Aggregative consequentialism and several other popular moral theories are threatened with paralysis: when coupled with some plausible assumptions, they seem to imply that it is always ethically indifferent what you do. Modern cosmology teaches that the world might well contain an infinite number of happy and sad people and other candidate value-bearing locations. Aggregative ethics implies that such a world contains an infinite amount of positive value and an infinite amount of negative value. You can affect only a finite (...) amount of good or bad. In standard cardinal arithmetic, an infinite quantity is unchanged by the addition or subtraction of any finite quantity. So it appears you cannot change the value of the world. Modifications of aggregationism aimed at resolving the paralysis are only partially effective and cause severe side effects, including problems of “fanaticism”, “distortion”, and erosion of the intuitions that originally motivated the theory. Is the infinitarian challenge fatal? (shrink)

Economist-philosopher Amartya Sen's writings on social and political issues have attracted wide audiences. Section 2 introduces his contributions on: how people reason as agents within society; social determinants of people's (lack of) access to goods and of the effective freedoms and agency they enjoy or lack; and associated advocacy of self-specification of identity and high expectations for ‘voice’ and reasoning democracy. Section 3 considers his relation to social theory, his tools for theorizing action in society, and his limited degree of (...) attention to work by sociologists and to capitalism and power structures. Section 4 characterizes a style marked by conceptual refinement, emphases on complexity and individuality, including personal individuality, and reformist optimism. Section 5 shows the features from Sections 3 and 4 at work in his conception of personhood that advocates freedom to make a reasoned composition of personal identity. Similarly, Section 6 addresses his conception of public reasoning and neglect of the sociology of democracy. It contrasts the ideal of a reasoning polity with features in many countries. Sen's programmes for critical autonomy in personhood and for reasoned politics play, nevertheless, a normic role, while his analytical formats help investigation of obstacles to more widespread agency, voice, and democratic participation. (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)

Research ethics consultation is increasingly recognized as a potentially valuable mechanism for addressing the depth and breadth of ethical issues that arise in research related to human health and well-being. However, fundamental questions remain, including: What is “research ethics consultation”? And what is its justification beyond the purposes already served by existing entities? We examine how a research ethics consultation service may differ from or complement the role of an institutional review board by offering a definition of (...) research ethics consultation and by exploring the potential scope of a consultation service in terms of types of clients served, questions addressed, and advice provided at various stages of the research process. We then consider the relationship between research ethics consultation services and IRBs, as well as the issues that may arise between them, including possible conflicts of interest. (shrink)

1. Ḳlorshṭeln dem emes̀'n Toyrehdign 'ṿeg tsu a gliḳlikh leb' durkh arbeṭn af di mides̀ on darfn nutsn profesyonale ṭerapi. Ṿen darfn yo nutsn ṭerapi un ṿos iz der rikhṭiger tsugang dertsu. A breyṭe erḳlerung iber di yesoydes̀ fun Idishḳeyṭ.

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)

Increasingly research in the field of business and society suggests that ethics and corporate social responsibility can be profitable. Yet this work raises a troubling question: Is it ethical to use ethics and social responsibility in a strategic way? Is it possible to be ethical or socially responsible for the wrong reason? In this article, we define a strategy concept in order to situate the different approaches to the strategic use of ethics and social responsibility found in (...) the current literature. We then analyze the ethics of such approaches using both utilitarianism and deontology and end by defining limits to the strategic use of ethics. (shrink)

In vitro fertilisation ‘add-ons’ are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical (...) to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical—namely, morally good and righteous, the question was considered in relation to three key values of medical ethics—autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child. (shrink)

BackgroundThis paper discusses the contentious issue of reuse of stored biological samples and data obtained from research participants in past clinical research to answer future ethical and scientifically valid research questions. Many countries have regulations and guidelines that guide the use and exportation of stored biological samples and data. However, there are variations in regulations and guidelines governing the reuse of stored biological samples and data in Sub-Saharan Africa including Malawi.DiscussionThe current research ethics regulations and guidelines in Malawi do (...) not allow indefinite storage and reuse of biological samples and data for future unspecified research. This comes even though the country has managed to answer pertinent research questions using stored biological samples and data. We acknowledge the limited technical expertise and equipment unavailable in Malawi that necessitates exportation of biological samples and data and the genuine concern raised by the regulatory authorities about the possible exploitation of biological samples and data by researchers. We also acknowledge that Malawi does not have bio-banks for storing biological samples and data for future research purposes. This creates room for possible exploitation of biological samples and data collected from research participants in primary research projects in Malawi. However, research ethics committees require completion and approval of material transfer agreements and data transfer agreements for biological samples and data collected for research purposes respectively and this requirement may partly address the concern raised by the regulatory authorities. Our concern though is that there is no such requirement for biological samples and data collected from patients for clinical or diagnostic purposes.SummaryIn conclusion, we propose developing a medical data and material transfer agreement for biological samples and data collected from patients for clinical or diagnostic purposes in both public and private health facilities that may end up in research centers outside Malawi. We also propose revision of the current research ethics regulations and guidelines in Malawi in order to allow secondary use of biological samples and data collected from primary research projects as a way of maximizing the use of collected samples and data. Finally, we call for consultation of all stakeholders within the Malawi research community when regulatory authorities are developing policies that govern research in Malawi. (shrink)

Dear Editor,I was pleased to see a recent piece by Lao-Tzu Allan-Blitz entitled “Is It Ethical to Mandate SARS-CoV-2 Vaccinations among Incarcerated Persons?” I agree with the author that incarcera...

Many clinical ethicists have argued that ethics expertise is impossible. Their skeptical argument usually rests on the assumptions that to be an ethics expert is to know the correct moral conclusions, which can only be arrived at by having the correct ethical theories. In this paper, I argue that this skeptical argument is unsound. To wit, ordinary ethical deliberations do not require the appeal to ethical or meta-ethical theories. Instead, by agreeing to resolve moral differences by appealing to (...) reasons, the participants agree to the Default Principle—a substantive rule that tells us how to adjudicate an ethical disagreement. The Default Principle also entails a commitment to arguments by parity, and together these two methodological approaches allow us to make genuine moral progress without assuming any deep ethical principles. Ethical expertise, in one sense, is thus the ability and knowledge to deploy the Default Principle and arguments by parity. (shrink)

Classic statements of research ethics advise against permitting physician-investigators to obtain consent for research participation from patients with whom they have preexisting treatment relationships. Reluctance about “dual-role” consent reflects the view that distinct normative commitments govern physician–patient and investigator–participant relationships, and that blurring the research–care boundary could lead to ethical transgressions. However, several features of contemporary research demand reconsideration of the ethics of dual-role consent. Here, we examine three arguments advanced against dual-role consent: that it creates role conflict (...) for the physician-investigator; that it can compromise the voluntariness of the patient-participant’s consent; and that it promotes therapeutic misconceptions. Although these concerns have merit in some circumstances, they are not dispositive in all cases. Rather, their force—and the ethical acceptability of dual-role consent—varies with features of the particular study. As research participation more closely approximates usual care, it becomes increasingly acceptable, or even preferable, for physicians to seek consent for research from their own patients. It is time for a more nuanced approach to dual-role consent. (shrink)

Abortion is one of the most divisive topics in healthcare. Proponents and opponents hold strong views. Some health workers who oppose abortion assert a right of conscientious objection to it, a position itself that others find unethical. Even if allowance for objection should be made, it is not clear how far it should extend. Can conscientious objection be given as a reason not to refer when a woman requests her doctor to do so? This paper explores the idea of the (...) general practitioner (GP) who declines to make a direct referral for abortion, asking the woman to see another GP instead. The purpose is to defend the claim that an appeal to conscientious objection in this way can be reasonable and ethical. (shrink)

By following the recently published paper in Science titled “Coercive Citation in Academic Publishing”, in this paper, we aim to discuss the demand of some journals that request authors to cite recently published papers in that journal to increase the impact factor of that journal. It will be mentioned that some of these demands are not ethical and consequently will diminish the reputation of the journal.

Purpose– This paper aims to explore human technology relations through the lens of sci-fi movies within the life cycle of the ETHICOMP conference series. Here, different perspectives on artificial intelligent agents, primarily in the shape of robots, but also including other kinds of intelligent systems, are explored. Hence, IT-ethical issues related to humans interactions with social robots and artificial intelligent agents are illustrated with reference to: Alex Proyas’ I, Robot; James Cameron’s Terminator; and the Wachowski brothers’ Matrix. All three movies (...) present robots cast in the roles of moral agents capable of doing good or evil. Steven Spielberg’s Artificial Intelligence, A.I. gives rise to a discussion of the robot seen as a moral patient and furthermore reflects on possibilities for care and trust relations between robots and humans. Andrew Stanton’s Wall-E shapes a discussion of robots as altruistic machines in the role as facilitators of a flourishing society. Steven Spielberg’s Minority Report allows for a discussion of knowledge-discovering technology and the possibility for balancing data utility and data privacy.Design/methodology/approach– Observations of themes in sci-fi movies within the life span of the ETHICOMP conference series are discussed with the purpose of illustrating ways in which science fiction reflects (science) faction. In that sense, science fiction does not express our worries for a distant future, but rather casts light over questions, which is of concern in the present time.Findings– Human technology interactions are addressed and it is shown how sci-fi films highlight philosophical questions that puzzle us today, such as which kind of relationships can and ought to be formed with robots, and whether the roles they play as social actors demand that one ought to assign moral standing to them. The paper does not present firm answers but instead pays attention to the selection and framing of questions that deserve attention.Originality/value– To relate sci-fi movies to topics raised during the past 20 years of the ETHICOMP conference series, seemed to be an appropriate way of celebrating the 20-year anniversary of the ETHICOMP conference series. (shrink)

Living kidney transplantation offers the best results for patients with end-stage renal disease (ESRD). This form of transplantation is no longer restricted to genetically or emotionally related donors, as shown by the acceptance of non-directed living anonymous donors, and the development of exchange programmes (EPs). EPs make it possible to perform living kidney transplantation among incompatible pairs, but while such programmes can help increase living organ donation, they can also create a degree of unfairness. Kidney transplant recipients in the O (...) blood group are at a disadvantage when it comes to EPs because they can only receive organs from O donors, whereas O donors are universal donors. This poses a major challenge in terms of distributive justice and equity. A way to remedy this situation is through altruistic unbalanced paired kidney exchange (AUPKE), in which a compatible pair consisting of an O blood group donor and a non-O recipient is invited to participate in an EP. Although the AUPKE approach appears fairer for O recipients, it still raises ethical questions. How does this type of exchange affect the donor/recipient gift relationship? Should recipients in compatible pairs receive a ‘better organ’ than the one they would otherwise have received from their intended donor? Finally, what is the role of transplant teams in AUPKE? This article will examine the organisational and ethical challenges associated with EPs and AUPKE, and compare different EP policies in countries where such programmes exist. (shrink)

Doctors hold coexisting ethical duties to avoid causing deliberate harm to their patients (non-maleficence), to act in patients’ best interests (beneficence), to respect patients’ right to self-determination (autonomy) and to ensure that costs and benefits are fairly distributed among patients (justice). In the context of non-directed altruistic kidney donations (NDAKD), doctors’ duties of autonomy and justice are in tension with those of non-maleficence and beneficence. This article examines these competing duties across three scenarios in which general practitioners (GPs) could promote (...) NDAKD to healthy adults. In the first—when a healthy adult patient prompts the GP to discuss NDAKD—the GP is ethically obligated to counsel the patient about NDAKD to respect their autonomy, yet this does not constitute any form of promotion of NDAKD. In the remaining scenarios, healthy adult patients are unaware of the possibility of NDAKD. In the second, it is ethically permissible for GPs to indirectly raise awareness of NDAKD among healthy adults by displaying recruitment campaign material to non-specified groups of patients in their waiting rooms. In the third, it is ethically impermissible for GPs to directly promote NDAKD to individual healthy adults by raising the possibility of NDAKD with such individuals. The major counterarguments raised against this position are problems with kinds of counselling that fail to reach expected professional standards, rather than problems with the ethical claims made in this article. (shrink)

This paper examines the claims that moral objections to the patenting of human genes are misplaced and rest on confusions about what a patent is, or what is patented by a human gene patent. It shows that theese objections rest on too simple a conception of property rights, and the connections betwteen familiar moral objections to private property and moral objections to the patenting of human genes. Above all, the paper claims, objections to HGPs often reflect worries about the lack (...) of democratic oversight, accountability and participation involved in grants of intellectual property. The paper claims that we should take these worries seriously, whether or not we think HGPs immoral. (shrink)

Data monitoring committees often are employed to review interim findings of randomised controlled trials. Interim findings are kept confidential until the data monitoring committee finds that they provide sufficiently compelling evidence regarding efficacy, typically because they have crossed the pre-defined statistical boundaries, or they raise serious concerns about safety. While this practice is vital to maintaining the scientific integrity of controlled trials and thereby ensuring their social value, it has been criticised as unethical. Commentators argue that withholding interim findings from (...) research participants is deceptive, inconsistent with valid informed consent, and a violation of respect for participants’ autonomy. The present article examines these arguments, focusing specifically on confidential data monitoring for efficacy. This practice need not be deceptive provided its use is disclosed to prospective research participants. In addition, confidential data monitoring does not make research participants worse off than they would be in the clinical setting and represents an acceptable limitation on the options available to prospective research participants. Taken together, these considerations suggest confidential data monitoring, subject to adequate safeguards, is ethically acceptable. (shrink)

Incarcerated persons have suffered a disproportionate burden of SARS-CoV-2 infection compared to the general population, with heightened risk for adverse...

In the Democratic Republic of Congo, only an estimated 2% of all AIDS patients have access to treatment. As AIDS treatment access is scaled‐up in the coming years, difficult rationing decisions will have to be made concerning who will come to gain access to this scarce medical resource. This article focuses on the position, expressed by representatives of Médecins sans Frontières (MSF), that the practice of AIDS treatment access rationing is fundamentally unethical because it conflicts with the ideal of universal (...) treatment access and the human right to health. The conclusion is that MSF's position lacks coherence, has negative practical implications, and is unfair to governments struggling to increase patient's access to AIDS treatment in unfavorable circumstances. (shrink)

This essay considers the ethical implications of engaging in a pedagogy of discomfort, using as a point of departure Butler's reflections on ethical violence and norms. The author shows how this attempt is full of tensions that cannot, if ever, be easily resolved. To address these tensions, the author first offers a brief overview of the notion of pedagogy of discomfort and discusses its relevance with Foucault's idea of ‘ethic of discomfort’ and the promise of ‘safe classroom.’ Then, he focuses (...) on Butler's account of ethical violence and norms to show how the subject's constitution and regulation are inextricably linked to violence in several ways. In the final part of the paper, the author turns more specifically to the ways in which a pedagogy of discomfort might entail ethical violence, suggesting how the turn to a nonviolent ethics might become possible or whether the ethical resonances of that challenge will always entail a degree of ambivalence. (shrink)

Recent judicial rulings and changes in federal and state legislation have given for-profit corporations a growing list of rights and constitutional protections, including the right to practice religion free from many types of federal or state restriction. In this paper, we highlight the implications of these developments using Rawls’ Theory of Justice to explore the consequences of for-profit corporate religious freedom for consumers and employees. We identify preliminary principles to spark a discussion as to how expanding religious freedom for businesses (...) and fair access to goods and services can coexist in the for-profit marketplace. (shrink)