In recent years, a great deal of evidence has accumulated on the health risks and environmental impacts of some herbicides. Both conventional agriculture and agroecology are searching for alternatives to address the challenges posed by the consequences of herbicide use. In this search, peasant and indigenous agroecosystems have much to contribute since their crops evolved thousands of years ago together with diverse communities of weeds, and farmers have carried out sophisticated strategies to manage them. Through participant observation, semi-structured interviews, (...) free lists, and botanical collection, we document a milpa design that integrates and manages spontaneous vegetation to take advantage of its presence and minimize risks of crop loss. The objective of this article is to critically contrast agroecological mechanisms in this milpa design which matches the prevention principle with a set of recommendations recognized as preventive in conventional weed science. (shrink)

To find the neural substrates of consciousness, researchers compare subjects’ neural activity when they are aware of stimuli against neural activity when they are not aware. Ideally, to guarantee that the neural substrates of consciousness—and nothing but the neural substrates of consciousness—are isolated, the only difference between these two contrast conditions should be conscious awareness. Nevertheless, in practice, it is quite challenging to eliminate confounds and irrelevant differences between conscious and unconscious conditions. In particular, there is an often-neglected confound that (...) is crucial to eliminate from neuroimaging studies: task performance. Unless subjects’ task performance is matched (and hence perceptual signal processing is matched), researchers risk finding the neural correlates of perception, rather than conscious perception. Here, we discuss the theoretical motivations for the performance matching framework and review empirical demonstrations of, and theoretical inferences derived from, obtaining differences in consciousness while controlling for task performance. We summarize signal detection theoretic modeling frameworks that explain how it is that we can derive performance-matched differences in consciousness without the effect being trivially driven by differences in criterion setting, and also provide principles for designing experimental paradigms that yield performance-matched differences in awareness. Finally, we address potential technical and theoretical issues that stem from matching performance across conditions of awareness, and we introduce the notion of “triangulation” for designing comprehensive experimental sets that can better reveal the neural substrates of consciousness. (shrink)

Providing meaningful and actionable explanations for end-users is a situated problem requiring the intersection of multiple disciplines to address social, operational, and technical challenges. However, the explainable artificial intelligence community has not commonly adopted or created tangible design tools that allow interdisciplinary work to develop reliable AI-powered solutions. This paper proposes a formative architecture that defines the explanation space from a user-inspired perspective. The architecture comprises five intertwined components to outline explanation requirements for a task: (1) the end-users’ mental (...) models, (2) the end-users’ cognitive process, (3) the user interface, (4) the Human-Explainer Agent, and (5) the agent process. We first define each component of the architecture. Then, we present the Abstracted Explanation Space, a modeling tool that aggregates the architecture’s components to support designers in systematically aligning explanations with end-users’ work practices, needs, and goals. It guides the specifications of what needs to be explained (content: end-users’ mental model), why this explanation is necessary (context: end-users’ cognitive process), to delimit how to explain it (format: Human-Explainer Agent and user interface), and when the explanations should be given. We then exemplify the tool’s use in an ongoing case study in the aircraft maintenance domain. Finally, we discuss possible contributions of the tool, known limitations or areas for improvement, and future work to be done. (shrink)

© 2016 Informa UK Limited, trading as Taylor & Francis Group. In this introduction, we first give a brief overview of the debate over multiculturalism in political theory. We then situate Alan Patten’s Equal Recognition in that context by highlighting his major normative thesis, according to which there are reasons of principle, in a liberal democracy, to grant special forms of public recognition and accommodation to cultural minorities. Finally, we present a succinct summary of the nine articles that follow this (...) introduction and that critically engage with Patten’s arguments. (shrink)

A basic income is typically defined as an individual’s entitlement to receive a regular payment as a right, independent of other sources of income, employment or willingness to work, or living situation. In this article, we examine what it means for the state to institute a right to basic income. The normative literature on basic income has developed numerous arguments in support of basic income as an inextricable component of a just social order, but there exists little analysis about basic (...) income within a jurisprudential or philosophical rights perspective. In our view, strong reasons of either a principled or a pragmatic nature in support of instituting a basic income scheme nevertheless often fall short of ascribing to basic income a distinctive Hohfeldian rights status. This article aims to partially redress this gap by examining two sets of questions. First, what are the implications – ethical and practical – of adopting basic income as a legal right as opposed to a mere policy? Second, we also enquire whether there should be such a right: what, if anything, is the ethical foundation that warrants granting basic income a distinctive legal rights status? This article suggests that any such foundation must be grounded in comparative evaluation and discusses several comparative strategies available to basic income advocates. The aim of this article is not to offer a definite argument in favor of a legal right to basic income, but to chart several lines of argument that a rights perspective might add to the contemporary discussion. (shrink)

Progress towards Universal Health Coverage (UHC) requires making difficult trade-offs. In this journal, Dr. Margaret Chan, the WHO Director-General, has endorsed the principles for making such decisions put forward by the WHO Consultative Group on Equity and UHC. These principles include maximizing population health, priority for the worse off, and shielding people from health-related financial risks. But how should one apply these principles in particular cases and how should one adjudicate between them when their demands conflict? This (...) paper by some members of the Consultative Group and a diverse group of health policy professionals addresses these questions. It considers three stylized versions of actual policy dilemmas. Each of these cases pertains to one of the three principal dimensions of progress towards UHC: which services to cover first, which populations to prioritize for coverage, and how to move from out-of-pocket expenditures to pre-payment with pooling of funds. Our cases are simplified to highlight common trade-offs. While we make specific recommendations, our primary aim is to demonstrate both the form and substance of the reasoning involved in striking a fair balance between competing interests on the road to UHC. (shrink)

Risk taking is a component of the decision-making process in situations that involve uncertainty and in which the probability of each outcome – rewards and/or negative consequences – is already known. The influence of cognitive and emotional processes in decision making may affect how risky situations are addressed. First, inaccurate assessments of situations may constitute a perceptual bias in decision making, which might influence RT. Second, there seems to be consensus that a proneness bias exists, known as (...) risk proneness, which can be defined as the propensity to be attracted to potentially risky activities. In the present study, we take the approach that risk perception and risk proneness affect RT behaviours. The study hypothesises that locus of control, emotion regulation, and executive control act as perceptual biases in RT, and that personality, sensation seeking, and impulsivity traits act as proneness biases in RT. The results suggest that locus of control, emotion regulation and executive control influence certain domains of RT, while personality influences in all domains except the recreational, and sensation seeking and impulsivity are involved in all domains of RT. The results of the study constitute a foundation upon which to build in this research area and can contribute to the increased understanding of human behaviour in risky situations. (shrink)

Using the principles of John Rawls' theory of justice, this book offers an alternative political vision; one which describes a mode of governance that will enable communities to implement a sustainable and socially just future. Rawls described a theory of justice that not only describes the sort of society in which anyone would like to live but that any society can create a society based on just institutions. While philosophers have demonstrated that Rawls's theory can provide a framework for (...) the discussion of questions of environmental justice, the problem for many philosophical theories is that discussions of sustainable development open the need to address questions of ecological interdependence, historical inequality in past resource use and the recognition that we cannot afford to ignore the limitations of growth. These ideas do not fit in comfortably in standard discourse about theories of justice. In contrast, this book frames the discussion of global justice in terms of environmental sustainability. The author argues that these ideas can be used to develop a coherent political theory which reconciles cosmopolitan arguments and the non-cosmopolitan or nationalist arguments concerning social and environmental justice. This book will be of great interest to students and scholars of environment philosophy and ethics, moral and political philosophy, global studies and sustainable development. (shrink)

Based on our experience in teaching ethics, we have developed, tested, and presented in this article a program of instruction that rests on four pillars: popular feature films, a six-stage ethical decision-making process, the principles necessary to address ethical situations, and the classroom instructor. Taken separately, there is nothing new or unique in these pillars. Taken together, however, and to our knowledge, these four pillars, including the requirement that each student is expected to prepare a written abstract (...) of the film prior to the classroom discussion of that film in which the student is expected to demonstrate a practical application of ethical principles to actual and concrete moral situations, constitute a new, unique, and tested way to teach ethics to undergraduate students of management and economics. (shrink)

BackgroundMoral dilemmas have arisen concerning whether physicians and other providers should treat patients who have declined COVID vaccination and are now sick with this disease. Several ethicists have argued that clinicians have obligations to treat such patients, yet providing care to these patients has distressed clinicians, who have at times declined to do so. Critical questions thus emerge regarding how best to proceed.Main bodyProviders face moral tensions: whether to place the benefits to an unvaccinated patient over their duties to (...) protect themselves and their families, staff and other patients, and goals of working collaboratively with patients. Clinicians’ duties to treat such patients arguably outweigh claims otherwise, but these obligations are creating moral conflict and distress for providers. Moral distress has been associated with burnout, post-traumatic stress disorder, and interpersonal and work difficulties. Given ongoing vaccine refusals, these problems are unlikely to disappear in the foreseeable future. Society has obligations to address this moral distress due to principles of reciprocity, and implicit social contracts, as part of which physicians risk their lives in caring for patients for the good of society as a whole. Responses are thus urgently needed at several levels: by hospitals, medical schools, professional societies, governments, media, providers and patients. Medical training on professionalism should address these stresses, probing why doctors have duties to treat these patients, but also how moral conflicts can ensue, and how best to address these tensions. Governments and institutions should thus alter relevant policies and devote more resources to addressing clinicians’ psychological strains. Institutions should also improve organizational culture. Public health organizations and the media described clinicians, earlier in the pandemic, as heroes, committed to treating COVID patients. This narrative should now be changed to highlight the strains that unvaccinated patients cause—endangering hospital staff and others.ConclusionsUnvaccinated COVID patients should receive care, but multi-level strategies, involving enhanced policies, education and practice are vital to alleviate ensuing moral distress, and thus aid these clinicians and their patients. Ethical arguments that providers must treat these patients have not considered these obligations’ effects on clinicians, but should do so. (shrink)

Dans cet article, je tente de montrer que le principe d’impartialité et de généralisation qui définit le point de vue moral s’accommode mal de la distinction entre discours moral et discours éthique proposée par Habermas. Alors que celuici relie le jugement moral à un processus de décontextualisation qui affranchit le discours de ses réferences symboliques immédiates, je suggère plutôt, à la suite d’A. Wellmer, d’y voir une règle d’impartialité immanente aux situations d’action. Dans cette foulée, je (...) propose un examen critique du Principe “U” qui gît au coeur de la Diskursethik mais aussi de la théorie du consensus sur laquelle s’appuie ce principe, tout en reconnaissant par ailleurs l’importance de la philosophie de Habermas pour la théorie morale contemporaine. A la toute fin, j’aborde la question de l’enracinement du moral point of view dans la forme de vie moderne, en suggérant que sa conception de I’impartialité est peut-être elle-même liée à une certaine représentation du bien qui lui est propre. Faut-il alors maintenir la séparation étanche qu’etablir Habermas entre discours moral et discours éthique? Rien n’est moin sûr.I attempt to show that the principle of impartiality and generalization that defines the moral point of view is irreconcilable with Habermas’s distinction between moral and ethical discourse. While Habermas imposes a process of decontextualization upon moral judgment, which frees discourse from its immediate symbolic references, I suggest, following A. Wellmer, that an impartiality rule be extracted from them. Similarly, I undertake a critical analysis of the “U” principle at the heart of the Diskursethik and the underlying consensus theory, while recognizing the importance of Habermas’s philosophy for contemporary moral theory. Finally, I address the question of the entrenchment of the moral point of view in the modern life form. I suggest that his concept of impartiality is perhaps linked to a certain representation of the good peculiar to him. Should the impermeable division established by Habermas between moral and ethical discourse be maintained? Nothing is less certain. (shrink)

Dans cet article, je tente de montrer que le principe d’impartialité et de généralisation qui définit le point de vue moral s’accommode mal de la distinction entre discours moral et discours éthique proposée par Habermas. Alors que celuici relie le jugement moral à un processus de décontextualisation qui affranchit le discours de ses réferences symboliques immédiates, je suggère plutôt, à la suite d’A. Wellmer, d’y voir une règle d’impartialité immanente aux situations d’action. Dans cette foulée, je (...) propose un examen critique du Principe “U” qui gît au coeur de la Diskursethik mais aussi de la théorie du consensus sur laquelle s’appuie ce principe, tout en reconnaissant par ailleurs l’importance de la philosophie de Habermas pour la théorie morale contemporaine. A la toute fin, j’aborde la question de l’enracinement du moral point of view dans la forme de vie moderne, en suggérant que sa conception de I’impartialité est peut-être elle-même liée à une certaine représentation du bien qui lui est propre. Faut-il alors maintenir la séparation étanche qu’etablir Habermas entre discours moral et discours éthique? Rien n’est moin sûr.I attempt to show that the principle of impartiality and generalization that defines the moral point of view is irreconcilable with Habermas’s distinction between moral and ethical discourse. While Habermas imposes a process of decontextualization upon moral judgment, which frees discourse from its immediate symbolic references, I suggest, following A. Wellmer, that an impartiality rule be extracted from them. Similarly, I undertake a critical analysis of the “U” principle at the heart of the Diskursethik and the underlying consensus theory, while recognizing the importance of Habermas’s philosophy for contemporary moral theory. Finally, I address the question of the entrenchment of the moral point of view in the modern life form. I suggest that his concept of impartiality is perhaps linked to a certain representation of the good peculiar to him. Should the impermeable division established by Habermas between moral and ethical discourse be maintained? Nothing is less certain. (shrink)

One of the predominant debates in AI Ethics is the worry and necessity to create fair, transparent and accountable algorithms that do not perpetuate current social inequities. I offer a critical analysis of Reuben Binns’s argument in which he suggests using public reason to address the potential bias of the outcomes of machine learning algorithms. In contrast to him, I argue that ultimately what is needed is not public reason per se, but an audit of the implicit moral (...) assumptions of societies within which algorithms are built and applied. Public justification is appealing since it offers us the possibility to align the decision-making outcomes of the algorithm with the core moral values of stakeholders within a constitutional democratic society. My concern is that the common moral principles that form the foundation of public reason are not necessarily neutral, as they still express specific moral ideals and normative standards even if there is moral agreement by society as a whole, or among different stakeholders within society. Appealing to such normative standards may thus still lead to algorithmic outcomes being biased as common moral values may very well still be discriminatory even though they are formed from a consensus, and even if public reason is applied as a kind of filter for potential algorithmic outcomes. Hence, I argue that these implicit moral norms within society that we take as a given in public reasoning, need to be audited from generation to generation in order to effectively mitigate potential algorithmic bias. (shrink)

Introspection is a fundamental part of our mental lives. Nevertheless, its reliability and its underlying cognitive architecture have been widely disputed. Here, I propose a principled way to model introspection. By using time-tested principles from signal detection theory (SDT) and extrapolating them from perception to introspection, I offer a new framework for an introspective signal detection theory (iSDT). In SDT, the reliability of perceptual judgments is a function of the strength of an internal perceptual response (signal- to-noise ratio) which (...) is, to a large extent, driven by the intensity of the stimulus. In parallel to perception, iSDT models the reliability of introspective judgments as a function of the strength of an internal introspective response (signal-to-noise ratio) which is, to a large extent, driven by the intensity of conscious experiences. Thus, by modelling introspection after perception, iSDT can calibrate introspection’s reliability across a whole range of contexts. iSDT offers a novel, illuminating way of thinking about introspection and the cognitive processes that support it. (shrink)

Knowledge aims to fit the world, and action to change it. In this collection of essays, Onora O'Neill explores the relationship between these concepts and shows that principles are not enough for ethical thought or action: we also need to understand how practical judgement identifies ways of enacting them and of changing the way things are. Both ethical and technical judgement are supported, she contends, by bringing to bear multiple considerations, ranging from ethical principles to real-world constraints, and (...) while we will never find practical algorithms - let alone ethical algorithms - that resolve moral and political issues, good practical judgement can bring abstract principles to bear in situations that call for action. Her essays thus challenge claims that all inquiry must use either the empirical methods of scientific inquiry or the interpretive methods of the humanities. They will appeal to a range of readers in moral and political philosophy. (shrink)

This book is an original discussion of key problems in moral theory. The author argues that the work of recent feminist theorists in this area, particularly that of Carol Gilligan, marks a radically new departure in moral thinking. Gilligan claims that there is not only one true, moral voice, but two: one masculine, one feminine. Moral values and concerns associated with a feminine outlook are relational rather than autonomous; they depend upon interaction with others. In a (...) far-reaching examination and critique of Gilligan's theory, Hekman seeks to deconstruct the major traditions of moral theory which have been dominant since the Enlightenment. She challenges the centrepiece of that tradition: the disembodied, autonomous subject of modernist philosophy. Gilligan's approach transforms moral theory from the study of abstract universal principles to the analysis of moral claims situated in the interactions of people in definite social contexts. Hekman argues that Gilligan's approach entails a multiplicity of moral voices, not just one or even two. This book addresses moral problems in a challenging way and will find a wide readership among philosopher's, feminist thinkers and psychologists. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Hume Studies Volume XXIII, Number 2, November 1997, pp. 195-212 The Moral Self and the Indirect Passions SUSAN M. PURVIANCE David Hume1 and Immanuel Kant are celebrated for their clear-headed rejection of dogmatic metaphysics, Hume for rejecting traditional metaphysical positions on cause and effect, substance, and personal identity, Kant for rejecting all judgments of experience regarding the ultimate ground of objects and their relations, not just judgments of (...) cause and substantiality. Nevertheless, each argues that practical activity is not compromised by the rejection of metaphysical claims that others had taken to be crucial. Kant and Hume thought that political and moral life did not depend upon theoretical knowlege of the nature of the self, free will, or knowledge of the true motives of actions or the character of the agent. Because the grounds of morality and politics were too important to leave to the mercies of speculative metaphysics, each moved their foundations to higher ground, insulating the grounds of practical activity from the threat of metaphysical turmoil and skepticism. Contemporary philosophers have generally followed Hume and Kant in this regard, but often select very different strategies. Some think that the best way to avoid the problems associated with contemporary scientific ontologies is to separate ethics from the factual domain entirely. Some give moral and political language a noncognitivist interpretation, and others have interpreted values as a projection of the passions and affections of the subject or as the constructions of suitably situated practical reasoners.2 At the same time there has been a resurgence of interest in moral realism. Moral realists think that the objectivity of moral discourse, and hence the Susan M. Purviance is at the Department of Philosophy, The University of Toledo, Toledo OH 43606-3390 USA. 196 Susan M. Purviance possibility of moral truth, depend upon the existence of moral facts.3 Moral realists have tended to concentrate on the role of facts in establishing the truth of general moral principles, or the Tightness or moral value of particular individual actions. For moral realists, moral facts are the states of affairs that make general moral principles or particular moral judgments true. Whether these facts are of a naturalistic sort or not, whether they are literally on a par with natural facts, or whether they simply play the same role in practical knowledge that natural facts play in theoretical knowledge, is an open question. Moral realists often are naturalists, like David O. Brink and Jonathan Dancy, but they may be nonnaturalists, like G. E. Moore.4 Ethical naturalism accounts for moral motivation and the cultivation of good character in terms of moral qualities, and many hope to ground it in (or at least show that it is compatible with) the scientific understanding of objects and their relations and qualities. Naturalism is only one option, but realism has received support because it is not clear that antirealists have developed a convincing alternative to the grounding of concepts of moral agency and moral judgment in some sort of moral facts. Questions abound about what it means to ascribe responsibility to a moral self and how we can defend a notion of enduring character. Although moral realists have paid less attention to the ontological status of virtues and character traits than to moral principles, their status is equally important. Here the concern is with the sort of metaphysics of the self thought to be necessary to account for moral agency, responsibility, praise, and blame. I shall argue that there is a class of moral facts that justify or perhaps merely vindicate the ascription of moral powers to agents, and that these are the sorts of facts another sort of theorist is interested in, whereas the states of affairs that make moral judgments true are the sorts of facts that moral realists have been interested in. In order to distinguish this use of moral facts I shall call this sort of theory a Fact of Agency Theory, and it is a version of this theory that can be found in Hume's discussion of the problem of the self and the indirect passions. A realist metaphysics of morals needs to address two questions, the question of the reality of the... (shrink)

This book is an original discussion of key problems in moral theory. The author argues that the work of recent feminist theorists in this area, particularly that of Carol Gilligan, marks a radically new departure in moral thinking. Gilligan claims that there is not only one true, moral voice, but two: one masculine, one feminine. Moral values and concerns associated with a feminine outlook are relational rather than autonomous; they depend upon interaction with others. In a (...) far-reaching examination and critique of Gilligan's theory, Hekman seeks to deconstruct the major traditions of moral theory which have been dominant since the Enlightenment. She challenges the centrepiece of that tradition: the disembodied, autonomous subject of modernist philosophy. Gilligan's approach transforms moral theory from the study of abstract universal principles to the analysis of moral claims situated in the interactions of people in definite social contexts. Hekman argues that Gilligan's approach entails a multiplicity of moral voices, not just one or even two. This book addresses moral problems in a challenging way and will find a wide readership among philosopher's, feminist thinkers and psychologists. (shrink)

Situated within the framework of Confucian family-oriented ethics, this book explores the issue of familial partiality and specifically discusses whether it is morally praiseworthy to love one's family partially. In reviewing the tension between familial partiality and egalitarian impartiality from different perspectives while also drawing on binary metrics to understand the issue - that is, the weak and strong sense of familial partiality in Confucian moral theory - the author carefully discusses the efficacy of three major arguments to justify (...) moral partiality. It is concluded that the tree argument fails to justify moral partiality in Confucianism, the evolutionary argument only justifies moral partiality in the weak sense that we should devote more resources to our family, and the care argument fails to justify moral partiality in the strong sense that family takes priority in any case even at the expense of the principle of justice. Seeking to address the quandary, the author advances an alternative argument based on Thomas Aquinas' theory of love to interpret Confucian view of partial relationships, holding that partial treatment is assumed in partial relationships. The title will appeal to scholars and students interested in Confucianism, Chinese Philosophy, Moral Philosophy, and Comparative Philosophy. (shrink)

Can the theory of conceptual spaces developed by Peter Gärdenfors and others be applied to moral issues? Martin Peterson argues that several moral principles can be construed as regions in a shared similarity space, but Kristin Shrader-Frechette and Gert-Jan Lokhorst question Peterson’s claim. They argue that the moral similarity judgments used to construct the space are underspecified and subjective. In this paper, we present new data indicating that moral principles can indeed be construed as (...) regions in a multidimensional conceptual space on the basis of moral similarity judgments. Four hundred and seventy-five students taking a course in engineering ethics completed a survey in which they were presented with ten cases featuring ethical issues related to technology and engineering. Participants were asked to judge the moral similarity of each pair of cases and to select which moral principle they believed should be applied for resolving the case. We used interval multidimensional scaling as well as individual differences scaling for analyzing the moral similarity judgments. Despite noteworthy individual variations in the judgments, the five moral principles included in the study were discernable in the aggregate multidimensional spaces, even for participants with no previous exposure to the principles. Participants tended to apply the same moral principles to cases rated as morally similar. Our overall conclusion is that moral similarity judgments, and their representation in multidimensional spaces, can help us identify moral principles that are relevant for assessing difficult moral choice situations. (shrink)

Modern ethics has been chiefly concerned with the analysis of the conditions and principles of morality; and, in particular, one of its most important achievements has been the further elucidation of the Kantian dictum that “I ought” implies that I can. On the face of it Kant's contention seems perfectly straightforward, but, on examination, it becomes apparent that the simple word “can” covers a somewhat complicated ambiguity. When it is said that I ought to do act A, it may (...) rightly be taken that I can do act A; but the question arises whether or not this in turn involves that I am aware that I can do act A. There is clearly some significance in the assertion that I can do many acts which, however, never occur to me, either because I am ignorant of certain facts or because I have a mistaken opinion about the facts. On the other hand, it may quite properly be said that I cannot perform any act of the possibility of which I am unaware. The problem then is to determine and examine the sense of the word “can” which is a pre-condition of moral obligation. (shrink)

Many alternatives or supplements to principalism seek to reconnect medical ethics with the thoughts, feelings, and motivations of the persons directly involved in ethically troublesome situations. This shift of attention, from deeds to doers, from principles to principals, acknowledges the importance of the moral agents involved in the situation — particular practitioners, patients, and families. Taking into account the subjective, lived experience of moral decision-making parallels recent efforts in the teaching of medicine to give the patient''s (...) subjectivity — his or her personal experience of being sick or disabled — epistemological parity with scientific medicine''s objective, biomedically-oriented view of the person''s sickness or disability.Moreover, the shift from principalism to principals signals a growing realization that ethical problems in the profession of medicine are inseparable from its practice. Philosophers and other humanists working in medicine should resist the temptation to institutionalize a professional role as solver of ethical problems, clarifier of values, or mediator of disputes and work instead to help practitioners practice medicine reflectively. (shrink)

There is a growing body of scholarship that is addressing the ethics, in particular, the bioethics of space travel and colonisation. Naturally, a variety of perspectives concerning the ethical issues and moral permissibility of different technological strategies for confronting the rigours of space travel and colonisation have emerged in the debate. Approaches ranging from genetically enhancing human astronauts to modifying the environments of planets to make them hospitable have been proposed as methods. This paper takes a look at a (...) critique of human bioenhancement proposed by Mirko Garasic who argues that the bioenhancement of human astronauts is not only functional but necessary and thus morally permissible. However, he further claims that the bioethical arguments proposed for the context of space do not apply to the context of Earth. This paper forwards three arguments for how Garasic’s views are philosophically dubious: (1) when he examines our responsibility towards future generations he refers to a moral principle (which we will call the principle of mere survival) which, besides being vague, is not morally acceptable; (2) the idea that human bioenhancement is not natural is not only debatable but morally irrelevant; and (3) it is not true that the situations that may arise in space travel cannot occur on Earth. We conclude that not only is the (bio)enhancement of humans on Earth permissible but perhaps even necessary in certain circumstances. (shrink)

The prioritisation of scarce resources has a particular urgency within the context of the COVID‐19 pandemic crisis. This paper sets out a hypothetical case of Patient X (who is a nurse) and Patient Y (who is a non‐health care worker). They are both in need of a ventilator due to COVID‐19 with the same clinical situation and expected outcomes. However, there is only one ventilator available. In addressing the question of who should get priority, the proposal is made that the (...) answer may lie in how the pandemic is metaphorically described using military terms. If nursing is understood to take place at the ‘frontline’ in the ‘battle’ against COVID‐19, a principle of military medical ethics—namely the principle of salvage—can offer guidance on how to prioritise access to a life‐saving resource in such a situation. This principle of salvage purports a moral direction to return wounded soldiers back to duty on the battlefield. Applying this principle to the hypothetical case, this paper proposes that Patient X (who is a nurse) should get priority of access to the ventilator so that he/she can return to the ‘frontline’ in the fight against COVID‐19. (shrink)

This essay situates some recent empirical research on the origin, nature, role, and reliability of moral intuitions against the background of nineteenth-century debates between ethical naturalism and rational intuitionism. The legitimate heir to Millian naturalism is the contemporary method of reflective equilibrium and its defeasible reliance on moral intuitions. Recent doubts about moral intuitions—worries that they reflect the operation of imperfect cognitive heuristics, are resistant to undermining evidence, are subject to framing effects, and are variable—are best addressed (...) by ethical naturalism as part of a broad dialectical equilibrium. (shrink)

As a moral principle toleration is universal, but only in the sense that potentially it is addressed to every rational and moral agent. The question is whether this principle is appropriate in all situations and what are those moral agents who recognize its practical actuality for them? Toleration is not an absolute ethical principle, but one among others in the context of a particular moral system. It should be given a proper place in the hierarchy (...) of principles. Understanding toleration as the absolute or even overriding principle may lead in the face of obvious and directly threatening wrong to its use as an umbrella for adoptive or escapist behavior. The limits to toleration are given by basic and minimal ethical task to resist evil. The principle of active opposition to evil by all possible means is prior to the principle of toleration. (shrink)

Departing from hypothetical dilemmas and drawing on examples from law, this paper offers a pragmatist account of normative induction that characterizes moral particularism and generalism as stages of inquiry into ethical problems, rather than rival accounts of moral knowledge and motivation. Pragmatism’s response to analytical moral theory lies in understanding the transformative nature of John Dewey’s social continuum of inquiry. The continuum is unrecognized in the analysis of hypothetical dilemmas, like the trolley problem, but can clearly be (...) seen in studies of law. Real moral dilemmas represent actual conflicts, of which the dimensions emerge through experience and the solution cannot be addressed through the analysis of cleverly balanced moral puzzles. Repeated over time, real problems drive the consensual formation and revision of social practices and the predication of general moral rules and principles. Ethical particularism holds that the evaluative cannot be “cashed out” propositionally, and that it is descriptively “shapeless.” It fails to recognize that real moral problems occur in a continuum, and at first encounter a shapeless particularist context of seemingly unlimited non-moral properties. Normativity is driven by repetition of similar situations toward shared practices and descriptive predication. Rather than a Dancian retention of epistemic status by defeated reasons, this illustrates retirement of relevant properties and accompanying reasons, transformation of the reasons environment, and a pluralist normative ontology. (shrink)

This work has been selected by scholars as being culturally important, and is part of the knowledge base of civilization as we know it. This work was reproduced from the original artifact, and remains as true to the original work as possible. Therefore, you will see the original copyright references, library stamps (as most of these works have been housed in our most important libraries around the world), and other notations in the work.This work is in the public domain in (...) the United States of America, and possibly other nations. Within the United States, you may freely copy and distribute this work, as no entity (individual or corporate) has a copyright on the body of the work.As a reproduction of a historical artifact, this work may contain missing or blurred pages, poor pictures, errant marks, etc. Scholars believe, and we concur, that this work is important enough to be preserved, reproduced, and made generally available to the public. We appreciate your support of the preservation process, and thank you for being an important part of keeping this knowledge alive and relevant. (shrink)

This chapter looks closely at the use of resilience as a value in pandemic discourses, and particularly at how it reflects the moral complexity of the situation the pandemic presents: an extended crisis where shocks and stressors interact and have an uncertain end. We review key aspects of how resilience has been conceptualised, generally speaking, focusing on its normative implications. Insofar as resilience is suggested as a goal, or used to evaluate individuals, groups and systems, the rhetorical use of (...) resilience in the pandemic has moral implications that we unpack. Asking questions such as resilience to what, of what, and for whom, drives our analysis of the multiple scales at which morally relevant factors must be considered, in terms of distance and certainty, and across space and over time. Further, we highlight the importance of particularly challenging, intersecting scales both within and beyond the pandemic, such as the interaction between other- and self-regarding concerns and the tension between transformation and conservation, as we consider when to take up opportunities for improving ourselves, our society and our systems, in times of extended crises and radical change. Given that a ‘return to normal’ is neither universally desirable nor likely, we recommend in this chapter ways to address resilience as a value that can shape approaches to policy and behaviour while also being explicit about the normative—evaluative and also prescriptive—implications of its use. (shrink)

The politics of climate change is marked by the fact that countries are dragging their heels in doing what they ought to do; namely, creating a binding global treaty, and fulfilling the duties assigned to each of them under it. Many different agents are culpable in this failure. But we can imagine a stylised version of the climate change case, in which no agents are culpable: if the bad effects of climate change were triggered only by crossing a particular threshold, (...) and it was reasonably, but mistakenly, believed by each country that insufficiently many other countries were willing to cooperate in order for that threshold to remain uncrossed, no country would be required to make a unilateral contribution. Yet even without culpability, we can diagnose a moral ill: the world has gone other than it should have. If not for the mistaken beliefs, there would have been a global climate treaty, and all the avoidance of future suffering that would come with it. In this article I argue that this moral ill has implications for the non-culpable agents, in that it generates duties to disgorge actual holdings over and above the counterpart holdings in the relevant counterfactual: those holdings the agents would have had, were the world to have gone as it should. (shrink)

University students will be our future business leaders, and will have to address social problems caused by business by implementing solutions such as social entrepreneurship ventures. In order to facilitate the learning process that will foster social entrepreneurship, however, a more holistic pedagogy is needed. Based on learning theory, we propose that students’ social entrepreneurship actions will depend on their learning about CSR and their absorptive capacity. We propose that instructors and higher education institutions can enhance this absorptive capacity (...) by exploiting Web 2.0 technologies. We tested our proposition with a sample of 425 university students using structural equation modeling and found support for the proposed relationships. (shrink)

International business faces a host of difficult moral conflicts. It is tempting to think that these conflicts can be morally resolved if we gained full knowledge of the situations, were rational enough, and were sufficiently objective. This paper explores the view that there are situations in which people in business must confront the possibility that they must compromise some of their important principles or values in order to protect other ones. One particularly interesting case that captures (...) this kind of situation is that of Google and its operations in China. In this paper, I examine the situation Google faces as part of the larger issue of moral compromise and integrity in business. Though I look at Google, this paper is just as much about the underlying or background views Google faces that are at work in business ethics. In the process, I argue the following: First, the framework Google has used to respond to criticisms of its actions does not successfully or obviously address the important ethical issues it faces. Second, an alternative ethical account can be presented that better addresses these ethical and human rights questions. However, this different framework brings the issue of moral compromise to the fore. This is an approach filled with dangers, particularly since it is widely held that one ought never to compromise one’s moral principles. Nevertheless, I wish to propose that there may be a place for moral compromise in business under certain conditions, which I attempt to specify. (shrink)

Our pains can be more or less intense, our mental imagery can be more or less vivid, our perceptual experiences can be more or less striking. These degrees of intensity of conscious experiences are all manifestations of a phenomenal property I call mental strength. In this article, I argue that mental strength is a domain-general phenomenal magnitude; in other words, it is a phenomenal quantity shared by all conscious experiences that explains their degree of felt intensity. Mental strength has been (...) largely overlooked in favor of mental states’ type, representational contents, domain-specific phenomenology, or processes such as attention. Considering mental strength in our reflections about the mind illuminates debates about the relation of representational contents and phenomenal character, and it also helps address questions about the structure and functions of consciousness. Mental strength provides a unifying construct to model what is shared in the phenomenology of different types of conscious experiences. (shrink)

Arguably the most foundational principle in perception research is that our experience of the world goes beyond the retinal image; we perceive the distal environment itself, not the proximal stimulation it causes. Shape may be the paradigm case of such “unconscious inference”: When a coin is rotated in depth, we infer the circular object it truly is, discarding the perspectival ellipse projected on our eyes. But is this really the fate of such perspectival shapes? Or does a tilted coin retain (...) an elliptical appearance even when we know it’s circular? This question has generated heated debate from Locke and Hume to the present; but whereas extant arguments rely primarily on introspection, this problem is also open to empirical test. If tilted coins bear a representational similarity to elliptical objects, then a circular coin should, when rotated, impair search for a distal ellipse. Here, nine experiments demonstrate that this is so, suggesting that perspectival shapes persist in the mind far longer than traditionally assumed. Subjects saw search arrays of three-dimensional “coins,” and simply had to locate a distally elliptical coin. Surprisingly, rotated circular coins slowed search for elliptical targets, even when subjects clearly knew the rotated coins were circular. This pattern arose with static and dynamic cues, couldn’t be explained by strategic responding or unfamiliarity, generalized across shape classes, and occurred even with sustained viewing. Finally, these effects extended beyond artificial displays to real-world objects viewed in naturalistic, full-cue conditions. We conclude that objects have a remarkably persistent dual character: their objective shape “out there,” and their perspectival shape “from here.”. (shrink)

This paper proposes a novel use of tax policy to address one of the most pressing issues arising from economic globalization and international migration, that of “brain drain” – in particular, the migration of certain skilled and highly trained or educated professionals from less and least developed countries to wealthy “western” countries. This problem is perhaps most pressing in relation to doctors, nurses, and other medical professionals, but exists also for teachers, lawyers, economists, engineers, and other highly skilled or (...) trained professionals. While there have been other proposals in the past to use tax policy to address brain drain (most famously versions of the so-called “Bhagwati Tax”, a form of exit tax), in this paper I provide an account of and justification for using tax credits, modeled loosely on the foreign tax credits U.S. citizens receive in certain situations for taxes paid in other countries. My proposal avoids several of the pitfalls of other methods of using tax policy to ameliorate the harms of brain drain, as it does not subject people from the developing world to potentially onerous double taxation, and does not depend on sophisticated tax collection capabilities within developing countries, capabilities which are often lacking. Additionally, my proposal also leads to fewer morally problematic restrictions on the liberty of citizens of less and least developed countries than do non-taxed based alternative proposals, such as temporary bans on migration. While the proposal cannot hope to completely solve the problems that arise in relation to brain drain – no approach can do this – it does provide a straightforward way to ameliorate the problems that arise from it without placing significant financial or liberty burdens on already less advantaged people from the developing world. -/- (This paper may be downloaded for free from the link to my SSRN page below). (shrink)

: We may better understand the development of the Neo-Confucian religiousethical tradition in East Asia if we can discern the different ways that the scholars of Japan and Korea reacted to and adjusted the discourse of the tradition. Focusing on the optimistic concept of human nature and an ethic of situation developed by the Kogakuha scholars in Japan, we will contrast them with the more rigoristic philosophy of kyŏng (reverential seriousness) and an ethic of principle emphasized by the Korean Neo-Confucian (...) thinkers Yi T'oegye and Yi Yulgok. By doing so, we attempt to delineate the salient characteristics of the Japanese and Korean traditions of moral culture. (shrink)

Crisis requires society to renew itself, albeit in a disruptive way. The current Covid-19 pandemic is transforming ways of working, living, and relating to each other on a global level, suddenly and dramatically. This paper focuses on the field of education to show how higher education institutions are undergoing radical transformations driven by the need to digitalize education and training processes in record time with academics who lack innate technological capabilities for online teaching. The university system must strive to overcome (...) this situation to be competitive and provide high-quality education in a scenario of digital transformation, disruptive technological innovations, and accelerated change. To achieve these goals, this paper explains some barriers and challenges that universities encounter, as well as technological resources and methodologies they have used in the current scenario to transform higher education to face Covid-19 disruption. The discussion and conclusion synthesize significant insights that can be applied to the digitalization of education in the foreseeable future. (shrink)

According to Wringe 2006 we have good reasons for accepting the existence of Global Collective Obligations - in other words, collective obligations which fall on the world’s population as a whole. One such reason is that the existence of such obligations provides a plausible solution a problem which is sometimes thought to arise if we think that individuals have a right to have their basic needs satisfied. However, obligations of this sort would be of little interest – either theoretical or (...) practical – if they did not give rise, either directly or indirectly, to any kinds of reasons for individuals to behave in certain ways. -/- In this paper, I shall argue that in many situations, forward-looking global obligations give rise to an obligation on individuals to work towards bringing into existence and support an institutional system which will enable their obligations to be met. My argument for this conclusion involves two steps. In the first step, I address a general question about how collective obligations can give rise to individual obligations without being reducible to them, and which obligations they give rise to. Here I give a Kant-inspired argument, based on the principles that ‘ought implies can’ and that the content of the moral law is given by reflecting on how agents should legislate in a kingdom of ends, which is designed to show that collective obligations can give rise to individual obligations. In the second step I apply this principle to the case of global forward-looking obligations. (shrink)

A new variational method, the principle of least radix economy, is formulated. The mathematical and physical relevance of the radix economy, also called digit capacity, is established, showing how physical laws can be derived from this concept in a unified way. The principle reinterprets and generalizes the principle of least action yielding two classes of physical solutions: least action paths and quantum wavefunctions. A new physical foundation of the Hilbert space of quantum mechanics is then accomplished and it is used (...) to derive the Schrödinger and Dirac equations and the breaking of the commutativity of spacetime geometry. The formulation provides an explanation of how determinism and random statistical behavior coexist in spacetime and a framework is developed that allows dynamical processes to be formulated in terms of chains of digits. These methods lead to a new foundation for Lorentz transformations and special relativity. The Parker-Rhodes combinatorial hierarchy is encompassed within our approach and this leads to an estimate of the interaction strength of the electromagnetic and gravitational forces that agrees with the experimental values to an error of less than one thousandth. Finally, it is shown how the principle of least-radix economy naturally gives rise to Boltzmann’s principle of classical statistical thermodynamics. A new expression for a general nonequilibrium entropy is proposed satisfying the Second Law of Thermodynamics. (shrink)

This edited volume presents a post-humanist reflection on education, mapping the complex transdisciplinary pedagogy and theoretical research while also addressing questions related to marginalised voices, colonial discourses, and the relationship between theory and practice. Exhibiting a re-imagination of education through themed relationalities that can transverse education, this cutting-edge book highlights the importance of matter in educational environments, enriching pedagogies, teacher-student relationships and curricular innovation. Chapters present contributions that explore education through various international contexts and educational sectors, unravelling educational implications with (...) reference to the climate change crisis, migrant children in education, post-pandemic education, feminist activisism and other emergent issues. The book examines the ongoing iterations of the entanglement of colonization, modernity, and humanity with education to propose a possibility of education capable of upholding heterogeneous worlds. Curated with a global perspective on transversal relationalities and offering a unique outlook on posthuman thoughts and actions related to education, this book will be an important reading for students, researchers and academics in the fields of philosophy of education, sociology of education, post humanism and new materialism, curriculum studies, and educational research. (shrink)

Claims about the transformations enabled by modern science and medicine have been accompanied by an unsettling question in recent years: might the knowledge being produced undermine--rather than further--human and animal well being? On the Dual Uses of Science and Ethics examines the potential for the skills, know-how, information, and techniques associated with modern biology to serve contrasting ends. In recognition of the moral ambiguity of science and technology, each chapter considers steps that might be undertaken to prevent the deliberate (...) spread of disease. Central to achieving this aim is the consideration of what role ethics might serve. To date, the ethical analysis of the themes of this volume has been limited. This book remedies this situation by bringing together contributors from a broad range of backgrounds to address a highly important ethical issue confronting humanity during the 21st century. (shrink)

PHOTO ID 121339257© Designer491| Dreamstime.com ABSTRACT When physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be apparent conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters future physicians’ commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. We use an ethical dilemma that was presented to a group of third-year medical students to examine how ethics education might be causing (...) them to give undue deference to autonomy, thereby undermining their commitment to beneficence. INTRODUCTION The right of patients to choose which treatments they prefer is rooted in today’s social mores and taught as a principle of medical ethics as respect for autonomy. Yet, when physicians use their clinical knowledge and skills to advance the well-being of their patients, there may be a conflict between patient autonomy and physician beneficence. We are skeptical that today’s medical ethics education adequately fosters a commitment to beneficence, which is both rationally defensible and fundamentally consistent with patient autonomy. I. An Ethical Dilemma The impetus for this paper arose when students who were completing their third clinical year discussed a real-life ethical dilemma. A middle-aged man developed a pulmonary hemorrhage while on blood thinners for a recently placed coronary stent. The bleeding was felt to be reversible, but the patient needed immediate intubation or he would die. The cardiologist was told that the patient previously expressed to other physicians that he never wanted to be intubated. However, the cardiologist made the decision to intubate the patient anyway, and the patient eventually recovered.[1] Students were asked if they believed that the cardiologist had acted ethically. Their overwhelming response was, “No, the patient should have been allowed to die.” We looked into how students applied ethical reasoning to conclude that this outcome was ethically preferred. To explore how the third-year clinical experience might have formed the students’ judgment, we presented the same case to students who were just beginning their third year. Their responses were essentially uniform in recommending intubation. While there is likely more than one reasonable view in this case, we agree with the physician and the younger medical students that intubation was the ethically appropriate decision and will present an argument for it. But first, we explain the reasoning behind the more advanced medical students’ decision to choose patient autonomy at the expense of beneficence. II. Medical Ethics Education and the Priority of Autonomy Beauchamp and Childress’s Principles of Biomedical Ethics, first published in 1979 and now in its 8th edition, is a significant part of the formal ethics education in medical school.[2] Students learn an ethical decision-making approach based on respect for four ethical principles: autonomy, beneficence, nonmaleficence, and justice. While Beauchamp and Childress officially afford no prima facie superiority to any principle, the importance of respect for patient autonomy has increased through the editions of their book. For example, early editions of their book opposed the legalization of physician-assisted death compared to recent editions that defended it.[3] As another example, Beauchamp and Childress make paternalism harder to justify by adding an autonomy-protecting condition to the list of conditions for acceptable paternalism.[4] Authority, they contend, need not conflict with autonomy—provided the authority is autonomously chosen.[5] “The main requirement,” they write, “is to respect a particular patient’s or subject’s autonomous choices, whatever they may be.[6] In the principlism of Beauchamp and Childress, autonomy now seems to have a kind of default priority.[7] However, the bioethics discourse has strong counternarratives, noting some movement to elevate the role of beneficence and to respect the input of stakeholders, including the family and the healthcare team. Ethics education achieves particular relevance in the third clinical year when students become embedded in the care of patients and learn from what has been called the informal curriculum. They observe how attending physicians approach day-to-day ethical problems at the patient’s bedside. In this context, students observe the importance of informed consent for serious treatments or invasive procedures, a practice that highlights the principle of patient autonomy. In both the formal and informal curriculum, medical students observe how, in the words of Paul Wolpe, “patient autonomy has become the central and most powerful principle in ethical decision-making in American medicine.”[8] In short, students appear to learn a deference for patient autonomy. This curricular shift in favor of autonomy coincides with legal developments that protect patients’ rights and decision-making with respect to their healthcare choices. The priority of autonomy in medicine benefits patients by reflecting their choices and, in some cases, their fundamental liberty. III. The Practice of Medicine and the Commitment to Beneficence There are many critiques of the dominant place that autonomy has in biomedical ethics,[9] especially considering that autonomy seems to be biased toward individualistic, Western, and somewhat American culture-driven values.[10] In addition, many bioethical dilemmas are cast as a conflict between autonomy and beneficence. Our point is that medical students bring to their study of medicine a commitment to beneficence that seems to be suppressed by practical ethics education. We think this commitment is rationally defensible and should be nurtured. It is striking that young medical students have a pre-reflective commitment to beneficence at all. For, as we mentioned, it is not just medicine but Western culture generally that prioritizes autonomy in settling ethical dilemmas. In wanting to act for the good of others (rather than simply agreeing to what others want), physicians are already swimming somewhat against the cultural tide.[11] However, doing so makes sense, given the nature of medicine and the profession of healing. When prospective medical students are asked why they wish to become physicians, the usual answer is some variation on caring for the sick and preventing disease. It is unlikely that a reason to become a physician is to respect a patient’s autonomy. It would be easy to dismiss medical students’ commitment to beneficence as a mere intuition and contrary to a more reasoned and deliberative approach. Beauchamp and Childress seem to minimize the value of physician intuition, stating that justifications for certain procedures are “…supported by good reasons. They need not rest merely in intuition or feeling.”[12] Henry Richardson writes that “situational or perceptive intuition…leaves the reasons for decision unarticulated.”[13] We think this is a crude and rather thin way of understanding intuition. Some bioethicists have defended intuition as essential to the practice of medicine and not something opposed to reason.[14] In the case we describe, we believe the ethical justifications s for the patient’s intubation are fundamentally sound: the patient did not have a “do not intubate” order written in the chart, the emergency intubation had not been foreseen, so the patient did not have the opportunity to consent to or reject intubation; the patient had consented to the treatment for his cardiac disease so his consent for intubation could have been assumed;[15] and the consequences of respecting his autonomy did not justify allowing him to die.[16] While it is possible to have more than one reasonable view on this case, we think the case for beneficence is strong and certainly should not be dismissed out of hand. We do not deny that if a patient makes a clearly documented, well-informed decision to forgo intubation that this decision ought to be respected by the physician (even if the physician disagrees with the patient’s decision). But, in this situation, as in many others in the practice of medicine, the patient’s real wishes and preferences are not well-articulated in advance. There are many cases where a physician acts based on what she believes the patient, or the surrogate, would want, sometimes in situations that do not allow much time for reflection. An example might be resuscitation of a newborn at the borderline of viability. In their ethics education, beneficence would mean acting first to save a life. If the patient or surrogate makes an informed decision to the contrary, a beneficent physician respects that autonomous decision. In the case presented, the patient expressed gratitude to the cardiologist when extubated. But what if he had expressed anger at the physician for violating his autonomy? There are those who could argue that not only was intubation ethically wrong but that the cardiologist put himself in legal jeopardy by his actions (especially if there had been a written refusal applicable to the specific situation). In the example we use, we point out that the cardiologist may not have escaped a lawsuit if the patient had died without intubation. His family, when hearing the circumstances, may have sued for failure to act and dereliction of the cardiologist’s duty to save him. Beyond a potential legal challenge for either action or inaction, there is an overriding ethical question the cardiologist had to address: what course would be most satisfying to his conscience? Would he rather allow a patient to die for fear of recrimination, or act to save his life, regardless of the personal consequences? In the absence of real knowledge about the patient’s considered wishes, it is most reasonable to err on the side of promoting patient well-being. A physician’s commitment to beneficence is not necessarily a way of undermining a patient’s autonomy. In acting for the patient's good, physicians are also acting on what it is reasonable to believe a patient (or most patients, perhaps) would want, which is obviously connected to what a patient does want. Pellegrino and Thomasma argue that beneficence includes respect for a patient’s autonomy since “the best interests of the patient are intimately linked with their preferences.”[17] Instead of conceptualizing ethical dilemmas in medicine as conflicts between autonomy and beneficence, it is possible that medical schools could teach students that truly practicing beneficence is a way of valuing patient autonomy, especially when the patient’s wishes are not specific to the situation and are not clearly expressed. CONCLUSION It is important for students and practicing physicians to understand the principle of respect for patient autonomy in a pluralistic society that demands personal self-determination. However, the role of the physician as a beneficent healer should not be diminished by this respect for autonomy. Respecting a patient’s autonomy is grounded in and manifested by physician beneficence.[18] That is, seeking what is good for the patient can only be good if it respects their personhood and dignity. We propose that a commitment to beneficence, incipient in young medical students, should be developed over time with their other clinical reasoning skills. Such a commitment need not be sacrificed on the altar of patient autonomy. Beneficence needs greater relative moral weight with students as they proceed in their ethics education. - [1] S. Jauhar, “When Doctors Need to Lie,” New York Times, February 22, 2014, https://www.nytimes.com/2014/02/23/opinion/sunday/when-doctors-need-to-lie.html. [2] T. L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019). [3] Louise A. Mitchell, “Major Changes in Principles of Biomedical Ethics,” The National Catholic Bioethics Quarterly 14, no. 3 (2014): 459–75, https://doi.org/10.5840/ncbq20141438. [4] Tom L. Beauchamp and James F. Childress, Principles of Biomedical Ethics, 8th ed. (New York, NY: Oxford University Press, 2019), 238. [5] Beauchamp and Childress, 103. [6] Beauchamp and Childress, p. 108. [7] For other accounts that prioritize autonomy, see e.g. Allen E. Buchanan and Dan W. Brock, Deciding for Others: The Ethics of Surrogate Decision Making (Cambridge University Press, 1989), 38–39; R Gillon, “Ethics Needs Principles—Four Can Encompass the Rest—and Respect for Autonomy Should Be ‘First among Equals,’” Journal of Medical Ethics 29, no. 5 (October 2003): 307–12, https://doi.org/10.1136/jme.29.5.307. For examples of critiques of these accounts, see footnote 9. [8] P. R. Wolpe, “The Triumph of Autonomy in American Bioethics: A Sociological View,” in Bioethics and Society: Constructing the Ethical Enterprise, p. 43. [9] V. A. Entwistle et al., “Supporting Patient Autonomy: The Importance of Clinician-Patient Relationships,” Journal of General Internal Medicine 25, no. 7 (July 2010): 741–45; C. Foster, Choosing Life, Choosing Death: The Tyranny of Autonomy in Medical Ethics and Law, 1st ed. (Oxford ; Hart Publishing, 2009); O. O’Neill, Autonomy and Trust in Bioethics, The Gifford Lectures, University of Edinburgh 2001 (Cambridge, UK: Cambridge University Press, 2002). [10] P. Marshall and B. Koenig, “Accounting for Culture in a Globalized Bioethics,” The Journal of Law, Medicine & Ethics: A Journal of the American Society of Law, Medicine & Ethics 32, no. 2 (2004): 252–66; R. Fan, “Self-Determination vs. Family-Determination: Two Incommensurable Principles of Autonomy,” Bioethics 11, no. 3–4 (1997): 309–22. [11] Arguments stressing the importance of beneficence, as ours does here, certainly approach paternalistic arguments. We set aside the complex issue of paternalism for purposes of this paper and simply note that the principle of beneficence as such does not say anything specifically about acting against the patient’s will. In the case study that focuses this paper, we do not believe the patient’s will or wishes were clearly indicated. [12] Beauchamp and Childress, Principles of Biomedical Ethics, p. 20, see note 2 above. [13] H. S. Richardson, “Specifying, Balancing, and Interpreting Bioethical Principles,” The Journal of Medicine and Philosophy: A Forum for Bioethics and Philosophy of Medicine 25, no. 3 (January 1, 2000): 285–307, p. 287. [14] H. D. Braude, Intuition in Medicine a Philosophical Defense of Clinical Reasoning (Chicago ; University of Chicago Press, 2012). [15] R. Kukla, “Conscientious Autonomy: Displacing Decisions in Health Care,” The Hastings Center Report 35, no. 2 (2005): 34–44. [16] M. Schermer, The Different Faces of Autonomy: Patient Autonomy in Ethical Theory and Hospital Practice, vol. 13, Library of Ethics and Applied Philosophy (Dordrecht: Springer Netherlands, 2002). [17] E. D. Pellegrino and D. C. Thomasma, For the Patient’s Good - the Restoration of Beneficence in Health Care (New York, NY: Oxford University Press, 1988), p. 29. [18] Pellegrino and Thomasma, For the Patient’s Good. 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In this study, we examine the relationship between appeal to self-perceptions of moral identity, included in the teaching of ethics, and the strengthening of moral judgment among postgraduate business students. As appeal to moral identity emphasizes personal engagement in the appraisal of an ethically charged situation, it addresses critiques of abstract rule application and principle transfer leveled at traditional business ethics teaching. Eighty-one participants completed a series of reflective writing exercises throughout a twelve-week business ethics unit. Based (...) on an instrument completed at the beginning and end of the education process, our results indicate a positive shift in moral judgement intensity. We, therefore, recommend appeal to moral identity as a leverage strategy to be employed in business ethics education in order to strengthen students’ moral judgment. (shrink)

This study addresses the Minnesota News Council's moral authority-that is, its ability to serve as a referent for the ethical or moral choices of others-and how its authority might be affected by perceptions of its legitimacy. After analyzing all of the Council's 125 written determinations, we argue that the Council's legitimacy and authority could be enlarged by clearer statements of ethical principles, explicit expressions of standards of conduct, and more consistent references to past determinations.

Since 2013, mortgage advisory has become an independent profession in the Netherlands. Initially working for mortgage providers, the newly nonpartisan advisers now work for standard advisory fees, thereby reducing conflicts of interest. In this article, I provide an ethical analysis of the different types of ethos of mortgage advisers, that is, the ways they see and talk about, and relate to their work in a certain way. The central research question is: What different kinds of ethos do mortgage advisers have, (...) and which moral dilemmas do they experience in their advisory work? The existence of moral dilemmas is controversial in ethics but nonetheless experienced in real-world business practice. An “ethological” understanding of morality is developed in this paper to understand how these dilemmas are experienced. Twenty-nine mortgage advisers have participated in Q methodological research, a mixed qualitative–quantitative small-sample method. Three different types of ethos were found: Principled Advisers, Moral Advisers, and Minimal Morality Advisers. In considering these three types, I argue that many mortgage advisers should professionalize their ethical stance and learn to address situations in which moral values are neglected. Business ethicists, in turn, need to acknowledge that something may be considered morally inappropriate but is still defensible in some other sense. In this paper, I develop a “layered” conception of business ethics that broadens the perspective from universal notions, such as “rights” and “duties,” toward a concrete ethos that people have in a certain professional practice. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Response to the CommentariesLloyd FieldsAbstractIn this response, I address three points raised in the commentaries: the question of whether there is a legitimate formal use of “moral,” the claim that a certain sort of affective capacity is required for acquiring the capacity to form other-regarding moral beliefs, and the problem of how to show that psychopaths lack the capacity to form other-regarding moral beliefs. I (...) maintain that there is a use of “moral” according to which moral beliefs need not be rational. Regarding the affective capacity that Adshead identifies, I explain that I had not intended that such a capacity be constitutive of a moral belief, even an other-regarding one. I then try a new approach, in the light of Adshead’s commentary, to the third point addressed, according to which the psychopath is unable to form other-regarding moral beliefs because a causally necessary condition for doing so is absent in him.KeywordsMoral beliefs, moral understanding, personality disorder, empathy, incapacity, responsibilityThe criticisms offered in the three excellent commentaries on my paper raise deep and important issues. I agree with many of the points made and will respond to three key issues: (1) the question of whether there is a legitimate formal use of “moral”; (2) the claim that there is a certain sort of affective capacity that is required in order to form other-regarding moral beliefs; (3) the problem of how to show that psychopaths lack the capacity to form other-regarding moral beliefs.I concede that Duff establishes (Duff 1977) that the psychopath lacks moral understanding in Duff’s own content-based sense of “moral.” It is illuminating, however, to emphasize that in my formal sense a psychopath of the kind that I consider in my paper is capable of some degree of understanding of “moral” concepts. Unlike Duff, I do not build rationality into my account of moral principles. Hence, I can accommodate eccentric, irrational or even “crazy” moral beliefs like that of Duff’s split-infinitive fanatic. A person can have irrational factual beliefs; why not irrational moral beliefs?Adshead in her commentary attributes to me the claim that moral beliefs, including other-regarding beliefs, “result” in a disposition to experience certain emotions, and to have certain attitudes in certain situations. She then writes, “it is arguable that the disposition to experience certain emotions and have certain attitudes towards others could be critical to acquiring the capacity to have other-regarding beliefs.” There is only an apparent disagreement here. First, I intended to claim that a disposition to experience certain emotions, etc., is partly constitutive of having a moral belief, not a result of having one. Second, in specifying my third condition of having a moral belief, I had in mind such attitudes and emotions as approval, disapproval, indignation and remorse. Adshead identifies an affective capacity, aspects of which are the recognition of, empathy with, and sympathy with, another’s distress. This capacity seems to correspond more or less to what Rousseau described as “natural compassion” (Rousseau [End Page 291] 1973, 66–69), which arises prior to reflection and the use of reason, and which is exemplified by a mother’s responsiveness to the distress of her child. Rousseau distinguished natural compassion from moral virtues, which require the use of reason. I agree with Adshead that having this affective capacity is likely to be critical to acquiring the capacity to have other-regarding moral beliefs.Radden’s incisive commentary poses the problem of how to show that the psychopath lacks the capacity to form other-regarding moral beliefs, since this does not follow from the fact that he fails to form them. In the light of Adshead’s commentary, I should like to try a different approach to this problem. At least one type of situation in which we say that something, x, cannot do a certain sort of thing, d, is one where a causally necessary condition for x doing d is absent. For example, we should say of a car, not simply that it does not run, but that, as it is presently constituted, it cannot run, if we found that the carburetor of its... (shrink)

The problems that I address concern the morality and rationality of decisions with respect to the application and practice of science. Formally, the situation is a standard decision theoretic one in which one has a set of alternatives and a set of outcomes. The standard solution is to maximize expected utility. This formal simplicity conceals considerable philosophical complexity. The most obvious is — whose expected utility should we maximize? The second is — are there any moral constraints on (...) what utility assignments we shall allow? The principle of rationality I am assuming is that a rational decision should be based on the total information available. Failure to cooperate in effecting such an amalgamation is subversive with respect to this overriding principle of rationality. It is a fundamental principle of truth seeking. Given the prima facie moral obligation to seek truth, failure to cooperate is prima facie immoral as well. (shrink)

The problems that I address concern the morality and rationality of decisions with respect to the application and practice of science. Formally, the situation is a standard decision theoretic one in which one has a set of alternatives and a set of outcomes. The standard solution is to maximize expected utility. This formal simplicity conceals considerable philosophical complexity. The most obvious is — whose expected utility should we maximize? The second is — are there any moral constraints on (...) what utility assignments we shall allow? The principle of rationality I am assuming is that a rational decision should be based on the total information available. Failure to cooperate in effecting such an amalgamation is subversive with respect to this overriding principle of rationality. It is a fundamental principle of truth seeking. Given the prima facie moral obligation to seek truth, failure to cooperate is prima facie immoral as well. (shrink)

Consciousness and confidence seem intimately related. Accordingly, some researchers use confidence ratings as a measure of, or proxy for, consciousness. Rosenthal discusses the potential connections between the two, and rejects confidence as a valid measure of consciousness. He argues that there are better alternatives to get at conscious experiences such as direct subjective reports of awareness (i.e. subjects’ reports of perceiving something or of the degree of visibility of a stimulus). In this chapter, we offer a different perspective. Confidence ratings (...) in general, and metacognitive measures in particular, may offer important advantages over subjective ratings. The arguments we offer here are supported by empirical, practical and socio-strategic considerations. However, we do not suggest consciousness and confidence are interchangeable. We recognize the limitations of confidence ratings in some experimental designs and for some research questions. Nevertheless, we also address a potential conceptual link between consciousness and confidence that stems from Rosenthal’s very own work on mental quality space theory. (shrink)