Professionals, it is said, have no use for simple lists of virtues and vices. The complexities and constraints of professional roles create peculiar moral demands on the people who occupy them, and traits that are vices in ordinary life are praised as virtues in the context of professional roles. Should this disturb us, or is it naive to presume that things should be otherwise? Taking medical and legal practice as key examples, Justin Oakley and Dean Cocking develop a rigorous articulation (...) and defence of virtue ethics, contrasting it with other types of character-based ethical theories and showing that it offers a promising new approach to the ethics of professional roles. They provide insights into the central notions of professional detachment, professional integrity, and moral character in professional life, and demonstrate how a virtue-based approach can help us better understand what ethical professional-client relationships would be like. (shrink)

Introduction In recent years there has been a welcome reawakening of philosophical interest in the emotions. A significant number of contemporary ...

Controlled Human Infection Model (CHIM) research involves the infection of otherwise healthy participants with disease often for the sake of vaccine development. The COVID-19 pandemic has emphasised the urgency of enhancing CHIM research capability and the importance of having clear ethical guidance for their conduct. The payment of CHIM participants is a controversial issue involving stakeholders across ethics, medicine and policymaking with allegations circulating suggesting exploitation, coercion and other violations of ethical principles. There are multiple approaches to payment: reimbursement, wage (...) payment and unlimited payment. We introduce a new Payment for Risk Model, which involves paying for time, pain and inconvenience and for risk associated with participation. We give philosophical arguments based on utility, fairness and avoidance of exploitation to support this. We also examine a cross-section of the UK public and CHIM experts. We found that CHIM participants are currently paid variable amounts. A representative sample of the UK public believes CHIM participants should be paid approximately triple the UK minimum wage and should be paid for the risk they endure throughout participation. CHIM experts believe CHIM participants should be paid more than double the UK minimum wage but are divided on the payment for risk. The Payment for Risk Model allows risk and pain to be accounted for in payment and could be used to determine ethically justifiable payment for CHIM participants.Although many research guidelines warn against paying large amounts or paying for risk, our empirical findings provide empirical support to the growing number of ethical arguments challenging this status quo. We close by suggesting two ways (value of statistical life or consistency with risk in other employment) by which payment for risk could be calculated. (shrink)

Despite advances in palliative care, some patients still suffer significantly at the end of life. Terminal Sedation (TS) refers to the use of sedatives in dying patients until the point of death. The following limits are commonly applied: (1) symptoms should be refractory, (2) sedatives should be administered proportionally to symptoms and (3) the patient should be imminently dying. The term ‘Expanded TS’ (ETS) can be used to describe the use of sedation at the end of life outside one or (...) more of these limits.In this paper, we explore and defend ETS, focusing on jurisdictions where assisted dying is lawful. We argue that ETS is morally permissible: (1) in cases of non-refractory suffering where earlier treatments are likely to fail, (2) where gradual sedation is likely to be ineffective or where unconsciousness is a clinically desirable outcome, (3) where the patient meets all criteria for assisted dying or (4) where the patient has greater than 2 weeks to live, is suffering intolerably, and sedation is considered to be the next best treatment option for their suffering.While remaining two distinct practices, there is scope for some convergence between the criteria for assisted dying and the criteria for ETS. Dying patients who are currently ineligible for TS, or even assisted dying, should not be left to suffer. ETS provides one means to bridge this gap. (shrink)

The revival of virtue ethics over the last thirty‐five years has produced a bewildering diversity of theories, which on the face of it seem united only by their opposition to various features of more familiar Kantian and Utilitarian ethical theories. In this paper I present a systematic account of the main positive features of virtue ethics, by articulating the common ground shared by its different varieties. I do so not to offer a fresh defence of virtue ethics, but rather to (...) provide a conceptual map that locates its main claims and arguments in relation to those of rival theories, and identifies its distinctive contribution to contemporary ethics. I set out six specific claims which are made by all forms of virtue ethics, and I explain how these claims distinguish the theory from recent character‐based forms of Kantian ethics and Utilitarianism. I then use this framework to briefly survey two main strands of virtue ethics which have been developed in the literature.1. (shrink)

In this article we argue that the worries about whether a consequentialist agent will be alienated from those who are special to her go deeper than has so far been appreciated. Rather than pointing to a problem with the consequentialist agent's motives or purposes, we argue that the problem facing a consequentialist agent in the case of friendship concerns the nature of the psychological disposition which such an agent would have and how this kind of disposition sits with those which (...) are commonly thought proper to relations of friendship. To the extent that we are right, then, the rejoinders which indirect consequentialists have offered to the problem of alienation are ill directed and so do not succeed in meeting the real problem. In articulating what we see as the source of the alienation problem which friendship poses for consequentialism, we also hope to clarify the general distinction between dispositions and motives and to show how certain kinds of guiding internalized normative dispositions help us to define and therefore distinguish between various types of relationships. Undertaking this task may also help to identify some of the crucial issues for an adequate moral psychology of friendship and its place in any plausible ethical theory. (shrink)

Originally published in 1992 this book attacks many recent philosophical and psychological theories of the emotions and argues that our emotions themselves have intrinsic moral significance. He demonstrates that a proper understanding of the emotions reveals the fundamental role they play in our moral lives and the practical consequences that arise from being morally responsible for our emotions.

Salespeople have long been considered unique employees. They tend to work apart from each other and experience little daily contact with supervisors and other organizational employees. Additionally, salespeople interact with customers in an increasingly complex and multifunctional environment. This provides numerous opportunities for unethical behavior which has been chronicled in the popular press as well as academic research. Much of the research in sales ethics has relied on conceptual foundations which focus on individual and organizational influencers on ethical decision making. (...) While significant, contributors to this research suggest that alternative theoretical perspectives and methods of investigation should be utilized and call for more research on the status of professional selling as a whole. We answer this call by exploring an alternative and complementary perspective based on the theory of occupational choice, social learning, and work groups to gain insight on how the sales profession evolves as its own subculture that extends beyond individual and organizational boundaries. First, we discuss the characteristics of the sales profession and empirically examine the relationship between typical individual and organizational factors and sales professionals’ perceptions of ethical behavior. Second, we offer a theoretical explanation that our findings may be due to how salespeople choose and are socialized into the subculture of the sales profession. Third, we examine this theoretical perspective via qualitative in-depth interviews with experienced sales professionals. Results and implications are discussed in terms of a sales profession code of ethics and future research directions. (shrink)

Virtue ethics has emerged as a distinct field within moral theory - whether as an alternative account of right action or as a conception of normativity which departs entirely from the obligatoriness of morality - and has proved itself invaluable to many aspects of contemporary applied ethics. Virtue ethics now flourishes in philosophy, sociology and theology and its applications extend to law, politics and bioethics. 'The handbook of virtue ethics' brings together leading international scholars to provide an overview of the (...) field. Each chapter summarizes and assesses the most important work on a particular topic and sets this work in the context of historical developments. Taking a global approach by embracing a variety of major cultural traditions along with the Western, the handbook maps the emergence of virtue ethics and provides a framework for future developments. (shrink)

This chapter contains sections titled: The Rise of Virtue Ethics Essential Features of Virtue Ethics Virtue Ethics Approaches to Bioethics Criticisms of Virtue Ethics Conclusion References Further reading.

In this paper we argue that dissociative identity disorder (DID) is best interpreted as a causal model of a (possible) post-traumatic psychological process, as a mechanical model of an abnormal psychological condition. From this perspective we examine and criticize the evidential status of DID, and we demonstrate that there is really no good reason to believe that anyone has ever suffered from DID so understood. This is so because the proponents of DID violate basic methodological principles of good causal modeling. (...) When every ounce of your concentration is fixed upon blasting a winged pig out of the sky, you do not question its species' ontological status. James Morrow, City of Truth (1990). (shrink)

In many recent discussions of the morality of actions where both good and bad consequences foreseeably ensue, the moral significance of the distinction between intended and foreseen consequences is rejected. This distinction is thought to bear on the moral status of actions by those who support the Doctrine of Double Effect. According to this doctrine, roughly speaking, to perform an action intending to bring about a particular bad effect as a means to some commensurate good end is impermissible, while performing (...) an action where one intends only this good end and merely foresees the bad as an unintended sideeffect may be permissible. Consequentialists argue that this is a distinction which makes no moral difference to the evaluation of the initial act in the two cases, given that the overall consequences are the same in each case. In this paper we aim to show that a standard consequentialist line of argument against the moral relevance of the intention/foresight distinction fails. Consequentialists commonly reject the moral relevance of this distinction on the grounds that there is no asymmetry in moral responsibility between intending and foreseeing evil. We argue that even if this claim about moral responsibility is correct, it does not entail, as many Consequentialists believe, that there is no moral asymmetry between acts of intended and foreseen evil. We go on to argue that those consequentialists who do concede the moral relevance of the intention/foresight distinction at the level of agent evaluations cannot consistently make such a concession, and that such a position is in any case untenable, because it entails a complete severance of important conceptual connections between act and agent evaluations. (shrink)

This paper argues that the provision of effective informed consent by surgical patients requires the disclosure of material information about the comparative clinical performance of available surgeons. We develop a new ethical argument for the conclusion that comparative information about surgeons' performance - surgeons' report cards - should be provided to patients, a conclusion that has already been supported by legal and economic arguments. We consider some recent institutional and legal developments in this area, and we respond to some common (...) objections to the use of report cards on the clinical performance of surgeons. (shrink)

ABSTRACT In this paper we argue that the standard focus on problems of informed consent in debates about the ethics of human experimentation is inadequate because it fails to capture a more fundamental way in which such experiments may be wrong. Taking clinical trials as our case in point, we suggest that it is the moral offence of using people as mere means which better characterizes what is wrong with violations of personal autonomy in certain kinds of clinical trials. This (...) account also helps bring out another important way in which the autonomy of the participants in clinical trials my be violated, even in cases where they have given informed consent to their involvement. Where relevant information about the trial is framed in such a way as to induce a patient's participation by appeal to their nonrational preferences, this is also a violation of their autonomy, and one which is distinct from a failure of informed consent. The underlying wrongness of both kinds of violations, we argue, is plausibly captured by the moral offence of using people as mere means. (shrink)

We thank the authors of the five commentaries for their careful and highly constructive consideration of our paper,1 which has enabled us to develop our proposal. Participation in research has traditionally been viewed as altruistic. Over time, payments for inconvenience and lost wages have been allowed, as have small incentives, usually in kind. The problem, particularly with controlled human infection model research or ‘challenge studies’, is that they are unpleasant and time-consuming. Researchers want to offer carrots to incentivise participation. We (...) are proposing that research participation be viewed as a job with the full suite of financial entitlements of fairly remunerated work, including payment for risk and labour law protections. This would be a significant shift from current practice and standards. Ambuehl, Ockenfels and Roth have grasped this basic point and have beautifully elaborated how a fair price could be arrived at using economic theory. They build on our proposal helpfully and suggest ‘ salary for time involvement that is adjusted to account for the amount of discomfort experienced during participation, insurance against ex post adverse outcomes and ex ante compensation for risks that cannot be compensated ex post.’3 This effectively addresses Fernandez Lynch and Largent’s2 concern that compensation for risk is inappropriate for harms which do not eventuate. However, because death cannot be compensated for, there must be payment for risk of death, as Ambuehl, Ockenfels and Roth convincingly argue.3 Indeed, the three-part model suggested by Ambuehl, Ockenfels and Roth makes us realise that job model would be a better title for our model than a payment for risk model. The alternative to a properly remunerated job model is the original altruistic model. However, this …. (shrink)

In this issue of the Hastings Center Report, Ann Hamric, John Arras, and Margaret Mohrmann highlight how contemporary accounts of the virtue of courage in health care often gloss over deeper problems in the underlying health care systems themselves. They express particular concerns about the appropriateness and personal costs of exhortations to health professionals to take courageous action in circumstances where this is “required only because of unethical institutional structures” (p. 39). They offer valuable points that are not adequately recognized (...) in discussions of courage as a professional virtue in health care practice. The call for more judicious appeals to health professionals to exercise courage in health care practice should clearly be heeded. A sole reliance on practitioner courage for exposing unethical workplace practices would be misguided. Nevertheless, there is still a legitimate place for encouraging health professionals to develop and act on courage. (shrink)

The standard problem with many slippery slope arguments is that they fail to provide us with the necessary evidence to warrant our believing that the significantly morally worse circumstances they predict will in fact come about. As such these arguments have widely been criticised as ‘scare-mongering’. Consequentialists have traditionally been at the forefront of such criticisms, demanding that we get serious about guiding our prescriptions for right action by a comprehensive appreciation of the empirical facts. This is not surprising, since (...) consequentialism has traditionally been committed to the idea that right action be driven by empirical realities, and this hard-headed approach has been an especially notable feature of Australian consequentialism. But this apparent empirical hard-headedness is very selective. While consequentialists have understood their moral outlook and commitments as guided by a partnership with empirical science – most explicitly in their replies to the arguments of their detractors – some consequentialists have been remarkably complacent about providing empirical support for their own prescriptions. Our key example here is the consequentialist claim that our current practises of partiality in fact maximise the good, impartially conceived. This claim has invariably been made without compelling support for the large empirical claims upon which it rests, and so, like the speculative empirical hand-waving of weak slippery slope arguments, it seems similarly to be undermined. While these arguments have presented us with ‘wishful thinking’ rather than ‘scare-mongering’, we argue in this paper that their complacency in meeting the relevant empirical justificatory burden remains much the same. (shrink)

Although the number of women in middle management has grown quite rapidly in the last two decades, the number of female CEOs in large corporations remains extremely low. This article examines many explanations for why women have not risen to the top, including lack of line experience, inadequate career opportunities, gender differences in linguistic styles and socialization, gender-based stereotypes, the old boy network at the top, and tokenism. Alternative explanations are also presented and analyzed, such as differences between female leadership (...) styles and the type of leadership style expected at the top of organizations, feminist explanations for the underrepresentation of women in top management positions, and the possibility that the most talented women in business often avoid corporate life in favor of entrepreneurial careers. (shrink)

Immanuel Kant argues in the Foundations that remote scenarios are diagnostic of genuine virtue. When agents commonly thought to have a particular virtue fail to exhibit that virtue in an extreme situation, he argues, they do not truly have the virtue at all, and our propensities to fail in such ways indicate that true virtue might never have existed. Kant’s suggestion that failure to show, say, courage in extraordinary circumstances necessarily silences one’s claim to have genuine courage seems to rely (...) on an implausibly demanding standard for warranted virtue attributions. In contrast to this approach, some philosophers—such as Robert Adams and John Doris—have argued for probabilistic accounts of warranted virtue attributions. But despite the initial plausibility of such accounts, I argue that a sole reliance on probabilistic approaches is inadequate, as they are insufficiently sensitive to considerations of credit and fault, which emerge when agents have developed various insurance strategies and protective capacities against their responding poorly to particular eventualities. I also argue that medical graduates should develop the sorts of virtuous dispositions necessary to protect patient welfare against various countervailing influences, and that repeated failures to uphold the proper goals of medicine in emergency scenarios might indeed be diagnostic of whether an individual practitioner does have the relevant medical virtue. In closing, I consider the dispositions involved in friendship. I seek to develop a principled way of determining when remote scenarios can be illuminating of genuine friendship and genuine virtue. (shrink)

We are grateful to the commentators on our article1 for their thoughtful engagement with the ethical and clinical complexity of expanded terminal sedation (ETS) in end-of-life care. We will start by noting some points of common ground, before moving on to the more challenging ways in which TS might be permissibly expanded. First, several commentators pointed out, and we completely concur, that it is important to provide patients with full information about their end-of-life options, including the ‘outcomes, uncertainties and costs (...) of ETS’.2 Where possible, they should be given time to ‘process their feelings and to reflect on how they wish to live in their last few days, weeks or months’.3 Furthermore, where patients receive sedation, it will be critical that they receive appropriate medical and nursing care to prevent physical complications such as pressure ulcers.2 This would be no different from other patients who are in states of reduced consciousness from disease. We acknowledge that there are heightened risks with earlier and more rapid TS, including the potential loss of spiritual and social moments,4 as well as the meaning that can be derived from conscious existential distress.3 However, while these conscious experiences might be valuable to some, others might weigh them less highly against the foreseen …. (shrink)

As the rising costs of lifestyle-related diseases place increasing strain on public healthcare systems, the individual’s role in disease may be proposed as a healthcare rationing criterion. Literature thus far has largely focused on retrospective responsibility in healthcare. The concept of prospective responsibility, in the form of a lifestyle contract, warrants further investigation. The responsibilisation in healthcare debate also needs to take into account innovative developments in mobile health technology, such as wearable biometric devices and mobile apps, which may change (...) how we hold others accountable for their lifestyles. Little is known about public attitudes towards lifestyle contracts and the use of mobile health technology to hold people responsible in the context of healthcare. This paper has two components. Firstly, it details empirical findings from a survey of 81 members of the United Kingdom general public on public attitudes towards individual responsibility and rationing healthcare, prospective and retrospective responsibility, and the acceptability of lifestyle contracts in the context of mobile health technology. Secondly, we draw on the empirical findings and propose a model of prospective intention-based lifestyle contracts, which is both more aligned with public intuitions and less ethically objectionable than more traditional, retrospective models of responsibility in healthcare. (shrink)

Could it ever be ethically justifiable to remove a dead man’s sperm to enable his partner to bear a child to him? If he had clearly indicated his agreement to this in advance, then the posthumous removal of his sperm for this purpose can be ethically justified, particularly in circumstances where the interests of the resulting child can be adequately met. Few dead men would have addressed such a possibility while alive, however, unless they had a specific reason to consider (...) such an issue, perhaps because of a terminal illness. Without a prior indication that removal of his sperm for this purpose would be in accordance with his wishes in such circumstances, the posthumous use of a man’s sperm for procreation is unethical.Posthumously removing organs and tissue from those who have given prior consent to this is commonly thought ethically acceptable. Indeed, some argue that cadaveric organ donation can be ethically …. (shrink)

The Roman Catholic Church in Australia has lobbied politicians to prohibit embryonic stem cell research, on the grounds that such research violates the sanctity and inherent dignity of human life. I suggest, however, that reasoned reflection does not uniquely support such conclusions about the morality of stem cell research. A recent parliamentary standing committee report recommended that embryonic stem cell research be allowed to proceed in certain circumstances, and there appears to be widespread support in the Australian community for this (...) position. I argue that the moral value of democracy requires parliamentarians to acknowledge the informed views of the wider community here, and to resist lobbying by church leaders on this issue. (shrink)

There is ongoing debate within the bioethics literature regarding to what extent (if any) it is ethically justifiable for doctors to engage in religious discussion with their patients, in cases where patients cite religious considerations as influencing their medical decision-making. In this paper, we concede that certain forms of religious discussion between doctors and patients are morally permissible (though not necessarily morally obligatory), insofar as patients’ religious beliefs may comprise an important part of their overall wellbeing and can influence their (...) medical decisions. However, we argue that it is not morally permissible for doctors to engage in substantive religious discussion with their patients, beyond simply inquiring about the patient's values (which may include their religious values) or referring patients to a chaplain or religious figure for further discussion. In support of this claim, we put forward two key arguments which have remained relatively unaddressed in the current debate. First, we argue that it is not practical for doctors to engage in substantive religious discussion with patients, and hence it cannot be morally obligatory for them to do so. Second, we argue that, while doctors might have a professional duty to ensure that their patient's religious interests (if any) are addressed, this does not entail that doctors themselves are the ones who should directly address these interests. Along the way, we anticipate and respond to some possible objections to these two key arguments. (shrink)

Alberto Giubilini and Francesca Minerva reject arguments from claims that fetuses and newborn infants are potential persons, because they argue that potential persons cannot be harmed.1 But whether or not potential persons can be harmed, is it clear that potential persons are entirely lacking in moral status, of a kind that could count as a reason against bringing about their demise? We do not generally regard potential as entirely lacking in moral value until it is actualised. For example, parents who (...) believe they have identified in their child an emerging musical talent commonly see this potential as having some value, however small, which would count as a reason against destroying that …. (shrink)

The many difficult ethical issues raised by family caregiving have been thrust into prominence by recent changes to hospital funding systems which encourage earlier discharge of patients. This paper investigates the sort of involvement that health professionals might justifiably have in family caregiving arrangements. It argues that the proper role of health professionals in protecting exhausted family caregivers can be clarified by considering some analogies with arguments about justifiable breaches of patient confidentiality. The paper also argues that health professionals who (...) seek to encourage neglectful adult children to help care for their sick parents should not do so by appealing to what a health professional takes those childrens’ filial duties to be. (shrink)