This paper describes the change of emphasis that occurred in the teaching of ethics to small groups of clinical students. Although the original focus of the course was on the analysis of ethical dilemmas associated with individual patients known to the students, it soon became evident that there were, for the students themselves, more fundamental ethical dilemmas in their new role as clinical students. These included worries about how to respond when patients asked questions which their consultants had previously deceived (...) them about, worries about inflicting pain on patients, as with intravenous cannulation, and the role of the medical student in the clinical team. We emphasise the need to explore student experiences as part of the process of ethics teaching. (shrink)

Australian medical researchers are attempting to formulate a response to some of the ethical issues in medical research. The debate over the in vitro fertilisation programme has highlighted some community concern about research ethics and the role of the ethics committee. While very little is known about Australian ethics committees, it appears that a two-tiered approach comprising both ethical review and scientific review is acceptable to the research community. However, this approach plus some problems with the nature of informed consent, (...) begs the question of the role of these committees in the broader context of medical research in the community. Important aspects of a seminar for members of hospital ethics committees are reported. (shrink)

1 Evidence-based policy requires researchers to provide the answers to ecological questions that are of interest to policy makers. To find out what those questions are in the UK, representatives from 28 organizations involved in policy, together with scientists from 10 academic institutions, were asked to generate a list of questions from their organizations. 2 During a 2-day workshop the initial list of 1003 questions generated from consulting at least 654 policy makers and academics was used as a basis for (...) generating a short list of 100 questions of significant policy relevance. Short-listing was decided on the basis of the preferences of the representatives from the policy-led organizations. 3 The areas covered included most major issues of environmental concern in the UK, including agriculture, marine fisheries, climate change, ecosystem function and land management. 4 The most striking outcome was the preference for general questions rather than narrow ones. The reason is that policy is driven by broad issues rather than specific ones. In contrast, scientists are frequently best equipped to answer specific questions. This means that it may be necessary to extract the underpinning specific question before researchers can proceed. 5 Synthesis and applications. Greater communication between policy makers and scientists is required in order to ensure that applied ecologists are dealing with issues in a way that can feed into policy. It is particularly important that applied ecologists emphasize the generic value of their work wherever possible. (shrink)

Moral philosophers agree that welfare matters. But they disagree about what it is, or how much it matters. In this vital new work, Wayne Sumner presents an original theory of welfare, investigating its nature and discussing its importance. He considers and rejects all notable theories of welfare, both objective and subjective, including hedonism and theories founded on desire or preference. His own theory connects welfare closely with happiness or life satisfaction. Reacting against the value pluralism that currently dominates moral philosophy, (...) he advances welfare as the only basic ethical value. He concludes by discussing the implications of this thesis for ethical and political theory. Written in clear, non-technical language, and including a definitive survey of other work in this area, Sumner's book is essential reading for moral philosophers, political theorists, and welfare economists. (shrink)

What does it mean for someone to have a moral right to something? What kinds of creatures can have rights, and which rights can they have? While rights are indispensable to our moral and political thinking, they are also mysterious and controversial; as long as these controversies remain unsolved, rights will remain vulnerable to skepticism. Here, Sumner constructs both a coherent concept of a moral right and a workable substantive theory of rights to provide the moral foundation necessary to dispel (...) such doubts. (shrink)

Suppose that the ultimate point of ethics is to make the world a better place. If it is, we must face the question: better in what respect? If the good is prior to the right — that is, if the rationale for all requirements of the right is that they serve to further the good in one way or another — then what is this good? Is there a single fundamental value capable of underlying and unifying all of our moral (...) categories? If so, how might it defeat the claims of rival candidates for this role? If not, is there instead a plurality of basic goods, each irreducible to any of the others? In that case, how do they fit together into a unified picture of the moral life? These are the questions I wish to address, in a necessarily limited way. To many the questions will seem hopelessly old-fashioned or misguided. Some deontologists will wish to reverse my ordering of the good and the right, holding that the right constrains acceptable conceptions of the good. For many contractarians, neither the good nor the right will seem normatively basic, since both are to be derived from a prior conception of rationality. Finally, some theorists will reject the classification of moral theories in terms of their basic normative categories, arguing that the whole foundationalist enterprise in ethics should be abandoned. In the face of these challenges to the priority of the good, and in light of the many current varieties of moral skepticism and relativism, I cannot provide a very convincing justification for raising the questions I intend to discuss. (shrink)

In this timely book L.W. Sumner addresses these issues within the wider context of palliative care for patients in the dying process.

If I lead a life of virtue, that may well be good for you. But will it also be good for me? The idea that it will—or even must—is an ancient one, and its appeal runs deep. For if this idea is correct then we can provide everyone with a good reason—arguably the best reason—for being virtuous. However, for all the effort which has been invested in defending the idea, by some of the best minds in the history of philosophy, (...) it remains unproven. Worse, in this skeptical age hardly anyone really believes it. I don't really believe it either, at least not in its strongest forms, but I think that the question is nonetheless worth examining. Even if we cannot show that virtue and self-interest coincide, we can at least measure the breadth of the gap between them. (shrink)

No one who cares about equal opportunity can derive much comfort from the present occupational distribution of working women. In the various industrial societies of the West, women comprise between one quarter and one-half of the national labor force. However, they tend to clustered in employment sectors – especially clerical, sales, and service J occupations – which rank relatively low in remuneration, status, autonomy, and other perquisites. Meanwhile, the more prestigious and rewarding managerial and professional positions, as well as the (...) major categories of blue-collar labor, remain largely a male preserve. In the same societies the average income earned by full-time female workers is one-half to two- J thirds that of their male counterparts. Although this disparity owes much to i other factors, including lower pay for work similar or even identical to that r standardly done by men, much of it can be explained only by the concentration of working women in traditional female job ghettos. (shrink)

Ever since medical assistance in dying (MAID) became legal in Canada in 2016, controversy has enveloped the refusal by many faith‐based institutions to allow this service on their premises. In a recent article in this journal, Philip and Joshua Shadd have proposed ‘changing the conversation’ on this issue, reframing it as an exercise not of conscience but of an institutional right of self‐governance. This reframing, they claim, will serve to show how health‐care institutions may be justified in refusing to provide (...) MAID on moral or religious grounds. I argue that it will not make it easier to justify institutional refusal, and is likely to make it harder. (shrink)

How are we to understand the role of bioethics in the health care system, government, and academe? This collection of original essays raises these and other questions about the nature of bioethics as a discipline.

When Amartya Sen defends his capability theory of well-being he contrasts it with the utility theory advocated by the classical utilitarians, including John Stuart Mill. Yet a closer examination of the two theories reveals that they are much more similar than they appear. Each theory can be interpreted in either a subjective or an objective way. When both are interpreted subjectively the differences between them are slight, and likewise for the objective interpretations. Finally, whatever differences may remain are less important (...) than they might seem, since the two theories are developed by Sen and Mill for different purposes and are in that sense not genuine rivals. (shrink)

No one who cares about equal opportunity can derive much comfort from the present occupational distribution of working women. In the various industrial societies of the West, women comprise between one quarter and one-half of the national labor force. However, they tend to clustered in employment sectors – especially clerical, sales, and service J occupations – which rank relatively low in remuneration, status, autonomy, and other perquisites. Meanwhile, the more prestigious and rewarding managerial and professional positions, as well as the (...) major categories of blue-collar labor, remain largely a male preserve. In the same societies the average income earned by full-time female workers is one-half to two- J thirds that of their male counterparts. Although this disparity owes much to i other factors, including lower pay for work similar or even identical to that r standardly done by men, much of it can be explained only by the concentration of working women in traditional female job ghettos. (shrink)

This paper defends an account of compassion and argues for the centrality of compassion to the proper practice of medicine. The argument proceeds by showing that failures of compassion can lead to poor medical treatment and disastrous outcomes. Several case studies are discussed, exemplifying the difference between compassionate and noncompassionate responses to patients seeking help. Arguments are offered in support of approaching reports of persistent pain with a trusting attitude, rather than distrust or skepticism. The article concludes by suggesting educational (...) improvements to encourage compassion. (shrink)

Hanlester Network v. Shalala ) marks the first test of the application of the Medicare-Medicaid anti-kickback statute to physician self-referral joint ventures. The most recent development in this ongoing litigation was the April 6, 1995 decision of the Ninth Circuit Court of Appeals, holding the Hanlester Network vicariously liable for its marketing vice president's knowing and willful violation of the antikickback statute. The vice president had offered to pay physician-investors in order to induce their referrals of program-related business.The Hanlester Network (...) was a California general partnership comprised of corporations, clinical laboratories, and individual investors. In April 1987, it entered into a management agreement on behalf of the clinical laboratories with SmithKline BioScience Laboratories. (shrink)

When medical assistance in dying (MAiD) was legalized in Canada in June 2016, the question of allowing decisionally capable persons to make advance requests in anticipation of later incapacity was reserved for further consideration during the mandatory parliamentary review originally scheduled to begin in June 2020 (but since delayed by COVID-19). In its current form the legislation does not permit such requests, since it stipulates that at the time at which the procedure is to be administered the patient must give (...) “express consent” to receiving it. Since express consent presupposes decisional capacity, this requirement rules out administering MAiD to a patient who has lost capacity. Amendments to the legislation passed by Parliament in March 2021 open the door slightly by allowing advance requests by patients after they have been approved for MAiD, if they fear losing capacity before the procedure can be administered. But this provision would apply only to patients whose natural death was deemed to be “reasonably foreseeable”, and would continue to exclude (a) requests made after diagnosis of a “grievous and irremediable medical condition” but in advance of approval for MAiD, and (b) requests made before such a diagnosis. My aim in this paper is twofold: to explore the ethical and legal issues concerning advance requests for MAiD, and to argue for expanding provision for such requests to include both of these further scenarios. (shrink)

Animal liberationists tend to divide into two mutually antagonistic camps: animal welfarists, who share a utilitarian moral outlook, and animal rightists, who presuppose a structure of basic rights. However, the gap between these groups tends to be exaggerated by their allegiance to oversimplified versions of their favored moral frameworks. For their part, animal rightists should acknowledge that rights, however basic, are also defeasible by appeals to consequences. Contrariwise, animal welfarists should recognize that rights, however derivative, are capable of constraining appeals (...) to consequences. If both sides move to more defensible theoretical positions, their remaining differences on that level may be compatible with a broad area of convergence on practical issues. Keywords: animal welfare, animal rights, ethics CiteULike Connotea Del.icio.us What's this? (shrink)