The dominant model for bioethical inquiry taught in medical schools is that of principlism. The heritage of this methodology can be traced to the Enlightenment project of generating a universalizable justification for normative morality arising from within the individual, rational agent. This project has been criticized by Alasdair MacIntyre who suggests that its failure has resulted in a fragmented and incoherent contemporary ethical framework characterized by fundamental intractability in moral debate. This incoherence implicates principlist conceptions of bioethics. Medical ethics as (...) practiced, though, is partially in keeping with teleological alternatives to principlism. Nonetheless, the hegemony of principlism threatens to harm the practice of good medicine whenever it is used to provide justification for the sanction or prohibition of practices, despite not being equipped to grant moral authority to such justifications. An example of this failure and its resulting harm is expressed in the growing obsolescence of living donor liver transplantation. (shrink)

In order to promote social distancing during the recent COVID-19 pandemic, physicians and healthcare systems have made efforts to replace in-person with virtual clinic visits when feasible. While these efforts have been well received and seem compatible with sound clinical practice, they do not perfectly replicate the experience of a face-to-face exchange between doctor and patient. This essay attempts to describe features of the virtual visit that distinguish it from its face-to-face analog and considers the phenomenological work of Emmanuel Levinas (...) in arguing that these differences may limit the force of the ethical summons a provider would otherwise experience before the face of a patient. The diminishment of this signal therapeutic experience may engender vocational as well as clinical consequences, which should be weighed against the practical benefits of the virtual visit as we consider whether our enthusiasm for this mode of practice should continue. (shrink)

This is one of four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and nineteen multi-disciplinary partner organizations. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policymakers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.This paper focuses on the fourth core element: information that can be used in shaping and applying law as a public health tool, specifically in the context of public health emergencies. (shrink)

This is one of four interrelated action agenda papers resulting from the National Summit on Public Health Legal Preparedness convened in June 2007 by the Centers for Disease Control and Prevention and nineteen multi-disciplinary partner organizations. Each of the action agenda papers deals with one of the four core elements of public health legal preparedness: laws and legal authorities; competency in using those laws; coordination of law-based public health actions; and information. Options presented in this paper are for consideration by (...) policymakers and practitioners — in all jurisdictions and all relevant sectors and disciplines — with responsibilities for all-hazards emergency preparedness.This paper focuses on the fourth core element: information that can be used in shaping and applying law as a public health tool, specifically in the context of public health emergencies. (shrink)

The Department of Health and Human Services, Office for Civil Rights enforces Section 504 of the 1973 Rehabilitation Act and Title II of the Americans with Disabilities Act. OCR works through complaint investigations and compliance reviews, as well as outreach, technical assistance, and public education to promote voluntary compliance. In the Olmstead decision of June 1999, the Supreme Court held that the ADA’s “integration regulation” requires state and local government to administer services, programs, and activities in the most integrated setting (...) appropriate to the needs of qualified individuals with disabilities. The decision changed the focus from whether a right to more integrated services exists, to under what circumstances and how services will be provided. The New Freedom Initiative announced by President Bush in February 2001 is a broadbased initiative to remove barriers to community living for people with disabilities and promote swift implementation of the Olmstead decision. (shrink)

All communities have common resources that are vulnerable to selfish motives. The current paper explores this challenge in the specific case of the urban commons, defined as the public spaces and scenery of city neighborhoods. A theoretical model differentiates between individual incentives and social incentives for caring for the commons. The quality of a commons is defined as the level of physical (e.g., loose garbage) and social (e.g., public disturbances) disorder. A first study compared levels of disorder across the census (...) block groups of a single city; the second compared the disorder generated by individual addresses in two neighborhoods. Each study found that homeownership, an individual incentive, was the main predictor of disorder. Owner-occupied parcels generated less disorder than their renter-occupied neighbors, but both parcel types produced less disorder in a neighborhood with greater homeownership. The results emphasize the need for considering both individual and social incentives for group-beneficial behaviors. (shrink)