As the COVID-19 pandemic impacts on health service delivery, health providers are modifying care pathways and staffing models in ways that require health professionals to be reallocated to work in critical care settings. Many of the roles that staff are being allocated to in the intensive care unit and emergency department pose additional risks to themselves, and new policies for staff reallocation are causing distress and uncertainty to the professionals concerned. In this paper, we analyse a range of ethical issues (...) associated with changes to staff allocation processes in the face of COVID-19. In line with a dominant view in the medical ethics literature, we claim, first, that no individual health professional has a specific, positive obligation to treat a patient when doing so places that professional at risk of harm, and so there is a clear ethical tension in any reallocation process in this context. Next, we argue that the changing asymmetries of health needs in hospitals means that careful consideration needs to be given to a stepwise process for deallocating staff from their usual duties. We conclude by considering how a justifiable process of reallocating professionals to high-risk clinical roles should be configured once those who are ‘fit for reallocation’ have been identified. We claim that this process needs to attend to three questions that we consider in detail: (1) how the choice to make reallocation decisions is made, (2) what justifiable models for reallocation might look like and (3) what is owed to those who are reallocated. (shrink)

This article argues that religious and other "non-public" reasoning can have a legitimate and beneficial role in justifying health-related resource allocation decisions affecting individuals, subpopulations and whole communities. Section I critically examines Norman Daniels’s exclusion of such reasoning from such justifications. Section II shows the inadequacy of Daniels’s approach to healthcare as a matter of basic justice, arguing that consensus public reason is indeterminate in certain areas of healthcare policy, including the use of life-sustaining resources and issues related to risk (...) and responsibility. Section III shows how resource allocation decision-making can appropriately incorporate religious and "non-public" reasoning via the medical professional practice of collaborative deliberation. (shrink)

Religion, belief and culture should be recognized as potential sources of moral purpose and personal strength in healthcare, enhancing the welfare of both clinicians and patients amidst the experience of ill-health, healing, suffering and dying. Communication between doctors and patients and between healthcare staff should attend sensitively to the welfare benefits of religion, belief and culture. Doctors should respect personal religious and cultural commitments, taking account of their significance for treatment and care preferences. Good doctors understand their own beliefs and (...) those of others. They hold that patient welfare is best served by understanding the importance of religion, belief and culture to patients and colleagues. The sensitive navigation of differences between people's religions, beliefs and cultures is part of doctors' civic obligations and in the UK should follow the guidance of the General Medical Council and Department of Health. In particular, apparent conflict between clinical judgement or normal practices and a patient's culture, religion and belief should be considered carefully. Doctors' own religion or culture may play an important role in promoting adherence to this good practice. In all matters, doctors' conduct should be governed by the law and arrangements for conscientious objection that are in effect. (shrink)

This article responds to Jeffrey Stout’s argument in favour of immanent criticism of religious convictions in public reasoning by examining the affective dimension of religious loyalty and conscience. To this end, a conversation between Jonathan Edwards and Martha Nussbaum is undertaken to explore the basis on which the shared evaluations of religious citizens, especially Christians, should inform public discourse. Whereas the affections of Edwards’s sense of the heart are shown to be epistemologically over-realised and in unsustainable tension with the political (...) implications of his contested social ontology, Nussbaum’s cognitivist theory of emotions improves on Edwards’s by providing a basis for social criticism of religious convictions, but is then found incompatible with her own commitment to a Rawlsian overlapping consensus. Moreover, the political appeal of the Protestant-Stoic conscience she advocates is cast into doubt by considering how Protestant and perhaps Islamic concepts of conscience structure eschatological loyalties that foster not Rawls’s overlapping consensus or even Nigel Biggar’s ‘tense consensus’ but rather the ‘tense communion’ appropriate to twenty-first-century democracies. (shrink)

The focus of this project, New Conversations in Islamic and Christian Political Thought, concerns the ‘pre-modern’ or ‘long’ traditions of political thought in Islam and Christianity. The renaissance in Christian political thought since World War II has not yet witnessed a sustained engagement with Islamic political thought. Meanwhile, the interface of religion and political life has increasingly become a major focus of academic and public discourse. By exploring the varied traditions of Islam and Christianity, this project seeks to retrieve and (...) develop wisdom in political understanding with a view to enriching this discourse. (shrink)

This volume explores how 'the market'continues to affect and redefine health professionals as moral beings and impact on the care they provide. By reflecting on the meaning of the market and the medical profession, this ground-breaking volume identifies a variety of ways to help preserve healthcare workers' integrity and ensure compassionate care.

The subtitle to the conference upon which this journal issue is based invited us to ‘follow Crowter’. This paper does so primarily by following the person and only thereby attends to the legal judgment. In particular, it will attend to her comment that When mum told me about the discrimination against babies like me in the womb, I felt like a knife had been put into my heart. It made me feel less valued than other people. The argument is that (...) (I) there are strong reasons for such an approach from the field of theological ethics and that this is valuable for pastoral theology and for bioethics. With this case made, the argument proceeds (II) by following and building on three elements of Heidi Crowter’s words concerning (a) the knife (b) the heart and (c) the person. The argument concludes (III) with theological reflection and deliberation regarding institutions, practices and actions which will make for ‘ethical society’, principally focussed on ecclesial life. (shrink)

This paper considers what concept of accommodation is necessary to identify and address discrimination, disadvantages and disparities in such a way that the plurality of religious people with their beliefs, values and practices may be justly accommodated in healthcare. It evaluates threats to the possibility of such accommodation pertaining by considering what beliefs and practices might increase the risk of unjust discrimination against and disadvantage for religious people, whether as individuals or as groups; and the risk of disparities between the (...) care provided to religious people. The claim is that there is an important cluster of risks that are political in kind and emergent within philosophical bioethics. While not amounting (yet) to a trend, they are sufficiently threatening to a just civic life for patients and healthcare staff as to warrant scrutiny. After an Introductory Section 1, Section 2 evaluates a criticism of ‘accommodation’ and the apparently additional health-related requirements that those of religious faith demand, when compared with other people. It does so by comparing Lori Beaman's idea of agonism with that of a distinct and somewhat complementary approach in Jonathan Chaplin's political philosophy, before examining the role of established religion in setting the conditions for the accommodation of religion and belief in healthcare. Section 3 examines risks to such accommodation by engaging critically with three health-related instantiations of political philosophy that differ radically from both Beaman and Chaplin. A concluding Section 4 focusses on appropriate modes of communicating about religious and other beliefs in healthcare. (shrink)

Compassion in Healthcare gives an account of the nature and content of compassion and its role in healthcare based on notions of pilgrimage and civic life. Drawing on the author's real-world collaborations, the book proposes strategies for an improved understanding of compassionate relationships in healthcare practice.

This article considers the political significance of game theoretical notions of cooperation by responding theologically to the writings of David Willetts, a minister in the UK government. The argument is that the forms of cooperative institutional life which societies require can be neither explained nor planned for solely by mathematical modelling of rational self-interest. What altruistic, civic cooperation depends upon is a complex web of affective trust, often theologically formed by open-handed faith rather than a self-protective pinch, so that wise (...) risks may be taken for the sake of future generations. (shrink)

This is a non-evaluative overview of Justice: Rights and Wrongs covering its three parts: (i) an ‘archaeological’ account of justice and rights in the Christian tradition; (ii) a description of the goods to which we have rights; (iii) an argument grounding natural, inherent, human rights to goods in God’s love.

The symposium, with which the present issue of SCE is concerned, concluded with a frank and probing discussion about the future of theological ethics. It is the purpose of this final contribution to provide a sense of the character of that debate.

A theological treatment of the role of affections such as joy, compassion, and shame in contemporary politics. Hordern discusses what affections are and how they play a role in parts of political life such as representation and law. He shows that affections have an intelligent role to play in fostering loyalty, trust and public moral reasoning.

In some popular and political discourse, ‘compassion’ is commonly conceived as a simple or ‘given’ aspect of the world. And yet public discussion also focusses on whether ‘compassion' has gone wrong in some way, suggesting that there might be various more or less satisfactory versions of compassion. At the same time, some thinkers doubt whether compassion should any longer be expected of those working in healthcare. This article draws on philosophical and theological resources to argue that the conceptual context which (...) forms compassion is crucial for determining the ethos of healthcare. The discussion explores three themes – politics, suffering and responsibility – which must be addressed in order to understand what is wrong with compassion, to identify lines of future investigation and to develop possible remedies. (shrink)