BackgroundSexual boundary violations in healthcare are harmful and exploitative sexual transgressions in the professional–client relationship. Persons with mental health issues or intellectual disabilities, especially those living in residential settings, are especially vulnerable to SBV because they often receive long-term intimate care. Promoting good sexual health and preventing SBV in these care contexts is a moral and practical challenge for healthcare organizations.MethodsWe carried out a qualitative interview study with 16 Dutch policy advisors, regulators, healthcare professionals and other relevant experts to explore (...) their perspectives on preventing SBV in mental health and disability care organizations. We used inductive thematic analysis to interpret our data.ResultsWe found three main themes on how healthcare organizations can prevent SBV in mental health and disability care: setting rules and regulations, engaging in dialogue about sexuality, and addressing systemic and organizational dimensions.ConclusionOur findings suggest that preventing SBV in mental health and disability care organizations necessitates setting suitable rules and regulations and facilitating dialogue about positive aspects of sexuality and intimacy, as well as about boundaries, and inappropriate behaviors or feelings. Combining both further requires organizational policies and practices that promote transparency and reflection, and focus on creating a safe environment. Our findings will help prevent SBV and promote sexual health in mental health and disability care organizations. (shrink)

When do you have to sacrifice life and limb, time and money, to prevent harm to others? When must you save more people rather than fewer? These questions might arise in emergencies involving strangers drowning or trapped in burning buildings, but they also arise in our everyday lives, in which we confront opportunities to donate time or money to help distant strangers in need of food, shelter, or medical care. With the resources available, we can provide more help--or less. -/- (...) In The Rules of Rescue, Theron Pummer argues that we are often morally required to engage in effective altruism, directing altruistic efforts in ways that help the most. Even when the personal sacrifice involved makes it morally permissible not to help at all, he contends, it often remains wrong to provide less help rather than more. Using carefully crafted examples, he defends the view that helping distant strangers is more morally akin to rescuing nearby strangers than most of us realize. The ubiquity of opportunities to help distant strangers threatens to make morality extremely demanding, and Pummer argues that it is only thanks to adequate permissions grounded in considerations of cost and autonomy that we may pursue our own plans and projects. He ultimately concludes that many of us are required to provide no less help over our lives than we would have done if we were effective altruists. (shrink)

The Covid-19 pandemic has led to a health crisis of a scale unprecedented in post-war Europe. In response, a large amount of healthcare resources have been redirected to Covid-19 preventive measures, for instance population-wide vaccination campaigns, large-scale SARS-CoV-2 testing, and the large-scale distribution of protective equipment to high-risk groups and hospitals and nursing homes. Despite the importance of these measures in epidemiological and economic terms, health economists and medical ethicists have been relatively silent about the ethical rationales underlying the (...) large-scale allocation of healthcare resources to these measures. The present paper seeks to encourage this debate by demonstrating how the resource allocation to Covid-19 preventive measures can be understood through the paradigm of the Rule of Rescue, without claiming that the Rule of Rescue is the sole rationale of resource allocation in the Covid-19 pandemic. (shrink)

Preventive use of force may be defined as the initiation of military action in anticipation of harmful actions that are neither presently occurring nor imminent. This essay explores the permissibility of preventive war from a cosmopolitan normative perspective, one that recognizes the basic human rights of all persons, not just citizens of a particular country or countries. It argues that preventive war can only be justified if it is undertaken within an appropriate rule-governed, institutional framework that (...) is designed to help protect vulnerable countries against unjustified interventions while also avoiding unacceptable risks of the costs of inaction. The key to ensuring the fairness of rules governing the preventive use of force is accountability.This essay proposes a scheme that would make those promoting and those rejecting the preventive use of force more accountable. The proposal contains the following crucial features:States proposing preventive war are required to enter into a contract with a diverse body of states as a condition for authorization of their actions;Prior to taking preventive action, states must make an evidence-based case to the UN Security Council, and agree in advance to submit themselves to an evaluation by an impartial body after the preventive action occurred;Both proponents of action and those opposing it will be held accountable ex post for the accuracy of their prior statements and the proportionality of their actions;Sanctions will be imposed against intervening states or states that opposed preventive action, respectively, depending on the findings of the ex post evaluation.If preventive action were blocked in the Security Council, states seeking to engage in preventive action could then present their case in a different body–a coalition of democratic states–with its own ex post and ex ante accountability procedures. (shrink)

Does A cause B simply if A prevents what would have prevented B? Such a case is known as double prevention: where we have the prevention of a prevention. One theory of causation is that A causes B when B counterfactually depends on A and, as there is such a dependence, proponents of the view must rule that double prevention is causation.<br><br>However, if double prevention is causation, it means that causation can be an extrinsic matter, that the cause and (...) effect need not be connected by a continuous chain of events, that there can be causation by absence, and that there can be causation at a distance. All of these implications jar with strong intuitions we have about the nature of causation. There is, on the other hand, a theory of causation based on an ontology of real dispositions, where causation involves the passing around of powers. This theory in contrast entails that double prevention is not causation and, on this issue, it can claim a victory over the counterfactual dependence account. (shrink)

A US Department of Health and Human Services Final Rule, Protecting Statutory Conscience Rights in Health Care, and a proposed bill in the British House of Lords, the Conscientious Objection Bill, may well warrant a concern that—to borrow a phrase Daniel Callahan applied to self-determination—conscientious objection in health care has “run amok.” Insofar as there are no significant constraints or limitations on accommodation, both rules endorse an approach that is aptly designated “conscience absolutism.” There are two common strategies to (...) counter conscience absolutism and prevent conscientious objection in medicine from running amok. One, non-toleration, is to decline to accommodate physicians who refuse to provide legal, professionally accepted, clinically appropriate medical services within the scope of their clinical competence. The other, compromise or reasonable accommodation, is to impose constraints on accommodation. Several arguments for non-toleration are critically analyzed, and I argue that none warrants its acceptance. I maintain that non-toleration is an excessively blunt instrument to prevent conscientious objection in medicine from running amok. Instead, I defend a more nuanced contextual approach that includes constraints on accommodation. (shrink)

I defend a form of preventive detention through the creation of an offence of ‘being a persistent violent dangerous offender’. This differs from alternative proposals and actual habitual offender laws that impose extra periods of incarceration on offenders after they have completed the sentence for their most recent crime or as a result of a certain number of prior convictions. I, instead, would make ‘being a persistent violent dangerous offender’ an offence itself. Persons to be preventively detained would be (...) tried and convicted of this offence. My approach would then have one significant advantage: provided the elements of being a PVDO could be rendered sufficiently determinate, punishing persons under such an offence would comport with central rule of law values, most importantly legality and fair notice, as well as principles of proportionality in sentencing. (shrink)

The precautionary principle brings a special challenge to the practice of evidence-based public health decision-making, suggesting changes in the interpretative methods of public health used to identify causes of disease. In this paper, precautionary changes to these methods are examined: including discounting contrary evidence, reducing the number of causal criteria, weakening the rules of evidence assigned to the criteria, and altering thresholds for statistical significance. All such changes reflect the precautionary goal of earlier primary preventive intervention, i.e. acting on (...) insufficient evidence, the least amount, or minimum level, of evidence for causation. Evaluating the impact of these changes will be difficult without a careful study of how well the current methods of causal inference work, their theoretical foundations, and the ethical implications of their applications. That research program will be most productive if it is jointly developed by public health professionals trained in the ethics and philosophy and by bioethicists and philosophers trained in the theories, methods, and practice of public health. (shrink)

This essay introduces the political thought of Hans G. Ulrich as it is presented in his seminal work Wie Geschöpfe leben. What sets Ulrich's thought apart from most other authors in the field is that his interest is not in an account of community or citizenship, but in the status politicus — the political form of existence that is bestowed on human beings as God's creatures who are called to be `ruled by the spirit' instead of succumbing to any form (...) of rule by which human beings exert dominion over human beings. Drawing from Biblical sources and a fresh reading of Luther's doctrine of the two regimes in the spirit of the Confessing Church, Ulrich arrives at a highly emancipative account of political existence that does not derive its rationale from the necessity for co-existence or common action, but from the liberation from `ungodly ties' that prevent people from free discourse and cooperation. (shrink)

You have not opened the wrong journal!The police have a duty to protect the public and to investigate any, and all, serious crimes. The article by Lynøe and Leijonhufvud raises important issues about the interaction between hospital staff and police in cases in which suggested medical negligence crosses into the arena of serious legal offences, which range from murder and homicide to serious assault.1Although arising in Sweden, the issues raised in this case are generalisable. While our understanding is limited to (...) the journal article there seem several uncontested facts: a children's intensive care doctor was arrested, charged and acquitted of the mercy killing of an infant in a Swedish hospital. The baby had sustained severe brain injury prior to this clinician's involvement, either due to birth asphyxia or to an accidental overdose of salt. The baby died after withdrawal of life-sustaining treatment with parental agreement. At a later stage, the family asked the police to investigate the initial salt incident. Despite the team attending the baby after WLST stating that only a morphine infusion was administered, a 25-day postmortem femoral artery sample showed ‘an extremely high level of thiopentone’ , although no control sample was analysed.Healthcare staff are subject to the laws of their country. However, Lynøe and Leijonhufvud raise the issue of a conflict between what they term ‘soft law’—the rules, regulations and ethics of healthcare practice and the law of the land. …. (shrink)

The present brief commentary to Englert’s recent article on Kant’s distinction between practical ideas and ideals extends the significance of its contribution by considering the psychological dimensions underpinned by those ethical concepts. According to regulatory focus theory, in the moral domain the prevention focus subsumes duties and obligations, whereas the promotion focus underlies aspirations toward virtue. I argue here that prevention motives induce the enactment of behaviours consistent with ethical rules corresponding to Kant’s practical idea, and that promotion motives inspire (...) imitation processes aimed at advancement toward the archetypal excellence of Kant’s practical ideal. I conclude discussing the relevance and value, beyond Kant’s ethical conception, of a psychological analysis of the main Western normative theories through the lens of regulatory focus and the other motivational primitives. (shrink)

The article exposes the analysis of different socio-philosophical approaches to the fixation of a rule in contemporary praxis. It clarifies the status and role of the rule as a notion in practical philosophy. The author compares the advantages of neo-Aristotelian, neo-Kantian and socio-critical approaches to the revelation of valid forms of praxis rules. In the framework of social philosophy, the article demonstrates the interdependency and succession of these approaches to the interpretation of the essence of the practical (...) class='Hi'>rule. The renaissance of the Aristotelean definition of praxis is considered in the works by E. Stein and A. MacIntyre. The relevance of the neo-Kantian approach to the revelation of the nature of practical rule in contemporary social theory is justified on the basis of works by R. Jaeggi, E. von Redecker and J. Butler. The author traces the productive interaction between the neo-Aristotelean and the neo-Kantian approaches to defining praxis rules. Special attention is paid to the philosophy of H. Lotze and E. Lask, where is accomplished the practical turn from the Aristotelean accomplished deed itself to the Kantian judgement about a value of this or that form fulfillment. The dominance of the axiological approach to praxis in contemporary social theory is problematised by means of the neo-Aristotelean interpretation, which prevents its alienation from the essence of the virtue action. The late modern characteristic forms of the practical rule fulfillment in creative activity are considered. There is justified the necessity of turning the theory of practices to the neo-Kantian and the neo-Aristotelean traditions in order to reveal valid forms of expressing and preserving the value-normative nature of rules in contemporary society. That can partially overcome the pragmatic relativism of the theory of practices, which neglects the traditional sense of the praxis rule in its situational intersubjective interpretation. Taking into account complexity and non-linear development of social reality, as well as of the variety of approaches to its reflection, there is explicated the relevance of the determination of contextually possible and universally necessary forms of praxis rules, which are justifiable as value meaningful. (shrink)

People accept conclusions of valid conditional inferences (e.g., if p then q, p therefore q) less, the more disablers (circumstances that prevent q to happen although p is true) exist. We investigated whether rules that through their phrasing exclude disablers evoke higher acceptance ratings than rules that do not exclude disablers. In three experiments we re-phrased content-rich conditionals from the literature as either universal or existential rules and embedded these rules in Modus Ponens and Modus Tollens inferences. In Experiments 2 (...) and 3, we also used abstract rules. The acceptance of conclusions increased when the rule was phrased with “all” instead of “some” and the number of disablers had a higher impact on existential rules than on universal rules. Further, the effect of quantifier was more pronounced for abstract rules and when tested within subjects. We discuss the relevance of phrasing, quantifiers and knowledge on reasoning. (shrink)

In the paper “An archeology of corruption in medicine”, Miles Little, Wendy Lipworth, and Ian Kerridge present an account of corruption and describe its prevalent forms in medicine. In presenting an individual-focused account of corruption found within “social entities”, Little et al. argue that these entities are corruptible by nature and that certain individuals are prone to take advantage of the corruptibility of social entities to pursue their own ends. The authors state that this is not preventable, so the way (...) to remedy corruption is via management and, where necessary, punishment. This commentary will briefly lay out the key features and functions of corruption as presented by Little et al., before providing a critical discussion that will focus on whether corruptibility is a necessary feature of social entities. I will propose that it is not a necessary feature, though it may frequently arise where individualistic values are unchecked. Corruption can be prevented within social entities by enhancing structures that direct toward virtue and which promote and reward cooperation instead of competition. (shrink)

Criminal law scholars approach legality in various ways. Some scholars eschew over-arching principles and proceed directly to one or more distinct “rules”: (1) the rule against retroactive criminalization; (2) the rule that criminal statutes be construed narrowly; (3) the rule against the judicial creation of common-law offenses; and (4) the rule that vague criminal statutes are void. Other scholars seek a single principle, i.e., the “principle of legality,” that they claim underlies the four rules. In contrast, (...) I believe that both approaches are misguided. There is no such thing as a single “principle of legality;” yet, the four aforementioned rules are not unrelated to each other. The so-called “principle of legality” consists of two distinct norms that derive, respectively, from two fundamental principles of criminal justice, viz., the principle, “No person shall be punished in the absence of a bad mind,” and the principle that underlies the maxim, “Every person is presumed innocent until proven guilty.” The first norm of legality explains the rules regarding ex post facto legislation, and rules regarding “notice” and “fair warning” of judicial decisions. When a person is punished for violating a rule that was non-existent or unclear at the time he acted, he is punished for conduct that the state now condemns and seeks to prevent by means of penal sanctions. Accordingly, at the time the person is prosecuted, his claim is not that he did not do anything that the state regards as wrong, but, rather, that he neither knew nor should have known that he was doing something that the state would come to regard as wrong. He ought, indeed, to be excused for his mistake, but only because of a principle that is common to excuses generally: “No person ought to be punished in the absence of a guilty mind.” He should be excused because even when a person does something the state condemns and seeks to prevent, he ought not to be blamed for it unless he was motivated in a certain way, namely, by an attitude of disrespect for the legitimate interests of the political community by whose norms he is bound.The second norm of legality informs several of the remaining rules, though not all of them. The second norm is that a person ought not to be punished in the name of a political community unless it can confidently be said that the community officially regards his conduct as warranting the criminal punishment at issue. It is a norm that is most commonly associated with the rule of lenity, but it is not confined to the construction of statutes that are ambiguous or vague. It can also be also violated when a person is punished for violating a statute that has fallen into desuetude, regardless of how widely promulgated or narrowly defined the statute may be. This second norm derives from a principle that also underlies the presumption of innocence - the only difference being that the presumption of innocence is a preference for acquittal in the event of uncertainty regarding the facts which an actor is charged, while the second norm of legality is a preference for acquittal in the event of uncertainty regarding the scope of the offense which he is charged.Nevertheless, one “rule” remains that this analysis throws into question - namely, the rule that “vague” criminal statutes are void. Criminal statutes are sometimes so broadly defined that they do, indeed, infringe constitutionally protected rights of speech, movement, etc. - in which event they ought to be invalidated on those very grounds. And criminal statutes are sometimes so broadly drafted that, before applying them, courts ought to construe them to apply only to constitutionally unprotected acts that courts can confidently say the relevant political community regards as warranting punishment. But once statutes are so construed to apply only to constitutionally unprotected conduct, courts have no further reason to invalidate them on grounds of “vagueness.” Lack of “notice” is no reason to invalidate them because, with respect to the narrowly defined conduct such statutes are construed to prohibit, “common social duty” alone ought to alert actors that their conduct is suspect. (shrink)

In this paper, we address the question of whether AI should be used for suicide prevention on social media data. We focus on algorithms that can identify persons with suicidal ideation based on their postings on social media platforms and investigate whether private companies like Facebook are justified in using these. To find out if that is the case, we start with providing two examples for AI-based means of suicide prevention in social media. Subsequently, we frame suicide prevention as an (...) issue of beneficence, develop two fictional cases to explore the scope of the principle of beneficence and apply the lessons learned to Facebook’s employment of AI for suicide prevention. We show that Facebook is neither acting under an obligation of beneficence nor acting meritoriously. This insight leads us to the general question of who is entitled to help. We conclude that private companies like Facebook can play an important role in suicide prevention, if they comply with specific rules which we derive from beneficence and autonomy as core principles of biomedical ethics. At the same time, public bodies have an obligation to create appropriate framework conditions for AI-based tools of suicide prevention. As an outlook we depict how cooperation between public and private institutions can make an important contribution to combating suicide and, in this way, put the principle of beneficence into practice. (shrink)

According to Brad Hooker's rule-consequentialism, as well as ordinary moral prohibitions against lying, stealing, killing, and harming others, the optimific code will include an over-riding “prevent disaster clause”. This paper explores two issues related to the disaster clause. The first issue is whether the disaster clause is vague—and whether this is a problem for rule-consequentialism. I argue that on Hooker's rule-consequentialism, there will be cases where it is indeterminate whether a given outcome counts as a disaster such (...) that it is permissible to infringe a given prohibition to avoid that outcome. I argue that it counts in favour of Hooker's rule-consequentialism that it makes this space for vagueness. The second issue is how to understand the disaster clause so that it does not make rule-consequentialism intolerably demanding—and more particularly whether avoiding over-demandingness requires the rule-consequentialist to place a counterintuitive limit on requirements to aid. I will argue that rule-consequentialism can avoid over-demandingness without placing a counterintuitive limit on requirements to aid. (shrink)

Involuntary psychiatric commitment for suicide prevention and physician aid-in-dying (PAD) in terminal illness combine to create a moral dilemma. If PAD in terminal illness is permissible, it should also be permissible for some who suffer from nonterminal psychiatric illness: suffering provides much of the justification for PAD, and the suffering in mental illness can be as severe as in physical illness. But involuntary psychiatric commitment to prevent suicide suggests that the suffering of persons with mental illness does not justify ending (...) their own lives, ruling out PAD. Since both practices have compelling underlying justifications, the most reasonable accommodation might seem to be to allow PAD for persons with mental illness whose suffering is severe enough to justify self-killing, but prohibit PAD for persons whose suffering is less severe. This compromise, however, would require the articulation of standards by which persons’ mental as well as physical suffering could be evaluated. Doing so would present a serious philosophical challenge. (shrink)

A number of articles and empirical studies over the past decade, most by Paul Robinson and co-authors, have suggested a relationship between the extent of the criminal law's reputation for being just in its distribution of criminal liability and punishment in the eyes of the community – its "moral credibility" – and its ability to gain that community's deference and compliance through a variety of mechanisms that enhance its crime-control effectiveness. This has led to proposals to have criminal liability and (...) punishment rules reflect lay intuitions of justice – "empirical desert" – as a means of enhancing the system's moral credibility. In a recent article, Christopher Slobogin and Lauren Brinkley-Rubinstein (SBR) report seven sets of studies that they argue undermine these claims of empirical desert and moral credibility and instead support SBR's proposed distributive principle of "individual prevention," a view that focuses on an offender's future dangerousness rather than on his perceived desert. -/- The idea that there is a relationship between the criminal law's reputation for justness and its crime-control effectiveness did not originate with Robinson and his co-authors. Rather, it has been a common theme among a wide range of punishment theory scholars for many decades. A particularly important conclusion of recent Robinson studies, however, is their confirmation that this relationship is a continuous one: even small nudges in moral credibility can produce corresponding changes in the community's deference to the criminal law. This is important because it shows that even piecemeal changes or changes at the margin – as in reforming even one unjust doctrine or procedure – can have real implications for crime-control. SBR's studies, rather than contradicting the crime-control power of empirical desert, in fact confirm it. Further, SBR's studies do not provide support for their proposed "individual prevention" distributive principle, contrary to what they claim. -/- While SBR try to associate their principle with the popular "limiting retributivism" adopted by the American Law Institute in its 2007 amendment of the Model Penal Code, in fact it is, in many respects, just the reverse of that principle. With limiting retributivism, the Model Code's new provision sets desert as dominant, never allowing punishment to conflict with it. SBR would have "punishment" essentially always set according to future dangerousness; it is to be constrained by desert only when the extent of the resulting injustices or failures of justice is so egregious as to significantly delegitimize the government and its law. This ignores the fact that even minor departures from justice may have an important cumulative effect on the system as a whole. What SBR propose – essentially substituting preventive detention for criminal justice – promotes the worst of the failed policies of the 1960s, where detention decisions were made at the back-end by "experts," and conflicts with the trend of the past several decades of encouraging more community involvement in criminal punishment, not less. (shrink)

Much has been said about Confucius’ negative formulation of the Golden Rule. Most discussions center on explaining why this formulation, while negative, does not differ at all in intention from the positive formulation. It is my view that such attempts may have the effect of blurring the essential point behind the specifically negative formulation, a point which I hope to elucidate in this essay. It is my first contention that such a negative formulation is consonant with other basic implicit (...) Confucian attitudes such as modesty and the belief in the inherent goodness of human nature. My second contention is that this negative formulation has the intent and/or effect of promoting growth and, more importantly, preventing moral harm. My broader thesis is that the negative version of the Golden Rule does differ significantly from the positive version and that the difference that exists might well have been intended by Confucius to highlight the nature of his most basic moral principle. (shrink)

Colleges and universities have largely abandoned their traditional stance in loco parentis, as moral guardians over student life, and instead seek to promote toleration while preventing conflict. In this volume David A Hoekema argues that in doing so, they fail to provide an atmosphere conducive to the attainment of the kind of responsible independence that such goals presuppose.

No one questions the importance of protecting human subjects of research, but over the past few years dissatisfaction has surfaced with the manner in which the protection is conferred by the federal regulatory system referred to as “The Common Rule. ” Some of the criticism surfaces in print. Some bubbles out anecdotally in conversations among researchers, with complaints about the review process being virtually inevitable whenever the topic arises. Like those in other disciplines that differ more or less dramatically (...) from the world of clinical medical research around which the Common Rule was conceptualized, public health researchers, particularly those working in official public health agencies, have experienced some tension and difficulty in adapting to the rules. The Centers For Disease Control and Prevention has adopted guidelines that require Common Rule review for “research” but not “practice” activities. (shrink)

At the end of the verses 44th, 45th, and 47th of the Surat al-Māʾida, it is seen that those who do not judge by what Allah has revealed are described as unbelievers, oppressors, and fāsiqs with the general expression. Especially in verse 44th of the surah, the fact that those who do not judge by Allah's revelations are characterized as misbelievers has been a subject of debate since the early period. Many different opinions have been expressed by the mufassirs about (...) who are included in this scope, who are the addressees of the verse, whether the” kufr” here is blasphemy in the form of denying Allah and leaving the religion, or is it a different type of “kufr”. As it is understood from the information in the sources regarding the asbāb al-nuzūl of these verses were revealed as the Jews destroyed the provisions set by Allah in the Torah, changed them with various ways, and discriminated between people in various ways and applied them. With the relevant verses in Sūrah al-Māʾida, all these injustices, lawlessness, and unfairness were made away and the Jews who committed them were strongly criticized. In this regard, it is seen that some commentators have devoted themselves to the reason for the verdict of the relevant verses and interpreted the characterizations in the verse as infidels, cruel, and fāsiqs as covering only the Jews who committed these acts. However, even if the information about the contents of the relevant verses shows that these verses are about the Jews, this does not mean that the scope of the verse should be limited to them. Because both the universality of the messages of the Qur'an in general and the fact that the address in the verses came in a public way do not allow these provisions to be allocated only to a certain group. In addition, according to the rules of istinbat, the fact that the reason for making a religious provision is specific does not prevent the generalization of it. When considered within the framework of the principles we have explained, it becomes clear that narrowing down the provisions of the verses by allocating them only to a certain group is not a correct approach. In this article, it is aimed to draw attention to the richness of meaning that emerges when the relevant verses are evaluated in terms of the types of indications in the fiqh method. When the verses within our subject are evaluated in terms of the types of indications, it is seen that these verses indicate that the implementation of a provision in force cannot be avoided. In the relevant verses, it's concluded that important principles and rules of law such as the realization of justice, the rule of law, equality before the law, no one's being privileged in the sight of the law, the powers of the head of state are limited, that there is no place for ijtihad where Allah's clear judgment exists. (shrink)

Deontic constraints prohibit an agent performing acts of a certain type even when doing so will prevent more instances of that act being performed by others. In this article I show how deontic constraints can be interpreted as either maximizing or non-maximizing rules. I then argue that they should be interpreted as maximizing rules because interpreting them as non-maximizing rules results in a problem with moral advice. Given this conclusion, a strong case can be made that consequentialism provides the best (...) account of deontic constraints. (shrink)

The dead donor rule (DDR) originally stated that organ donors must not be killed by and for organ donation. Scholars later added the requirement that vital organs should not be procured before death. Some now argue that the DDR is breached in donation after circulatory determination of death (DCDD) programs. DCDD programs do not breach the original version of the DDR because vital organs are procured only after circulation has ceased permanently as a consequence of withdrawal of life-sustaining therapy. (...) We hold that the original rendition of the DDR banning killing by and for organ donation is the fundamental norm that should be maintained in transplantation ethics. We propose separating the DDR from two other fundamental normative rules: the duties to prevent harm and to obtain informed consent. (shrink)

We compare the performance of liability rules for managing environmental disasters when third parties are harmed and cannot always be compensated. A firm can invest in safety to reduce the likelihood of accidents. The firm’s investment is unobservable to authorities. The presence of externalities and asymmetric information call for public intervention in order to define rules aimed at increasing prevention. We determine the investments in safety under No Liability, Strict Liability, and Negligence rules, and compare these to the first best. (...) Additionally, we investigate how the ability of the firm to fully cover potential damage affects the firm’s behavior. An experiment tests the theoretical predictions. In line with theory, Strict Liability and Negligence are equally effective; both perform better than No Liability; investment in safety is not sensitive to the ability of the firm to compensate potential victims. In contrast with theory, however, prevention rates absent liability are much higher and liability is much less effective. (shrink)

Since at least the 1980s, police departments in the United States have embraced a set of practices that aim, not to enable the prosecution of past criminal activity, but to discourage people from breaking the law in the first place. It is not clear that these practices effectively lower the crime rate. However, whatever its effect on the crime rate, I argue that preventive policing is essentially distinct from legal governance, and that excessive reliance on preventive policing undermines (...) legal governance. To show this, I emphasize law’s unique aptitude to define legal subjects’ ‘manifest’ status relations – that is, the rights and obligations that live within their local practices. I then argue, first, that preventive policing does not aim to define these relationships; and second, that excessive preventive policing threatens the relationship that law must bear with its subjects if law is to define their manifest relations authoritatively. (shrink)

Thirty years of debate have passed since the term “Rule of Rescue” has been introduced into medical ethics. Its main focus was on whether or why medical treatment for acute conditions should have priority over preventive measures irrespective of opportunity costs. Recent contributions, taking account of the widespread reluctance to accept purely efficiency-oriented prioritization approaches, advance another objection: Prioritizing treatment, they hold, discriminates against statistical lives. The reference to opportunity costs has also been renewed in a distinctly ethical (...) fashion: It has been stipulated that favoring help for identifiable lives amounts to a lack of benevolence for one’s fellow creatures. The present article argues against both objections. It suggests that the debate’s focus on consequences should be reoriented by asking which aspects of such states of affairs are actually attributable to a decision maker who judges within a specific situation of choice. (shrink)

Physicians play a critical role in preventing and treating firearm injury, although the scope of that role remains contentious and lacks systematic definition. This piece aims to utilize the fundamental principles of medical ethics to present a framework for physician involvement in firearm violence. Physicians' agency relationship with their patients creates ethical obligations grounded on three principles of medical ethics — patient autonomy, beneficence, and nonmaleficence. Taken together, they suggest that physicians ought to engage in clinical screening and treatment related (...) to firearm violence. The principle of beneficence also applies more generally, but more weakly, to relations between physicians and society, creating nonobligatory moral ideals. Balanced against physicians' primary obligations to patient agency relationships, general beneficence suggests that physicians may engage in public advocacy to address gun violence, although they are not ethically obligated to do so. A fourth foundational principle — justice — requires that clinicians attempt to ensure that the benefits and burdens of healthcare are distributed fairly. (shrink)

If the criminal trial is aimed simply at ascertaining the truth of a criminal charge, it is inherently problematic to prevent the prosecution from adducing relevant evidence on the ground of its unlawful provenance. This article challenges the starting premise by replacing the epistemic focus with a political perspective. It offers a normative justification for the exclusion of unlawfully obtained evidence that is rooted in a theory of the criminal trial as a process of holding the executive to the (...) class='Hi'>rule of law. On this theory, it is the admission rather than exclusion of such evidence that is inherently problematic. The differences between this theory and others that are in currency will be noted, as will its implications and limitations. (shrink)

Brad Hooker argues that the cost of inculcating in everyone the prevent disaster rule places a limit on its demandingness. My aim in this article is show that this is not true of existential risk reduction. However, this does not spell trouble for the reason that removing persistent global harms significantly improves our long-run chances of survival. We can expect things to get better, not worse, for our population.

Some of our most fundamental moral rules are violated by the practices of torture and war. If one examines the concrete forms these practices take, can the exceptions to the rules necessary to either torture or war be justified? Fighting Hurt brings together key essays by Henry Shue on the issue of torture, and relatedly, the moral challenges surrounding the initiation and conduct of war, and features a new introduction outlining the argument of the essays, putting them into context, and (...) describing how and in what ways his position has modified over time. The first six chapters marshal arguments that have been refined over 35 years for the conclusion that torture can never be justified in any actual circumstances whatsoever. The practice of torture has nothing significant in common with the ticking bomb scenario often used in its defence, and weak U.S. statutes have loop-holes for psychological torture of the kind now favoured by CIA in the 'war against terrorism'. The other sixteen chapters maintain that for as long as wars are in fact fought, it is morally urgent to limit specific destructive practices that cannot be prohibited. Two possible exceptions to the UN Charter's prohibition on all but defensive wars, humanitarian military intervention and preventive war to eliminate WMD, are evaluated; and one possible exception to the principle of discrimination, Michael Walzer's 'supreme emergency', is sharply criticized. Two other fundamental issues about the rules for the conduct of war receive extensive controversial treatment. The first is the rules to limit the bombing of dual-use infrastructure, with a focus on alternative interpretations of the principle of proportionality that limits 'collateral damage'. The second is the moral status of the laws of war as embodied in International Humanitarian Law. It is argued that the current philosophical critique of IHL by Jeff McMahan focused on individual moral liability to attack is an intellectual dead-end and that the morally best rules are international laws that are the same for all fighters.Examining real cases, including U.S. bombing of Iraq in 1991, the Clinton Administration decision not to intervene in the 1994 Rwandan genocide, NATO bombing of Serbia in 1999, and CIA torture after 9/11 and its alternatives, this book is highly accessible to general readers who are interested in the ethical status of American political life, especially foreign policy. (shrink)

If self-interested behavior conflicts with the collective welfare, rules of cooperation are often installed to prevent egoistic behavior. We hypothesized that installing such rules may instigate personal moral norms of cooperation, but that they fail in doing so when installed by a leader who is self-interested rather than self-sacrificing. Three studies confirmed this and also showed that, consequently, only self-sacrificing leaders were able to install rules that increase cooperation without the need for a perfectly operating monitoring system.

Many preventive intervention studies with adolescents address high-risk behaviors such as drug and alcohol use, and unprotected sex. Randomized controlled trials (RCT) are the gold standard methodology used to test the effectiveness of these behavioral interventions. Interventions outside the rigidly described protocol are prohibited. However, there are ethical challenges to implementing inflexible intervention protocols, especially when the target population is young, experiences many stressful events, and lives in a resource-poor environment. Teens who are at high risk for substance use (...) or sexual risk behaviors tend to be at risk for other problems such as exposure to violence, sexual and physical abuse, depression, and homelessness. How should investigators deal with the psychological and social needs of teenagers in prevention programs in an ethically appropriate way and at the same time preserve the validity of RCT results? We have identified program characteristics, participant characteristics, interaction with parents, and problems with adolescents not in the study as sources of ethical dilemmas in RCT with at-risk adolescents. As a result of our experience, we recommend that every behavioral intervention study develop an ethics protocol, which should include rules for providing help to participants, has contact information for experts to provide guidance, and an emergency procedure for dealing with life threatening situations. In addition, studies should have a resource manual, train research staff in these ethical issues, and work with a data safety and monitoring board or ethics committee. (shrink)

No one questions the importance of protecting human subjects of research, but over the past few years dissatisfaction has surfaced with the manner in which the protection is conferred by the federal regulatory system referred to as “The Common Rule. ” Some of the criticism surfaces in print. Some bubbles out anecdotally in conversations among researchers, with complaints about the review process being virtually inevitable whenever the topic arises. Like those in other disciplines that differ more or less dramatically (...) from the world of clinical medical research around which the Common Rule was conceptualized, public health researchers, particularly those working in official public health agencies, have experienced some tension and difficulty in adapting to the rules. The Centers For Disease Control and Prevention has adopted guidelines that require Common Rule review for “research” but not “practice” activities. (shrink)

Discrimination is often tremendously harmful. But cases of harmless yet morally wrongful discrimination suggest that there are factors that make discrimination wrong other than its harmfulness. This article analyzes three views that resist this conclusion and poses some challenges for each. The first view appeals to unnoticed forms of harm in cases of harmless discrimination. But it counterintuitively entails that discriminatory acts are morally wrong by definition. The second view holds that harmless discrimination is made wrong by how its perpetrator (...) wrongs the victim by disrespecting her moral status without setting back her wellbeing. But it is unclear how impermissibly wronging a person is different from unjustifiably harming her. The third view holds that, even if discriminatory acts can be made wrong by factors other than harm, they ought to be prohibited by a legal rule whose sole justification is that it prevents harm. But there may be reasons for legally prohibiting discriminatory acts other than harm prevention. (shrink)

Why do employees break organizational rules and why are organizations unable to prevent this? Past studies have suggested three predictors of rule-breaking: _predisposition_ due to normalization of rule-breaking; _pressure_ due to competitive and performance strain; and _opportunity_ to break the rules due to job characteristics associated with the assigned role and the time at work (e.g., Baucus, 1994). We used a purposive sample of 14,472 observations from 5,735 individuals nested in 199 organizations, to investigate these predictors in a (...) sports context where rule-breaking was likely to be low because of a high risk of detection and a strong compliance system. This allowed us to hold constant the effects of compliance systems and rules that were universally applied in all organizations so that we could compare differences in rule-breaking associated with predisposition, pressure, and opportunity. Compared to previous research, our method permitted us to draw four unique conclusions: (a) all three theories about predictors of rule-breaking were supported, even when all predictors were included simultaneously in a multivariate analysis; (b) individual rule-breaking was predicted by individual and organizational variables in multilevel models, suggesting that employees, the organization, and the industry all support rule-breaking under some conditions; (c) temporal precedence of predictor variables in longitudinal analysis suggested that they influenced current rule-breaking rather than the other way around; and (d) the use of a single-industry sample allowed us to collect nested data from individuals and organizations whose rule-breaking was more likely to be detected and penalized than in other industries, thus reducing undercount of rule-breaking. (shrink)

Current economic conditions have coincided with the implementation of the Health Insurance Portability and Accountability Act and forced public health officials to consider how to ethically incorporate compliance into their already strained budgets, while maintaining the integrity and intent of the legislation.As of April 14, 2003, the HIPAA Privacy Rule provides a new federal floor of protections for personal health information. The Privacy Rule establishes standards for the protection of health information held by many physicians’ offices, health plans, (...) and health care clearinghouses. The Rule protects personal health information by establishing conditions regulating the use and disclosure of individually identifiable health information by these entities, also referred to as covered entities. The Rule does not prevent the daily operations of health care establishments. (shrink)

This article combines a philosophical critique of the idea that public health nurses are primary technicians who neutrally hand over scientifically established facts on risks to the public and an empirical analysis of the actual work of public health nurses. It is argued that the relationship between facts and values in public health is complex and that, despite the introduction of several scientifically-based standards and guidelines, public health nurses are not technicians. They do moral work and experience ethical dilemmas. To (...) get a grip on the specific character of this moral work, we distance ourselves from the idea that there are ethical dilemmas in public health nursing for which we can provide general ethical rules and principles. Instead we suggest a contextual ethical approach, in which several different kinds of consideration may be important. To illustrate this, we analysed 15 in-depth interviews with nurses involved in the prevention of cot deaths in the Netherlands. It is shown that these nurses do not neutrally pass on the epidemiological facts on the risks of prone sleeping, warm bedclothes and passive smoking, but they are the moral architects of this preventive practice. It is also shown that this moral work and the ethical dilemmas they experience cannot be characterized in terms of general ethical rules and principles. It becomes clear that the moral work of nurses differs according to the three main risks at stake: the balance between virtue, risk taking and responsibility depends on the specific context. (shrink)

The aim of this Web-based survey of 15 German companies with an international profile was to identify which higher-level values serve as a basis for a company culture that promotes integrity and can thereby also be used to promote crime prevention. Results on about 2000 managers in German parent companies and almost 600 managers in Central and North European branch offices show that a major preventive role can be assigned to a company culture that promotes integrity. This requires a (...) ‘tone from the top’, ‘ethical leadership’ from the direct superior, and a general set of values that can be encouraged through training courses. Moreover, employees have to perceive these values as promoting their careers. The survey reveals that the companies in this study have basically succeeded in establishing their system of values in their Central and North European as well as their Asian branch offices. Moreover, it shows that the main values preventing crime on the management level are trustworthiness and consistency. Open communication is an important value on all levels of a company, and this is supplemented by transparency, compliance with the rules, and a rejection of behaving in one’s own interest. It is concluded that in spite of regional differences, major international companies can possibly make an important contribution to bringing about cultural change in regions with an affinity for corruption by implementing a culture that promotes integrity in both their company and their daily business. (shrink)

The article deals with the Dawson College Massacre, focusing on the story of Kimveer Gill, a 25-year-old man from Laval, Montreal who wished to murder young students in Dawson College. It is argued that the international community should continue working together to devise rules for monitoring specific Internet sites, as human lives are at stake. Preemptive measures could prevent the translation of murderous thoughts into murderous actions. Designated monitoring mechanisms of certain websites that promote violence and seek legitimacy as well (...) as adherents to the actualization of murderous thoughts and hateful messages have a potential of preventing such unfortunate events. Our intention is to draw the attention of the multifaceted international community to the shared interest and need in developing monitoring schemes for certain websites, in order to prevent hideous crimes. (shrink)

The Covid‐19 pandemic has created a clinical environment in which health care practitioners are experiencing moral distress in numerous and novel ways. In this narrative reflection, a pediatric palliative care physician explores how his hospital's strict visitation policy set the stage for moral distress when, in the early months of the pandemic, it prevented two parents from being together at the bedside of their dying child.

This volume is a revised, enlarged, and broadened version of Gert's classic 1970 book, The Moral Rules. Advocating an approach he terms "morality as impartial rationality," Gert here presents a full discussion of his moral theory, adding a wealth of new illuminating detail to his analysis of the concepts--rationality/irrationality, good/evil, and impartiality--by which he defines morality. He constructs a "moral system" that includes rules prohibiting the kinds of actions that cause evil, procedures for determining when violation of the rules is (...) permitted, and ideals which encourage actions that prevent or relieve suffering. To be valid, Gert argues, any such system must be "a public system that applies to all rational persons." The book concludes with a discussion of medical ethics, demonstrating the link between moral theory and its application to real moral problems. (shrink)

Today, certain rule-violating behaviours, such as doping, are considered to be an issue of concern for the sport community. This paper underlines and examines the affective dimensions involved in moral responses to, and attitudes towards, rule-violating behaviours in sport. The key role played by affective processes underlying individual-level moral judgement has already been implicated by recent developments in moral psychological theories, and by neurophysiological studies. However, we propose and discuss the possibility of affective processes operating on a social (...) level which may influence athletes' individual-level attitudes. We conclude that one-sided focus on individual rule-violating behaviour and individual sanctions may prove to be ineffective in coming to terms with the issue. In this regard we recommend a twofold approach by addressing underlying social dimensions, along with preventive measures through affect-oriented education. (shrink)

In this article, the Golden Rule, a central ethical value to both Judaism and Confucianism, is evaluated in its prescriptive and proscriptive sentential formulations. Contrary to the positively worded, prescriptive formulation – “Love others as oneself” – the prohibitive formulation, which forms the injunction, “Do not harm others, as one would not harm oneself,” is shown to be the more prevalent Judaic and Confucian presentation of the Golden Rule. After establishing this point, the remainder of the article is (...) dedicated to an inquiry into why this preference between the two Golden-Rule-formulations occurs. In doing so, this article discovers four main benefits to the proscriptive formulations: I) harm-doing, as opposed to generalizable moral goodness, is easier for individuals to subjectively comprehend II) the prevention of harm-doing is the most fundamental ethical priority III) the proscriptive formulation preserves self-directed discovery of what is good, thus preserving moral autonomy IV) individuals are psychologically pre-disposed toward responding to prohibitions rather than counsels of goodness. (shrink)

BackgroundThe German guidelines for liver transplantation stipulate that every patient with alcohol-related liver disease needs to prove evidence of a 6-month abstinence period before they can be admitted to the waiting list for liver transplantation. This internationally widespread abstinence rule has been criticised as it prevents patients at least temporarily from receiving an effective and potentially life-saving therapy. This poses the question of how this abstinence rule is depicted and justified by transplantation professionals.ArgumentsIn case of the 6‑month abstinence (...) rule, guidelines are used as a tool for rationing health care. Four frames of interpretation can be reconstructed from the ethical and medical literature. Each linguistically mediated frame offers a different representation of the 6‑month abstinence rule. According to these different framings, the 6‑month waiting period is depicted (1) as a diagnostic tool to determine the regenerative capacity of the liver, (2) as a prognostic tool to determine the prospects of success of a transplantation, and (3) to determine the drinking behaviour after transplantation. In a further context, the abstinence rule (4) is interpreted as an expression of an obligation to avoid behaviour harmful to health.ConclusionThese four frames provide linguistically mediated patterns of interpretation that are used by different actors to limit the indication for liver transplantation. They give rise to different ethical questions that allow a systematic ethical assessment of the 6‑month abstinence rule. (shrink)

The study sought to determine whether impression management tactics by an employee could effectively lessen the recommended punishment for an ethical rule infraction by this individual. Subjects read a vignette in which an employee violated the confidentiality of personnel records. The employee was presented as either having had a history of previous infractions or no such historical information was provided. Additionally, the employee was described as using either no impression management tactics, an apology, or a justification for his behavior. (...) Result show that in the case of a history of multiple offenses, the employee''s use of justifications effectively mitigated others'' judgments of the wrongfulness of the employee''s action, while apologies did not. Similarly, the justification appeared to lessen respondent recommendations for punishment, prevention of promotion, and demotion/firing, but only when there is a history of multiple offenses. In most cases, apologies tended to exacerbate the problem when previous offenses had been committed. The data are discussed in terms of their implications for the study of employee use of impression management tactics. (shrink)

‘The deep state’ is a theme in a recent conspiracy theory according to which opaque segments of the public administration prevent the will of the people from being fully reflected in public policy...

‘The deep state’ is a theme in a recent conspiracy theory according to which opaque segments of the public administration prevent the will of the people from being fully reflected in public policy...