Quality improvement (QI) is fundamental to maintaining high standards of health care. Significant debate exists concerning the necessity for an ethical approval system for those QI projects that push the boundaries, appearing more similar to research than QI. The authors discuss this issue identifying the core ethical issues in family medicine (FM), drawing upon the fundamental principles of medical ethics, including principles of autonomy, utility, justice and non-maleficence. Recent debate concerning the application of QI ethics boards is discussed with relevance (...) to primary care and issues such as general practitioner (GP) intentions, the impact of QI on patients and the use of confidential patient data and the impact of dissemination. The authors conclude that a system of QI ethical approval leaves many issues unresolved and potentially creates several barriers to implementing QI. To ensure ethical QI work is generated within FM it is essential for GPs to learn about and engage in more ethical reflection so that they can better judge and resolve these issues. (shrink)

A student's future as a knowledge worker (one who "thinks for a living" with the task of problem solving) is the starting point of this book. With this in mind, the book combines a review of philosophical positions and problems with practical examples and perspectives gained from everyday challenges faced by knowledge workers in their businesses and organizations. Through the use of summative chapters, highlighted key concepts, questions for reflection, and illustrative examples on how to work with the theories presented, (...) the book provides a clear and accessible introduction to this challenging subject. Philosophy of Science primarily addresses students studying language, communication, marketing, economics, and management. However, the survey of the theoretical schools of thought - as well as the discussions on research ethics and the role of research in society - will be equally relevant for other students in the humanities and the natural and social sciences. (shrink)

The question that this paper tries to answer is Q: “Can good academic bioethics be done without commitment to moral theory?” It is argued that the answer to Q is an unequivocal “Yes” for most of what we could call “critical bioethics,” that is, the kind of bioethics work that primarily criticizes positions or arguments already in the literature or put forward by policymakers. The answer is also “Yes” for much of empirical bioethics. The second part of the paper then (...) provides an analysis of Q in relation to “constructive bioethics,” that is, bioethics work aimed at providing an argument for a particular position. In this part, it is argued that a number of the approaches or methods used that initially look like they involve no commitment to moral theory, nevertheless, involve such a commitment. This is shown to be the case for reflective equilibrium, mid-level theory, the use of theory fragments, and argument by analogy. (shrink)

For decades, nursing as a discipline has tried to establish itself within the socio‐professional and the socio‐political arenas. To date, several theorists have attempted to thoroughly define the essence (ontology) of nursing while others have proposed means (syntax) to achieve this ‘collective’ objective. Considering that this preoccupation, rooted in essentialism, is pervasive in the nursing literature, our claim is that these quests should be criticized because they impede innovative and transdisciplinary approaches to nursing theory. Our criticism includes the perspective supported (...) by the so‐called ‘postmodern nursing theorists’. We argue that the oeuvre of some nursing postmodern scholars is as prescriptive and linear as the ones they critique. Like it was done before, the discourse of these thinkers perpetuates the status quo by excluding alternative forms of knowledge that cross the boundaries of the discipline of nursing. Using the work of Deleuze and Guattari, this paper proposes an alternative way to conceive the development of nursing knowledge, which, we think, could represent an alternative way to explore the discipline of nursing. (shrink)

Morality and the invention of feminine desire -- Sexuality versus recognition : feminine desire in the ethical order -- The purest poem : Heidegger's Antigone -- From Oedipus to Antigone : revisiting the question of feminine desire -- Family politics/family ethics : Butler, Lacan, and the thing beyond the object.

What is the criterion of truth? This is a question that was resolved long ago by the revolutionary teachers of the proletariat. But as a result of damage done by the "Gang of Four" and a mass of distorted propaganda in the media under their control, it has become muddled beyond compare in recent years. In order to deepen the criticism of the "Gang of Four" and eradicate the remnants of their poison and influence, it is very important to clear (...) this up and sort it out. (shrink)

How do you decide what is ethically wrong and right? Few people make moral judgments by taking the theory first. Specifically written with the interests, needs, and experience of students in mind, this textbook approaches thinking ethically as you do in real life – by first encountering practical moral problems and then introducing theory to understand and integrate the issues. Built around engaging case studies from news media, court hearings, famous speeches and philosophical writings, each of the 15 chapters: - (...) explains and defines the moral problem dealt with - provides excerpts of readings on all sides of the issue - analyses the problem, using the relevant theory The examples are recognizable ethical problems, including judgments about racism and sexism, controversial debates such as assisted suicide and the death penalty, and contemporary concerns like privacy and technology, corporate responsibility, and the environment. The mission of the book is to assist you to engage in informed, independent, critical thinking and to enable you to enter into ethical discussions in the classroom and beyond. Supported by learning features, including study questions, key quotes, handy definitions and a companion website, this book is essential for any student of moral philosophy. (shrink)

There are those who would argue that, recently, the profession of nursing has made a radical shift, while others believe that a schism has been created among both scholars and clinicians as a result of the emerging dominance of the evidence‐based nursing movement. This paper offers a philosophical critique of this movement using Gilles Deleuze and Felix Guattari’s concept of schizoanalysis. As a conclusion, the authors posit that nursing professionals maintain a stance of academic freedom of thought and scientific integrity (...) through the acceptance of multiplicity, diversity, and polyvocality, and by challenging with politically charged concepts the totalizing perspectives that often spread through the profession/discipline of nursing. (shrink)

Two protechnology arguments, the “hopeful principle” and the “automatic escalator”, often used in bioethics, are identified and critically analysed in this paper. It is shown that the hopeful principle is closely related to the problematic precautionary principle, and the automatic escalator argument has close affinities to the often criticised empirical slippery slope argument. The hopeful principle is shown to be really hopeless as an argument, and automatic escalator arguments often lead nowhere when critically analysed. These arguments should therefore only be (...) used with great caution. (shrink)

ABSTRACTPast research reveals important connections between meditative practices and compassion. Most studies, however, focus on the effects of one type of meditation (vs. a no-intervention control...

In this paper, I discuss the aetiological account of biological interests, developed by Varner, in the context of artefactual organisms envisioned by current research in synthetic biology. In “Sections 2–5”, I present Varner's theory and criticise it for being incapable of ascribing non-derivative interests to artefactual organisms due to their lack of a history of natural selection. In “Sections 6–7”, I develop a new alternative to Varner's account, building on the organisational theory of biological teleology and function. I argue that (...) the organisational account of biological interest is superior to Varner's aetiological account because it can accommodate both artefactual and naturally evolved organisms, provides a non-arbitrary and practical way of determining biological interests, supports the claim that organisms have interests in a sense in which artefacts do not, and avoids the possibility of there being a conflict between what an organismic part is supposed to do and what is in the interest of the organism. (shrink)

One of the arguments that is often put forward in the discussion of human cloning is that it is in itself wrong to create a copy of a human being.

This paper presents an exposition of subsystems and of Quine's , originally defined and shown to be consistent by Crabbé, along with related systems and of type theory. A proof that (and so ) interpret the ramified theory of types is presented (this is a simplified exposition of a result of Crabbé). The new result that the consistency strength of is the same as that of is demonstrated. It will also be shown that cannot be finitely axiomatized (as can and (...) ). (shrink)

This paper analyses the British Human Fertilisation and Embryology Authority's 2002 public consultation on sex selection, a consultation that was mainly concerned with sex selection for non-medical reasons. Based on a close reading of the consultation document and questionnaire it is argued that the consultation is biased towards certain outcomes and can most plausibly be construed as an attempt not to investigate but to influence public opinion.

This paper analyses the question what other healthcare professions should learn from nursing ethics, e.g. what should medical ethics learn from nursing ethics. I first analyse and reject all strong versions of the claim that nursing ethics is unique, because nursing is a unique practice. I then move to the question of whether the link between nursing ethics and nursing theory can be a model for other areas of healthcare ethics. I provide an analysis of the possibility of creating a (...) theory of medicine and find that there cannot be a theory of medicine, and I argue briefly that this finding is also applicable to nursing. If there cannot be a theory of nursing, this entails that nursing ethics cannot be justifiably based on such a theory. In the final section, I then analyse the success of nursing ethics in resisting certain of the vices of Anglo‐American analytic ethics, in particular the reductionism and individualism that characterizes much of healthcare ethics. I conclude that other healthcare ethics could usefully learn from this aspect of nursing ethics. (shrink)

Violations of ethical conductThis article is about torture, power and the breach of ethical conduct among military doctors, nurses and medics in the “War on Terror”. Violations of ethical conduct have been widely recounted in academic and non-academic journals and reports.1 This paper is also a call to international boards of doctors and nurses to intervene directly to stop abuses undertaken by US military healthcare providers under the guise of the War on Terror. With evidence growing that US military and (...) security services are actively engaged in the ill treatment, torture and deaths of suspects, details about the participation of healthcare professionals in such unlawful and unethical activities remain for the most part timidly accounted for. But according to current literature on this topic, there is increasing evidence that US doctors, nurses and medics have been complicit in torture and other unethical activities in Afghanistan, Iraq and Guantanamo Bay .2–4The US government has inadequately dealt with these facts. Senior officials in the Bush administration who have played a major part in conducting the War on Terror have been either promoted or asked to remain in their posts. More seriously, despite worldwide condemnation of the reality behind the photos, allegations of torture continue at Guantanamo Bay, Cuba.5 The graphic and appalling nature of several photographs are by no means the only evidence of abuses conducted by the US on its own territory and abroad. But the complicity of healthcare professionals in many venues , such as in capital punishment procedures in the US, exacerbates the already disturbing extent of bio-political abuses by the US government.Doctors and nurses often top the polls as caring and trustworthy professionals.6 Indeed, so strong …. (shrink)

This Second Edition of A New Environmental Ethics: The Next Millennium for Life on Earth offers clear, powerful, and often moving thoughts from Holmes Rolston III, one of the first and most respected philosophers to write on the environment and often called the "father of environmental ethics." Rolston surveys the full spectrum of approaches in the field of environmental ethics and offers critical assessments of contemporary academic accounts. He draws on a lifetime of research and experience to suggest an (...) outlook, and even hope, for the future. This forward-looking analysis, focused on the new millennium, will be a necessary complement to any balanced textbook or anthology in environmental ethics. The First Edition guaranteed "to put you in your place." Beyond that, the Second Edition, asks whether you want to live a "de-natured life on a de-natured planet." Key Updates in the Second Edition - Covers the worsening environmental situation due to actions of the Trump administration, including withdrawal from the Paris accord and from the U.N. Framework Convention on Climate Change - Includes information on legislation in key U.S. states aimed to ameliorate the damage done at the Federal level - Increases coverage of group knowledge, group agreement and disagreement, and group action in collective environmental ethics, as distinguished from individual knowledge and action - Examines the deleterious effects of online consumer behavior - Explains how a loss of solidarity among a nation's citizens and even a larger solidary among humanity leads to environmental degradation - Offers new analysis of the effects of epistemic bubbles, echo chambers, and fake news on the behavior of voters and consumers - Provides an extended critique of the Anthropocene Epoch, and the prospect of geo-engineering Earth to become a synthetic environment. (shrink)

The possibility of creating human embryonic stem cell lines from the inner cell mass of blastocysts has led to considerable debate about how these scientific developments should be regulated. Part of this debate has focused on the ethical analysis and part on how this analysis should influence policymaking.

Tom Shakespeare’s book Disability rights and wrongs is very rich and interesting and ought to be compulsory reading for anyone interested in the relation between disability and medical ethics.1In my short contribution to this symposium on the book, I will focus on a particular aspect of his discussion of prenatal diagnosis and termination of pregnancy.In chapter 6 of Disability rights and wrongs, a chapter entitled Questioning prenatal diagnosis, the author discusses a wide range of issues concerning the relation between disability (...) and prenatal diagnosis. One of the arguments he discusses is the so-called “expressivist objection” to prenatal diagnosis—that is, the claim that prenatal diagnosis expresses a discriminatory or negative attitude towards people with disability. After having analysed the expressivist objection, Shakespeare, in line with a range of other authors, concludes that the argument is not sound: Nor should we interpret a decision to have a test or a termination as expressing disrespect or discrimination towards disabled people.1Is it thus time now to lay the expressivist objection to rest? In the following, I will suggest that it may be too early to completely dismiss the objection, partially because it is often misrepresented by its opponents, who argue against implausibly strong versions of the objection.THE OBJECTION UNFOLDEDWhat does the expressivist objection essentially claim? The core of the claim is, as described above, that prenatal diagnosis and termination of pregnancy expresses certain attitudes towards disabled people. What is taken to express these attitudes may be the social practice of prenatal diagnosis and termination of pregnancy either …. (shrink)

Environmental Ethics is a systematic account of values carried by the natural world, coupled with an inquiry into duties toward animals, plants, species, and ecosystems. A comprehensive philosophy of nature is illustrated by and integrated with numerous actual examples of ethical decisions made in encounters with fauna and flora, endangered species, and threatened ecosystems. The ethics developed is informed throughout by ecological science and evolutionary biology, with attention to the logic of moving from what is in nature to what ought (...) to be. The ethical theory is applied in detail to social, public, and business policy. Written in an engaging style, using diagrams and figures as well as numerous case studies, Environmental Ethics prods the reader into concrete application and invites reader participation in the ethical discussions. The ethics concludes by exploring the historical experiences of personal residence in a surrounding environment. Here is an adventure into what it means to live as responsible human beings in the community of life on Earth. In the series Ethics and Action, edited by Tom Regan. (shrink)

Law must evolve to play its part in addressing the anthropogenic threats of climate change and biodiversity loss. Lawyers have a key role to play in assisting that evolution, and the ethics that govern lawyers’ work will play a large part in determining its success. This article explains how four core approaches to legal ethics support lawyers in their work to address climate change and to facilitate more sustainable ways of living.

The discovery of an alternative method of producing induced human stem cells will affect the ethical evaluation of human embryonic stem cell researchOn 20 November 2007 two groups of researchers announced that they had independently managed to produce induced Pluripotent Cells from human adult somatic cells.1 2 The two groups used slightly different procedures, but both approaches involved overexpression of a group of four genes known to be actively expressed in human embryonic stem cells . The cells produced are very (...) similar to human embryonic stem cells, they are pluripotent and they differentiate to specific cell types when treated according to protocols leading to that specific differentiation in hESC.WHAT ARE THE IMPLICATIONS OF THESE RESULTS FOR STEM CELL ETHICS?There seems to be at least two areas of debate and research where there are important implications and one area where there are none.Let us deal with the area where these results have absolutely no implications first: the contentious debate about the moral status of the embryo. Nothing in these research results will or can affect the position of those who believe that they have good arguments showing either that the embryo has no moral status at all, or that the embryo has such significant moral status that …. (shrink)