The American Medical Association has provided a list of patient responsibilities, said to be derived from patient autonomy, without providing any justification for this derivation. In this article, the virtue of moral responsibility is proposed as a way to justify these kinds of limits on respect for individual autonomy. The need for such limits is explained by examining the traditional principles of health care ethics. What is missing in health care decision making, and can be provided by the virtue of (...) moral responsibility, is a careful consideration of the impact of individual decisions on particular others and the community, as a whole. The concept of moral responsibility as a virtue is then developed and examples of its application to health care decision making are provided. Finally, the roles of both physicians and health care ethicists in promoting the morally responsible exercise of individual autonomy are explored. (shrink)

The principle of respect for autonomy is increasingly under siege as a valuable component of healthcare ethics. Its critics charge that it has been elevated to a position out of proportion to its contribution, so that the individual's wishes and rights have come to dominate healthcare decisionmaking, while obligations and responsibilities are ignored or devalued. If we are to salvage respect for autonomy we must find a way to reconnect the individual and the community, rights and responsibilities, in the way (...) we think about, discuss, and make healthcare decisions. (shrink)

: The principle of respect for autonomy has come under increasing attack both within health care ethics, specifically, and as part of the more general communitarian challenge to predominantly liberal values. This paper will demonstrate the importance of respect for autonomy for the social practice of assigning moral responsibility and for the development of moral responsibility as a virtue. Guided by this virtue, the responsible exercise of autonomy may provide a much-needed connection between the individual and the community.

The current interest in and discussion of virtue ethics suggests that this approach to moral decisionmaking has several distinct advantages as applied to ethical issues in healthcare delivery. For the most part, calls to incorporate the virtues of the healthcare provider in discussions of these issues have sought to supplement rather than totally replace traditional ethical theories, such as the utilitarian focus on maximizing the best overall consequences and the Kantian concern to act on the duty of respect for persons. (...) Including virtue-based ethics in such discussions allows for a more eclectic view of what should be considered in resolving difficult moral problems. As many critics of the purely principle-based approach have noted, real moral dilemmas are usually quite messy and are not easily susceptible to satisfactory resolution solely on the basis of abstract moral theories or principles. (shrink)

Understanding the philosophical foundations of the principle of respect for autonomy is essential for its proper application within medical ethics. The foundations provided by Immanuel Kant's principle of humanity and John Stuart Mill's principle of liberty share substantial areas of agreement including: the grounding of respect for autonomy in the capacity for rational agency, the restriction of this principle to rational agents, and the important distinction between influence and control. Their work helps to clarify the scope and role of the (...) principle of respect for autonomy in health care delivery; its implications for truth telling, informed consent, and confidentiality; and its relationship to other moral principles, such as beneficence and distributive justice. (shrink)

In this article I provide an overview of philosophical conceptions of privacy and suggest 3 models to assist with the ethical analysis of privacy invasion by the news media. The models are framed by respect for persons, the comparison of harms and benefits, and the transfer of power. After describing the models, I demonstrate how they can be applied to news reporting that invades the privacy of public figures.

Journal of Mass Media Ethics, Volume 27, Issue 2, Page 157-159, April-June.

The coverage of national tragedies by the news media has come under increasing criticism. Yet, we continue to watch, listen, and read. One approach to resolving this conflict is through an understanding and recognition of the contribution the news media make to public discourse and public grieving.Themes from communication studies, political theory, and contemporary ethics are all employed to develop a new perspective on this type of news coverage. The perspective taken here is based on the ritual view of communication, (...) according to which the purpose of communication is the maintenance of society and the representation of shared beliefs. The argument is made that the news media in these tragic situations have the responsibility of providing needed information, stimulating public discourse, bringing us together as a community of fellow-citizens, and telling stories that engage our emotions and lead us to re-evaluate our own values, attitudes, choices, and actions. Specific examples are provided from the September 11 attacks to demonstrate that in all of these ways the news media make a valuable contribution to public grieving by initiating and supporting the kind of public discourse that can meet human needs in the face of grief and loss. (shrink)

This paper approaches the topic of visual art in medical education from a philosophical perspective, drawing on arguments from epistemology, philosophy of science, aesthetics, and contemporary ethical theory. Several medical ethicists have noted that the traditional clinical paradigm may increase the epistemic and emotional distance between patient and physician in part by focusing on the physical body and medical technology. Some of these same writers recommend a new approach to patients based on empathy and increased attention to suffering. After reviewing (...) these arguments, supporting examples, and recommendations, I explain how visual art that expresses or symbolizes the emotional response to illness could be used to introduce an additional paradigm into medical education. This would be a paradigm based on empathetic attention to patients' emotional experiences in illness. My own argument is that this additional way of perceiving and relating to patients may reduce the distance between patient and physician and may allow physicians to better meet the ideal of treating the patient as a person. (shrink)

This collection of essays examines a relationship which has provoked much current debate, the relationship between ethical theory and applied ethics. As moral philosophers have increasingly focused their attention on ethical issues in the professions and public policy development, the relevance of ethical theory to these issues and the competence of moral philosophers to address them have both been questioned.