical inquiry while the later chapters discuss more specific topics in applied health care ethics. The opening chapters by Michael Panicola are thought-provoking, especially since they encourage readers to participate in exercises to determine how they would respond to particular scenarios in their personal decision making. For example, after laying out the classic ethical theories, readers are asked to take a “quiz” by responding to multiple-choice questions to determine how they would respond to various ethical situations. The exercise demonstrates that moral discernment that relies on one ethical theory alone or one single approach to ethics is too narrow and confining for authentic dialogue in ethics. Another exercise calls upon readers to examine their fundamental bases for personal decision making by asking them to create a list of what they think are the ten things that constitute human flourishing and then narrow that list down to the top two. In addition to being engaging, these exercises help readers establish their personal moral stance by asking them to appropriate foundational norms in the process of moral discernment to the case studies throughout the book. They also help readers apply these norms to the specific topics in health care ethics presented in the later chapters.The authors of Health Care Ethics clearly identify human flourishing as the center and goal for all ethical inquiry. Demonstrating that “human flourishing” has different connotations for different people, they also argue that certain norms can be agreed upon to establish a framework for all conversations regarding moral decision making in health care. They especially emphasize a concern for the optimization of human flourishing in final chapters of the text. Chapters 4–12 provide detailed examinations of current topics in medical ethics. Each chapter includes case studies that raise questions concerning social ethics as well as health care morality, employing sources from law, sociology, philosophy, and theology. Each case underscores the complexity of moral decision making in health care ethics as well as the point that there is no one, pure approach to medical ethics that... (shrink)

The aim of this book is simple: to invite readers to consider what it means to lead a good life, and to offer practical advice, based on the Buddhist teachings, as to how this can be accomplished. In each of more than thirty brief essays, Master Hsing Yun treats a specific moral or ethical issue, using quotations from the rich treasury of the Buddhist scriptures as a point of departure for his discussion. Among the topics he considers (...) are control of the body and of speech, overcoming greed, ending anger, patience under insult, how to manage wealth, how to get along with others, what it means to practice Buddhism, and the blessings and joys of that practice. The Buddhist precepts are introduced as guideposts along this path of liberation, and friendship, gratitude, and service to others are presented as essential elements of a common quest to discover and to embody our innate goodness and humanity. (shrink)

From one of the leading policy experts of our time, an urgent rethinking of how we can better support each other to thrive. Whether we realize it or not, all of us participate in the social contract every day through mutual obligations among our family, community, place of work, and fellow citizens. Caring for others, paying taxes, and benefiting from public services define the social contract that supports and binds us together as a society. Today, however, our social (...) contract has been broken by changing gender roles, technology, new models of work, aging, and the perils of climate change. Minouche Shafik takes us through stages of life we all experience--raising children, getting educated, falling ill, working, growing old--and shows how a reordering of our societies is possible. Drawing on evidence and examples from around the world, she shows how every country can provide citizens with the basics to have a decent life and be able to contribute to society. But we owe each other more than this. A more generous and inclusive society would also share more risks collectively and ask everyone to contribute for as long as they can so that everyone can fulfill their potential. What We Owe Each Other identifies the key elements of a better social contract that recognizes our interdependencies, supports and invests more in each other, and expects more of individuals in return. Powerful, hopeful, and thought-provoking, What We Owe Each Other provides practical solutions to current challenges and demonstrates how we can build a better society--together"--Publisher's website. (shrink)

This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be (...) causing them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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Often hearing parents and adults belonging to the Deaf community have very different and opposite views regarding central themes in treatment and education of deaf children: cochlear implantation versus rejection of medicalization of deafness, oral communication versus Sign Language, and mainstreaming in regular schools versus education in deaf schools as the most natural learning environment for deaf children. The striking divergence of hearing and deaf people’s ethical judgments is a consequence of deafness and having normal hearing being “world-generating states,” (...) conditions that not only lead to a different understanding and perception of the world, but also to different courses of life that make the worlds of hearing and deaf people also really different.The views of hearing and deaf people stem from different worlds and different cosmologies, within which they have their own validity. The conflict between these two views is not resolved by arbitration or the choice for a middle course, but by negotiation. The basis for this negotiation may be an ethical analysis based on a Christian personalism that tries to combine full respect for the diversity of the negotiating partners with the effort of bringing their widely divergent worlds in communication with each other. (shrink)

The Philosophy of Modern Song: curious title, a curious book. If you bought it, as I did, because you are a devoted Dylan fan, hoping to find new Dylan songs inside, or at least new Dylan prose, you will be disappointed. In the photo of three musicians on the cover, none of them is Dylan. The one on the left is Little Richard. Who are the other two? Nowhere are we told their names, nor the names of the people (...) in any of the other photos, except for the sixty-six featured artists, though we will recognize many. The photo on the back cover might or might not be of the interior of Izzy Young's “Folklore Center,” reminiscent of Dylan's early days in Greenwich Village in the Sixties, when, together with my guitarist husband, I got to hear him perform after hours at the Gaslight and knew him well enough to say Hi when passing on the street.The basis for selecting the sixty-six songs anthologized and commented on is not immediately obvious. This is not a collection of Dylan's underappreciated favorites, though the taste represented is certainly eclectic and the choices are often surprising. The title does not help the reader who has not yet got her bearings... Philosophy? As if to justify his use of the word, Dylan eventually offers a lengthy comment on Albert Camus, but how relevant is that comment to these songs? And the word modern, too, means so many things—a sudden divergence from the past in the arts and literature; up-to-date and therefore good. These songs are not that kind of modern. If anything, the book looks backward, across the years of Dylan's long life to his musical awakening. Because we are almost the same age, I recognize the hodgepodge of styles and influences assembled here as belonging mostly to the early Fifties, when, like Bob, I was entering my teens by listening to, even dancing to, songs on the radio before I fell asleep at night. Enough about me! But no more apt basis for classifying these songs is suggested. They are not arranged alphabetically or chronologically.As for the anthologized songs, each one, once named, receives a commentary, and every commentary is called a chapter, and every chapter is divided into two parts, spelled out in letters as bold as a movie marquee. We are given the title of each song, the date of its release, and the name of the songwriter. The first part of each commentary consists of a paraphrase of “events” in the song, told almost exclusively in the second-person you rather than the more conventional I or the third-person he or she. Here is a passage from Dylan's paraphrase of “Blue Suede Shoes” by Carl Perkins: You get on well with most people, and you put up with a lot, and you hardly get caught off guard, but your shoes are something else. Minor things may annoy you, but you rise above them. Having your teeth kicked in, being pounded senseless, being dumped on and discredited, but you don't put any weight on that, none of it is as real to you as your shoes. They're priceless and beyond monetary worth.The paraphrase goes on for almost six pages, and to what end? The second half of each commentary, indicated by changes in the type, takes a few steps back to consider the sociological implications of the song in the context of its time. For instance, from the second half of the commentary on “Blue Suede Shoes”: “Shoes reveal character, station, and personality.” But Dylan does not use the opportunity to talk about his own character, station, personality. His associations with Carl Perkins and “Blue Suede Shoes” morph into an anecdote about a man called “Iron Felix, trusted consort to Lenin and Stalin.”A lengthy list of all required photo credits fills the two back pages but is printed in type so small it is almost illegible. If you want more information, and more importantly if you want to experience the songs discussed, your best bet is to search for the recordings on YouTube and to follow along, reading Dylan's commentary, one song at a time, while listening. Or, I hear rumors that we will need to purchase another book, the audio version of Philosophy of Modern Song, not yet released.Every song has its commentary, but nothing about this organization is stable, and as soon as the reader/listener thinks she has discovered a rationale for the order of the works selected, she is met with an exception. Basically, these seem to be songs about which Dylan has something anecdotal to say. More usefully, perhaps, they are organized around certain themes—those that have always preoccupied him: man's inhumanity to man, injustice, self-deception, the human situation. The anonymous author of the blurb on the jacket promises a master class in songwriting, but, if it exists at all, that lecture is exhausted in one or two observations, such as: “ ‘El Paso’ is built on five stanzas, each one two verses and a bridge and then returning to the next stanza.... ”It was almost fifty pages into the book that the sense of something missing overcame me. It was not only the words of the songs and the music that were missing; it was the author, the central intelligence that I love, the singer and songwriter whose name is credited on the cover but who never appears in the book, not even in a photograph. What I missed was Dylan. He had removed himself from his book's pages, except perhaps for a single instance: “You're an eighty-year old man, being wheeled around in a home for the elderly, and the nurses are getting on your nerves.... ”Has Bob Dylan grown weary of himself and all of his creations? The commentaries are not about Bob. In the whole book, the line quoted above may be the only exception. Does he refuse the “first person singular in the hopes of transcending ego”? Maybe; but we want to hear our master's voice. As for the philosophy of song? Besides the remarks on Camus, there is only one commentary in which Dylan explicitly states anything like a philosophy, and that is the one on “Willie the Wandering Gypsy and Me,” written and performed by Joe Shaver. The song has a philosophical point of view: “Keep moving, it's better, let the train keep on rolling.”. (shrink)

Introduction Hundreds of thousands of premature neonates born in low-income countries are implicitly denied treatment each year. Studies from India show that treatment is rationed even for neonates born at 32 gestational age weeks (GAW), and multiple external factors influence treatment decisions. Is withholding of life-saving treatment for children born between 28 and 32 GAW acceptable from an ethical perspective? Method A seven-step impartial ethical analysis, including outcome analysis of four accepted priority criteria: severity of disease, (...) treatment effect, cost effectiveness and evidence for neonates born at 28 and 32 GAW. Results The ethical analysis sketches out two possibilities: (a) It is not ethically permissible to limit treatment to neonates below 32 GAW when assigning high weight to health maximisation and overall health equality. Neonates below 32 GAW score high on severity of disease and efficiency and cost-effectiveness of treatment if one gives full weight to early years of a newborn life. It is in the child's best interest to be treated. (b) It can be considered ethically permissible if high weight is assigned to reducing inequality of welfare and maximising overall welfare and/or not granting full weight to early years of newborns is considered acceptable. From an equity-motivated health and welfare perspective, we would not accept (b), as it relies on accepting the lack of proper welfare policies for the poor and disabled in India. Conclusion Explicit priority processes in India for financing neonatal care are needed. If premature neonates are perceived as worth less than other patient groups, the reasons should be explored among a broad range of stakeholders. (shrink)

This paper aims to argue for the thesis that it is not a priori morally justified that the first phase of space colonisation is based on sexual reproduction. We ground this position on the argument that, at least in the first colonisation settlements, those born in space may not have a good chance of having a good life. This problem does not depend on the fact that life on another planet would have to deal with issues such as (...) solar radiation or with the decrease or entire absence of the force of gravity. These issues could plausibly be addressed given that the planets or settlements we will feasibly colonise could be completely transformed through geoengineering processes. Likewise, the ability of humans to live in space could be enhanced through genetic modification interventions. Even if, however, the problems concerning survival in space were solved, we think that, at least in the first period of colonisation of space or other planets, giving birth to children in space could be a morally irresponsible choice since we argue, the life we ​​could give them might not be good enough. We contend that this is the case since when we decide to have a baby. We argue that it is not morally right to be content that our children have a minimally sufficient life worth living; before we give birth to children in space, we should make sure we can give them a reasonable chance of having a good life. This principle applies both on Earth - at least where you can choose - and for space travel. (shrink)

This work has its origin in a master's research about Brazilian Education. The approach that we present in this text reveals the perspectives of caring perceived in a five-year-olds classroom in the daily life in a municipal center for Early Childhood Education in Fortaleza. The theoretical discussions on the theme involved a dialogue between Pedagogy and Philosophy of Education based on the contributions of Kramer, Pagni, Foucault, Rancière, Kohan and Boff. It was a qualitative research of phenomenological inspiration, which (...) method of data creation was participant observation. The analysis revealed that: in the interactions occurred in pedagogical practices, teachers and children take care of each other; the meaning of caring for children can be perceived in the minutia of their daily actions, as well as in affective involvement, in playing together, in speaking and listening to others, in sharing life on a daily basis; as for the meaning of caring for the adults, it is influenced by the way they were cared for, by their subjectivation and their choices in their way of being; caring humanizes teaching practices, inspiring emancipation; the policy on results that has aimed at "improving educational indices" may represent a danger to Early Childhood Education by minimizing the sharing of specific childhood experiences to training in order to achieve expected results. The study emphasized the need to reflect on the meaning of education and therefore proposes that caring be valued as an ethical decision and as an option for reflection on the way of living and interacting. (shrink)