A twenty‐person working group convened to discuss the ethical and policy considerations of the controversial intervention called “growth attenuation,” and if possible to develop practical guidance for health professionals. A consensus proved elusive, but most of the members did reach a compromise.

The effects of distant, intercessory prayer on health outcomes have been studied in a range of randomised, blinded clinical trials. However, while seeking the evidentiary status accorded this ‘gold standard’ methodology, many prayer studies fall short of the requirements of the World Medical Association's Declaration of Helsinki for the ethical conduct of trials involving human subjects. Within a sample of 15 such studies published in the medical literature, many were found to have ignored or waived key ethical precepts, including adequate (...) standards of care, patient confidentiality and informed consent. Prayer was considered in most studies to pose negligible or no risk to subjects, despite the fact that no clear mechanism of action nor any safety monitoring procedures were described. As a result, many studies did not meet basic ethical standards required of clinical trials of biophysical interventions, making application of their results ethically problematic. If investigators wish their data to adequately inform the use or rejection of intercessory prayer to improve health, these shortcomings should be addressed in future studies. (shrink)

Phenomenological interviews with queer women in rural Nova Scotia reveal significant forms of trauma experienced during labour and birth. Situating the accounts of participants within both phenomenological and intersectional analyses reveals harms enabled by structurally embedded heteronormative and homophobic healthcare practices and policies. Our account illustrates the breadth and depth of harm experienced and outlines how these violate core ethical principles and values in healthcare.

The following Acknowledgments were omitted in the original publication.

Abstract:In this paper I explore the topic of moral compromise in institutional settings and highlight how moral compromise may affirm, rather than undermine, personal integrity. Central to this relationship between moral compromise and integrity is a view of the self that is responsive to multiple commitments and grounded in an ethic of responsibility. I elaborate a number of virtues that are related to this notion of the self and highlight how these virtues may support the development of (...) individuals who are responsive and reasonable in moral discourse and discerning in establishing moral limits on compromise. I look at how moral regret is closely connected to moral compromise and emphasize its significance for reinforcing personal integrity. The paper closes with a discussion of the relevance of these topics to the field of business ethics. (shrink)

Philosophy of mind and cognitive science (e.g., Clark and Chalmers 1998; Clark 2010; Palermos 2014) have recently become increasingly receptive tothe hypothesis of extended cognition, according to which external artifacts such as our laptops and smartphones can—under appropriate circumstances—feature as material realisers of a person’s cognitive processes. We argue that, to the extent that the hypothesis of extended cognition is correct, our legal and ethical theorising and practice must be updated, by broadening our conception of personal assault so as to (...) include intentional harm towards gadgets that have been appropriately integrated. We next situate the theoretical case for extended personal assault within the context of some recent ethical and legal cases and close with some critical discussion. (shrink)

Compromise is usually associated with concerns about expedience and feelings of regret. It is seen as requiring the surrender of principle in order to avoid a worse outcome. This article proposes an alternative concept of compromise, one that complements without wholly replacing traditional notions of it. It focuses on the intrapersonal aspect of compromise, and envisions it as concerned with maintaining a sense of coherence in how one sees oneself as an ethical agent. This involves consideration of (...) ethical identity, and of the nature of principles as guides for action. The alternative conception proposed hopefully leads to a more affirmative idea of compromise, one less burdened with a sense of remorse. (shrink)

In the US, stem cell research is at a moral impasse—many see this research as ethically mandated due to its potential for ameliorating major diseases, while others see this research as ethically impermissible because it typically involves the destruction of embryos and use of ova from women. Because their creation does not require embryos or ova, induced pluripotent stem cells offer the most promising path for addressing the main ethical objections to stem cell research; however, this technology is still in (...) development. In order for scientists to advance induced pluripotent stem cell research to a point of translational readiness, they must continue to use ova and embryos in the interim. How then are we to ethically move forward with stem cell research? We argue that there is personal integrity and value in adopting a ‘moral compromise’ as a means for moving past the moral impasse in stem cell research. In a moral compromise, each party concedes part of their desired outcome in order to engage in a process that respects the values and desires of all parties equitably. Whereas some contend that moral compromise in stem cell research necessarily involves self-contradiction or loss of personal integrity, we argue that in the US context, stem cell research satisfies many of the key pre-conditions of an effective moral compromise. To illustrate our point, we offer a model solution wherein eggs and embryos are temporarily used until non-egg and non-embryonic sources of pluripotent stem cells are developed to a state of translational readiness. (shrink)

McGovern, Kevin; Brussen, Kerri Anne Some vaccines are produced using cell lines which were originally developed from tissue from an aborted foetus. Vaccines are ethically compromised by this connection to abortion. within the Catholic Church, the Pontifical Academy for Life has called for research and development of alternative vaccines which are ethically acceptable. Until alternative vaccines are developed, it has also accepted the use even of these ethically compromised vaccines in order to protect children, pregnant women and the population as (...) a whole from the risk of contracting serious disease. This article explores all these issues from an Australian perspective. (shrink)

This work focuses upon decisions to withhold or withdraw life-supporting treatment from incompetent patients. It offers a critical examination of the latest developments with a view to developing a new framework for resolving disputes in the clinic that is not only theoretically robust but also practically relevant.

In this chapter I will concentrate on compromise in ethical conflict and disagreement. I will discuss compromises related to disagreement with respect to public decisions between options that represent conflicting incommensurable human values. The central question will be whether in those cases a principled compromise is possible. A ‘principled compromise’ can be defined as a rational way to achieve a trade-off or balance between conflicting values, for instance, by rational assignment of relative weights. I will argue that (...) in some cases incommensurability will prevent a principled compromise in the defined sense. I will show why phrases used by some philosophers, such as ‘making a rational trade-off’, ‘striking the right balance’, ‘finding the Aristotelian Mean’ or ‘splitting the difference’, are based on misunderstandings about the characteristics of incommensurable values that are usually at stake in the pursuit of a compromise. I will show that incommensurable values lack an equivalence relation and how this prevents a determinate trade-off or balance between them. This is especially important with respect to the pursuit of compromises in ethical conflicts, including conflicts of justice, where we need a rational and ethical justification for the final decision. I will argue that the model of deliberative democracy presents a promising procedure for making the final decision legitimate but that, in the relevant cases, it cannot avoid an ethical deficit. (shrink)

Brussen, Kerri Anne Ethically compromised vaccines are vaccines where the virus used in the manufacture of the vaccine has been cultured in a cell line developed from tissue grown from an aborted foetus. In Australia, an ethically compromised vaccine is the only vaccine available for Chicken pox (varicella), shingles (zoster), Hepatitis A, and Rubella (which is part of the MMR - measles, mumps, rubella - vaccine). The poliovirus vaccine component of Quadracel, available in Western Australia, is ethically compromised. However, the (...) poliovirus component of Infanrix-IPV is not ethically compromised and is used in all other Australian States and Territories. The rabies vaccine, Rabipur, is not ethically compromised and is the preferred option to Merieux Inactivated Rabies Vaccine (MIRV) which is an ethically compromised vaccine. This article lists the ethically compromised vaccines available in the various Australian States and Territories, and explains why they are ethically compromised. It also explains when and why vaccination should still be accepted even when the only available vaccine is ethically compromised. (shrink)

On Compromise is an argument against contemporary liberal society's tendency to view compromise as an unalloyed good--politically, ethically, and artistically. In a series of clear, convincing essays, Rachel Greenwald Smith discusses the dangers of thinking about compromise as an end, rather than as a means. To illustrate her points, she recounts her stint in a band as a bass player, fighting with her bandmates about 'what the song wants,' and then moves outward to Bikini Kill and the (...) Riot Grrrl movement, the Iowa Writers' Workshop, Poetry magazine, the resurgence of fascism, and other wide-ranging topics. (shrink)

Following the decision of the House of Lords in Purdy, the Director of Public Prosecutions was required to promulgate guidance as to how prosecutorial discretion is exercised over the decision of whether to prosecute or not under the Suicide Act 1961. The resulting policy essentially confirms that if a lay person, who is motivated wholly by compassion, provides minor and reluctant assistance to a mentally competent adult, he or she is extremely unlikely to be prosecuted. Consequently, prosecutorial policy over cases (...) of complicity in suicide might be viewed as presenting a procedural compromise between explicitly allowing and robustly prohibiting assisted suicide. This paper explores the legal and ethical implications of compromising over complicity in suicide. (shrink)

In this essay the Co-chair of Ethics Working Group 17 of the Health Care Task Force discusses the formation, organization processes and activities of the group, and provides an analysis and critique of the experience. It is suggested that the creation of the group and its inclusion in the process made a social statement which legitimized ethics as a significant part of public policy deliberations. At the same time, major questions are raised about the role of ethics (...) in public policy arenas in which strategic compromise becomes the order of the day. Balanced and objective involvement may be illusory. Ethics, like informed consent, is a process, not an event and is ever evolving. Those who attempt to bring ethical considerations to the world of public policy have an obligation to think carefully about what should constitute an appropriate theoretical framework, make efforts to determine what is unique about ethics, and consider mechanisms for the various ethics disciplines to work effectively together. From this experience, the author developed a personal commitment to focus upon the critical importance of universal coverage for all Americans. Keywords: Clinton health plan, health care reform, universal access CiteULike Connotea Del.icio.us What's this? (shrink)

My invitation to respond to Lepora and Goodin may be the result of my work on complicity—in particular, the participation of health professionals in torture and aggressive interrogation in the so-called ‘war on terror’.1,2 However, instead of responding to the précis, I intend to address the section of the authors' book dealing with compromise and to explore the implications of their approach for some pressing public health issues.3,4 In their chapter entitled ‘Compromise as a Template’, Lepora and Goodin (...) contend that ‘[i]t is only when the intra-personal conflict forces an agent to choose among items of principled concern … to her that a compromise is genuinely involved’ (p. 19). The authors are right to emphasise the ethical significance of setting aside, forsaking or violating one's principles to reach an agreement. There may be serious implications for the integrity of an individual or an institution that makes such a compromise. But we should ensure that the intrapersonal focus does not lead to the neglect of other important ethical dimensions. A compromise may be problematic because of its impact on others who are affected by, but are not …. (shrink)

This book offers a conceptual history of compromise that demonstrates the connection between different understandings of compromise and corresponding differences in understandings of political representation.

In Against Purity, Alexis Shotwell proposes a powerful new conception of social movements as custodians for the past and incubators for liberated futures. Against Purity undertakes an analysis that draws on theories of race, disability, gender, and animal ethics as a foundation for an innovative approach to the politics and ethics of responding to systemic problems.

Philosophy of mind and cognitive science have recently become increasingly receptive to the hypothesis of extended cognition, according to which external artifacts such as our laptops and smartphones can—under appropriate circumstances—feature as material realizers of a person's cognitive processes. We argue that, to the extent that the hypothesis of extended cognition is correct, our legal and ethical theorizing and practice must be updated by broadening our conception of personal assault so as to include intentional harm toward gadgets that have been (...) appropriately integrated. We next situate the theoretical case for extended personal assault within the context of some recent ethical and legal cases and close with critical discussion. (shrink)

This article examines and synthesizes two different approaches to determining the content of business ethics courses and the manner in which they ought to be taught. The first approach, from a political perspective, argues that the institutional framework within which business operates ought to be tested by theories of distributive justice. The second approach, from the perspective of virtue theory, argues that we ought to examine the character of individual employees and the responsibilities associated with the roles which these (...) individuals play within organizations. I argue that Gadamer's interpretation of Aristotle's notion of phronesis shows an inseparable, bidirectional, conceptual link between the approaches of politics and virtue as well as providing insight into how business ethics might best be taught. (shrink)

The Global Competitiveness Report raises ethical issues on multiple levels. The traditional high ranking accorded the US is largely attributable to fallacies, poor science and ideology. The ideological bias finds expression in two ways: the inclusion of indices that do not provide competitive advantage, but that fit the Anglo/US ideology; and the exclusion of indices that are known to offer competitive advantage, but that do not fit the Anglo/US ideology. This flaw is compounded by methodological problems that raise further doubt (...) as to the reliability and validity of the survey results. The resultant false high ranking of the US, a strong proponent of Anglo/US capitalism, pseudo-legitimizes the propensity of US-dominated institutions and entities to persuade, coerce and, in the worst-case force other countries and their constituents to adopt Anglo/US practices and behaviours. This is ethically reprehensible because research shows that these practices and behaviours, when compared with other approaches, are sub-optimal in the results they produce for individuals, corporations and nations. The report also unjustly and unnecessarily stigmatizes entire groups of countries with little conceivable benefit to anyone. Given the report’s gravitas through the profound global influence it exerts on the decisions of top government and business leaders, these are serious ethical and economic issues. (shrink)

Nurses are often caught in the middle of what appear to be intractable moral conflicts. For such times, the function and limits of moral compromise need to be explored. Compromise is compatible with moral integrity if a number of conditions are met. Among these are the sharing of a moral language, mutual respect on the part of those who differ, acknowledgement of factual and moral complexities, and recognition of limits to compromise. Nurses are in a position uniquely (...) suited to leadership in fostering an environment that makes compromise with integrity possible. Keywords: compromise, integrity, nursing ethics CiteULike Connotea Del.icio.us What's this? (shrink)

In the article “Nudging and Informed Consent”, Cohen argues that the use of “nudging” by physicians in the clinical encounter may be ethically warranted because it results in an informed consent where obligations for beneficence and respect for autonomy are both met. However, the author's overenthusiastic support for nudging and his quick dismissal of shared decision-making leads him to assume that “soft” manipulation is un-problematic and that “wisdom” on the side of medical professionals will suffice to guard against abuse. Opposing (...) this view, we propose that: 1) patient preferences and values should not be boiled down to rational or irrational decisions based on cognitive reasoning alone, 2) potential threats to the physician-patient must be mitigated and could be minimized by employing alternative strategies that acknowledge the impact of cognitive heuristics in shaping decision-making but maintain transparency and trust, and 3) patient preferences and values can be legitimately influenced only under specific circumstances. The latter include: (1) exhaustion of other means; (2) evidence that nudging is effective in a specific context; (3) evidence of clear and active public misinformation (e.g., industry promoting smoking); (4) explicit pubic dialogue between various stakeholders including medical professional societies about nudging; (5) upholding shared decision-making as a preferred approach; and (6) a rich understanding of clinical reality beyond the simple dichotomy of beneficence-autonomy. (shrink)

Compromise is an inescapable part of human coexistence, from the mundane choices of domestic life to the grand stage of world politics. Notwithstanding its ubiquity, compromise raises a number of philosophical puzzles. One kind of problem is conceptual: what is compromise, and how might it differ from similar social phenomena, such as consensus and bargaining? A second kind of problem concerns the murky ethics of compromise, particularly on matters of moral significance. Compromise may have (...) a salutary role in facilitating cooperation, but it can also involve the sacrifice or betrayal of important values. Can there be moral reasons for genuine moral compromise and, if so, what form might they take? Similarly, are there any limits to moral compromise, or are all moral commitments ultimately subject to negotiation? (shrink)

I examine how co-parents should handle differing commitments about how to raise their child. Via thought experiment and the examination of our practices and affective reactions, I argue for a thesis about the locus of parental authority: that parental authority is invested in full in each individual parent, meaning that that the command of one parent is sufficient to bind the child to act in obedience. If this full-authority thesis is true, then for co-parents to command different things would be (...) for them to contest one another’s authority. The only course that respects the authority of both parents is for co-parents to agree to command the same thing. Further, what is commanded must not result from a ‘capitulation’ by one co-parent, rather, it should result from a compromise. Parental authority involves a duty to deliberate about which commands it is best to give the child. If a command results from a capitulation, one parent will rightly think of themselves as not having fulfilled their parental duty. Parental compromises are not best understood as bargains or conflicts, but by the metaphor of gifts given by each parent out of respect for the other’s authority. (shrink)

Compromise arises in contexts where irreconcilable claims must nonetheless somehow be resolved. Ordinary people in everyday life, politicians and artists, doctors engaging in research, humanitarian workers providing aid in the midst of war – all of them will have faced situations where compromise appeared to be the only reasonable option, and yet will have felt that there was nevertheless something deeply wrong with it. The aim of this paper is to help make sense of that sentiment. The focus (...) of this paper will be on some aspects of the morality of compromise. Its lynchpin will be to construe compromise as a joint action, in particular, a joint wrongdoing – taking part in, and sharing responsibility for, the doing of things that are wrong from the point of view of those who are the parties to the compromise. The question of ‘what is wrong with compromise?’ is thus recast as a question of ‘what is my part in the wrongs being done as part of the compromise?’ It is tempting to suppose that a compromise serves to dilute personal responsibility, parsing it out among parties to the compromise. Viewing a compromise as a joint action, in contrast, will help us to see how a compromise actually increases responsibility among parties to it. They are now jointly collaborating in some action that each of them sees as wrong, at least in part (albeit in differing parts). Discussions of compromise traditionally prioritize the inter-personal aspect – compromise, in the transitive form of ‘compromising with’ someone. But I argue that the intransitive form – ‘compromise of’ – deserves pride of place. The reason for prioritizing the intransitive ‘compromise of’ is simple: that is what is involved in the intra-personal calculation that must, of necessity, go on inside one's own head in the process of deciding whether or not to agree to a 'compromise with' someone else. In this paper I shall concentrate specifically on compromises of principles, or (more precisely) on ‘matters of principled concern to the compromising parties’. Not only is that the most troubling and morally problematic sort of compromise, it is also logically the most central case. I demonstrate that that is so by shifting the focus from inter-personal compromise to the more fundamental intra-personal process underlying it – the compromise we are involved in when adjudicating among our own conflicting values, to decide whether or not to agree to a compromise of the inter-personal sort. This is the subject of the first section of the paper below. Compromise involves resolving conflicts of principles through mutual concessions that are accepted and undertaken by all parties. Doing so may be on-balance desirable, not only from some larger perspective (of social peace, or whatever) but also from each party's own perspective. Nevertheless, from each party's perspective, compromise necessarily involves interacting with, and sometimes contributing to, wrongdoing. Morally, something is lost, even if more is gained on balance. (shrink)

Drawing on philosophy, law and political science, and on a wealth of practical experience delivering emergency medical services in conflict-ridden settings, Lepora and Goodin untangle the complexities surrounding compromise and complicity.

Though the art of compromise, i.e. of settling differences by mutual concessions, is part of communal living on any level, we often think that there is something wrong in compromise, especially in cases where moral convictions are involved. A first reason for distrusting compromises on moral matters refers to the idea of integrity, understood in the basic sense of 'standing for something', especially standing for the values and causes that to some extent confer identity. The second reason points (...) out the objective nature of moral values, which seems to make them immune from negotiation and barter. If one sincerely holds some moral conviction to be true, than compromising on that belief must be a sign of serious confusion.In order to reach a better understanding of these two reasons, I analyse what is involved in personal integrity and how this relates to moral integrity. I argue that the search for moral integrity naturally brings us to the question of how one could accept moral compromises and still uphold the idea that moral values and principles have an objective authority over us. To address this question I will present a version of moral pluralism which tries to capture the enormous complexity of what should matter to us as moral persons, and which explains why value-rankings are often deeply indeterminate. The general position I defend in this paper is that compromises involving moral values and norms may be morally required and, therefore, be laudable. To sustain this position I will arrive at a view of ethical objectivity that allows the possibility to negotiate about the truth of moral beliefs. (shrink)

Do lawmakers have a greater ethical responsibility to compromise than ordinary citizens? How does one rectify what is at stake when lawmakers concede to compromise for the sake of reaching resolution? Is compromise necessarily equalizing and is it a reasonable mode of problem solving and dispute resolution? In this latest installment from the NOMOS series, distinguished scholars across the fields of political science, law, and philosophy tackle the complex set of questions that relate to the practice of (...) compromise and its implications for social and political life in modern societies. -/- The volume, edited by Jack Knight, brings together a range of perspectives – in both disciplinary and substantive terms – on representation, political morality, disagreement, negotiation, and various forms of compromise. The ten essays reflect a variety of considerations across interdisciplinary lines, and provide a new and thought-provoking discussion of the policy, practice, and philosophy of compromise, covering a number of specific topics including alternative dispute resolution (ADR) and conscientious objection. -/- Examining these issues and more, Compromise offers new and thought provoking insights into the pressing issue of the importance of compromise in social and political affairs. (shrink)

In order for any democracy to function well, understanding how and when to compromise is a necessity. This book introduces students to how compromise makes governing possible. Using examples of how compromise works in their own lives, students will gain a better understanding of how compromise work on a larger level. Conversely, readers will also learn that compromise may be the wrong course of action in some situations and that some issues are of such critical (...) importance or high moral worth that standing firm is appropriate. (shrink)

This books examines the conditions under which scientists compromised the ideals of science, and elucidates these with reference to the challenges of profit motives and national security concerns. The book also offers suggestions for changing the political and economic conditions under which the integrity of science and its ethos can be practiced.

No one likes to compromise, but we almost always do. Our politics and associations are built upon negotiation, respect for diversity, bargaining and elections. Compromise seems an awkward stepchild of morality and even dictionaries reflect its moral ambiguity.

Ricoeur interpreted the work of compromise as a creative process to imagine a new world by projecting ourselves into other people. The challenge of compromise is to learn to tell our own story differently within the contours of a broader collective narrative, in compliance with the paradigm of translation. As such, Ricoeur’s political ethics of compromise is at risk of highlighting the element of creation, which refers to the social imagination of a shared vision of a (...) better society, at the cost of recognition of the element of renunciation, which refers to the reciprocal shelving of ideas and desires that the other side considers to be truly intolerable. However, I argue that we can read a delicate connection between forgetting, forgoing and forgiving in Ricoeur’s thought. It is, then, the model of forgiveness, as part of the paradigm of translation, that gives due respect to the importance of renunciation through the emphasis on the unjustifiable, for which renunciation even cannot suffice. The ‘poetics of pardon’ brings creation and renunciation together and, by doing so, it highlights that compromise always remains an object of hope. (shrink)