When Did I Begin? investigates the theoretical, moral, and biological issues surrounding the debate over the beginning of human life. With the continuing controversy over the use of in vitro fertilization techniques and experimentation with human embryos, these issues have been forced into the arena of public debate. Following a detailed analysis of the history of the question, Reverend Ford argues that a human individual could not begin before definitive individuation occurs with the appearance of the primitive streak about two (...) weeks after fertilization. This, he argues, is when it becomes finally known whether one or more human individuals are to form from a single egg. Thus, he questions the idea that the fertilized egg itself could be regarded as the beginning of the development of the human individual. The author also differs sharply, however, from those who would delay the beginning of the human person until the brain is formed, or until birth or the onset of conscious states. (shrink)

Background: Limited knowledge of the experiences of conflicts of conscience found in nursing literature. Objectives: To explore the individual experiences of a conflict of conscience for neonatal nurses in Alberta. Research design: Interpretive description was selected to help situate the findings in a meaningful clinical context. Participants and research context: Five interviews with neonatal nurses working in Neonatal Intensive Care Units throughout Alberta. Ethical consideration: Ethics approval from the Health Research Ethics Board at the University of Alberta. Findings: Three common (...) themes emerged from the interviews: the unforgettable conflict with pain and suffering, finding the nurse’s voice, and the unique proximity of nurses. Discussion and conclusion: The nurses described a conflict of conscience when the neonate in their care experienced undermanaged pain and unnecessary suffering. During these experiences, they felt guilty, sad, hopeless, and powerless when they were unable to follow their conscience. Informal ways to follow their conscience were employed before declaration of conscientious objection was considered. This study highlights the vital importance of respecting a conflict of conscience to maintain the moral integrity of neonatal nurses and exposes the complexities of conscientious objection. (shrink)

Decisions about targeting medical assistance in humanitarian contexts are fraught with dilemmas ranging from non-availability of basic services, to massive demographic and epidemiological shifts, and to the threat of insecurity and evacuations. Aid agencies are obliged, due to capacity constraints and competing priorities, to clearly define the objectives and the beneficiaries of their actions. That aid agencies have to set limits to their actions is not controversial, but the process of defining the limits raises ethical questions. In MSF, frameworks for (...) resource allocation are subject to constant reflection and reiteration, and perspectives are sought at all levels, from implementers at the programme level to the operational directors at headquarters. The perspectives of the programmes staff hold considerable weight as they have the knowledge and experience with particular communities to assess the degree of vulnerability and need, and are also the people who ultimately have to give explanations to beneficiaries when changes or closures are going to be instituted. Humanitarian agencies have a responsibility to ensuring that their workers are prepared to reflect on these dilemmas, and challenge the status quo when it costs lives. (shrink)

Background Nursing students must graduate prepared to bravely enact the art and science of nursing in environments infiltrated with ethical challenges. Given the necessity and moral obligation of nurses to engage in discourse within nursing ethics, nursing students must be provided a moral supportive learning space for these opportunities. Situating conversations and pedagogy within a brave space may offer a framework to engage in civil discourse while fostering moral courage for learners. Research Objective The aim of this research is to (...) explore the influence of a structured self-assessment tool called the ESA “Engagement Self-Assessment” on the alignment and creation of a brave space in a nursing ethics course. Research Design This study used an exploratory, cross-sectional survey design. Participants and Study Setting Data from 39 undergraduate nursing students enrolled in a nursing healthcare ethics & law course using the ESA were recruited. Ethical Considerations Participation was voluntary and informed without coercion. Written consent was obtained prior to participation. Research ethics approval was obtained by the Institutional Research Ethics Board of the recruited participants (Ethics # 2022-23-03). Findings The ESA provided structured self-reflection on the impact of shared vulnerability within a brave space. However, commitment to a brave space was not strongly influenced by the ESA, but rather by a mutual “commitment to others.” Conclusion A teaching tool such as an ESA can be used to facilitate instructor expectations of civil discourse and discussion of difficult topics. Rules of engagement such as those found in brave spaces can help transform fear of vulnerability into authentic growth for learners. A morally supportive learning space can support critical opportunities for ethical development. This study provides insight into how self-assessment and the use of a brave space in nursing ethics education can facilitate a morally supportive learning space. (shrink)

ABSTRACT Medical AID organisations such as Médecins Sans Frontières receive several requests from individuals and international academic institutions to conduct research at their implementation sites in Africa. Do AID agencies have an ethical duty to comply with research requests? In this paper we respond to the views and constructed theories (albeit unfounded) of one such researcher, whose request to conduct research at one of our sites in the Democratic Republic of Congo was turned down.

Ford's book on the question of when human personhood begins, When Did I Begin? Conception of the Human Individual in History, Philosophy and Science (Cambridge University Press; 1988), is reviewed by Michael J. Coughlan in this issue of Bioethics. Here Ford responds to Coughlan's review, focusing on three topics: the importance of rationality for personhood, how far back one can trace the ontological identity of what is indisputably a human individual and human person, and the difference between the awareness of (...) the reality of human persons and the varying degrees of perception of their value in the family and society. (shrink)

Ford, Norman M Throughout history Catholics held the commonly accepted views of the times regarding human reproduction, and these views changed as advances were made in scientific knowledge. Hence, it would be best to begin with Aristotle's views on human reproduction.

Ford, Norman M Doctors and nurses understand the personal dignity of their patients and their natural desire to be healthy and happy. The aged with failing memories or mental impairments are persons whose dignity and moral worth remain intact. They also know patients differ in their personal circumstances, their faith, their stages of life's journey and their attitude to sickness and approach of death. This awareness enables them to adequately perform their valuable professional services from a subject centred perspective as (...) well as from an objective approach based on our shared rational human nature. All this needs to be re-affirmed for patients, especially the aged, those living with post coma unresponsiveness, Alzheimer's disease and any other unconscious state. (shrink)

Ford, Norman There has been some confusion in the media over what Pope Benedict XVI meant by his comments on the use of condoms. He was discussing acts of sexual intercourse performed by male prostitutes in relation to HIV (human immune deficiency virus) infection in reply to a question put to him during an interview with Peter Seewald. The Vatican spokesman Fr Lombardi SJ said the Pope 'had confirmed to him that the example was valid in the case of all (...) prostitutes. The point of the example, he said, "was not the sex of the prostitute but the process of growing awareness of the risk [to] the life of the other person".' He was not referring to married couples nor contraception but the prevention of HIV infection from acts of prostitution. (shrink)