In lieu of an abstract, here is a brief excerpt of the content:Philosophy, Psychiatry, & Psychology 11.4 (2004) 299-301 [Access article in PDF] The Right Not to Know: A Challenge for Accurate Self-Assessment Ruth F. Chadwick Anderson and Lux present a very interesting and thought-provoking argument for the view that accurate self-assessment is a requirement for personal autonomy. What I want to suggest is that although this may be helpful in the context with which these authors are primarily (...) concerned, namely psychiatry and brain dysfunction, it is of less value to an account of autonomy more widely construed. I want to look at a possible counterexample, taken from another area of medicine, namely genetics.Toward the end of their article Anderson and Lux consider three objections to their position. I shall not discuss them all. My concern is with the third, that inaccurate self-assessment sometimes promotes autonomy, because knowing the truth about one's weaknesses is sometimes very debilitating. It is commonly argued that "you can if you think you can" and vice versa. As they point out, there are some complex issues involved here, in that if the result of the positive thinking is the ability to do the thing in question, then how can the self-assessment be deemed to have been inaccurate in the first place? They go on, however, to say that "it is unclear that inflated self-assessments yield benefits in contexts where what is required is not just effort but competence" (290).Now it has been argued, by some, in the context of genetics, that the proper understanding of autonomy may imply a "right not to know" facts about oneself. In other words, this is not just a matter of accurate or inaccurate assessment of the relevant facts about oneself; rather, what may be involved is a deliberate decision not to have access to facts that may be relevant to that assessment. There are clearly cases in which genetic information appears to be pertinent to an accurate self-assessment, as the following example suggests. Suppose there is information "available", through genetic testing, that would affect one's chances of having children, or of having children without a particular genetic disorder, and, knowing that such information is available, a couple decides not to avail themselves of this. This is clearly an inaccurate self-assessment, but is their autonomy compromised?It might be thought that the reasons for this decision not to know could be relevant. If they have no family history of any particular genetic disorder, it could be regarded as subjectively reasonable to decline such testing as might be offered. Anderson and Lux, however, argue that whether or not a self-assessment is accurate depends on externalities. In other words, A's self-assessment is not to be assessed as accurate, or [End Page 299] not, according to what it is subjectively reasonable to believe; it has to be measured against the facts. The more that the possibilities of genetic testing increase, the more that "facts" of this nature will be available, including in the context of psychiatry.It might be objected that genetic information is not the type of information that is relevant in this context. In so far as it is predictive and probabilistic it is, arguably, different from the type of diagnostic information involved in the cases discussed by Anderson and Lux. It is not the place here, however, to discuss in general terms the thesis of "genetic exceptionalism" with regard to medical information. The important point is refusal of access to information that may be relevant to an accurate self-assessment. Historically, people have been mistaken in their self-assessment because of lack of information—for example, lack of understanding of facts about the reproduction process has led individuals automatically to blame the woman partner of a couple for infertility. And, as Anderson and Lux rightly point out, being autonomous is compatible with making mistakes, and indeed requires the freedom to make mistakes, it would look rather different if a person continued to hold this without any attempt to avail himself of the relevant—and now available—information... (shrink)

The demand for bodily parts such as organs is increasing, and individuals in certain circumstances are responding by offering parts of their bodies for sale. Is there anything wrong in this? Kant had arguments to suggest that there is, namely that we have duties towards our own bodies, among which is the duty not to sell parts of them. Kant's reasons for holding this view are examined, and found to depend on a notion of what is intrinsically degrading. Rom Harré's (...) recent revision of Kant's argument, in terms of an obligation to preserve the body's organic integrity, is considered. Harré's view does not rule out all acts of selling, but he too ultimately depends on a test of what is intrinsically degrading. Both his view and Kant's are rejected in favour of a view which argues that it does make sense to speak of duties towards our own bodies, grounded in the duty to promote the flourishing of human beings, including ourselves. This provides a reason for opposing the sale of bodily parts, and the current trend towards the market ethic in health care provision. (shrink)

The term “industrial action” includes any noncooperation with management, such as strict “working to rule,” refusal of certain duties, going slow, and ultimately withdrawal of labor. The latter form of action, striking, has posed particular problems for professional ethics, especially in those professions that provide healthcare, because of the potential impact on patients' well-being. Examination of the issues, however, displays a difference in response between the healthcare professions, in particular between doctors and nurses. In considering the ethics of industrial (especially (...) strike) action there are various aspects of professional ethics to consider: (1) whether there is a tension between industrial action and the very notion of professional ethics; (2) what specific issues arise in the case of healthcare professions; (3) what, if anything, can explain and/or justify different responses from the medical and nursing professions? (shrink)

Genetic research has moved from Mendelian genetics to sequence maps to the study of natural human genetic variation at the level of the genome. This past decade of discovery has been accompanied by a shift in emphasis towards the ethical principles of reciprocity, mutuality, solidarity, citizenry and universality.

Genetic database initiatives have given rise to considerable debate about their potential harms and benefits. The question arises as to whether existing ethical frameworks are sufficient to mediate between the competing interests at stake. One approach is to strengthen mechanisms for obtaining informed consent and for protecting confidentiality. However, there is increasing interest in other ethical frameworks, involving solidarity — participation in research for the common good — and the sharing of the benefits of research.

The privacy concerns discussed in the 1990s in relation to the New Genetics failed to anticipate the relevant issues for individuals, families, geneticists and society. Consumers, for example, can now buy their personal genetic information and share it online. The challenges facing genetic privacy have evolved as new biotechnologies have developed, and personal privacy is increasingly challenged by the irrepressible flow of electronic data between the personal and public spheres and by surveillance for terrorism and security risks. This book considers (...) the right to know and the right not to know about your own and others’ genomes. It discusses new privacy concerns and developments in ethical thinking, with the greater emphasis on solidarity and equity. The multidisciplinary approach covers current topics such as biobanks and forensic databases, DIY testing, group rights and accountability, the food we eat and the role of the press and the new digital media. (shrink)

This chapter contains sections titled: Promise and Disappointment Ethical Issues Resource Allocation References.

Applied ethics, a subdiscipline of philosophy, lends itself to an encyclopedia format because of the many industries and intellectual fields that it encompasses. The Encyclopedia of Applied Ethics is based on twelve major categories, such as Biomedical Ethics and Environmental Ethics. Religious traditions that embody normative beliefs, as well as classical theories of ethics, are explored in a non-judgmental manner. Each of the twelve categories is divided into discrete areas that are covered by 5,000-6,000 word articles. Each of the 281 (...) articles begins with a definition of the subject and includes a table of contents, glossary of key terms, and bibliography. Second- and third- level headings, boxes, sidebars, and the like emphasize the reference-oriented nature of the material. The four volumes are arranged in an A-Z format, with a complete subject index at the end of the last volume. Articles are written by international experts, arranged alphabetically by title, not by subject, and cross-referenced so the reader can locate relevant information in other articles. One of Library Journal's Best Reference Sources for 1997! One of the CHOICE Outstanding Academic Books for 1998! Cross-references appear in each article to refer readers to related information A glossary and bibliography in each article provide readers with tools for learning and creative thinking. (shrink)

Despite the recent increased emphasis on ethics in health care, the subject of community health care is rarely specifically addressed. Yet it is in the community that many ethical issues arise, both in the particular practice situation and in the wider social issues connected with changes in government policy. This edited text discusses these questions and looks at the whole range of community health nursing in the UK. The multidisciplinary group of contributors explore the issues of theory and practice that (...) arise in community health care. They encourage critical reflection on the differences between hospital-based care and community care. Everyday issues are addressed that confront health practitioners working in the community, such as discrimination, mental health, standard setting, rationing in health care, public health, health promotion and discharge decision making. This book will be essential reading for practitioners on post-registration courses in community health and students following courses in health care ethics and nursing studies. (shrink)

This quotation from the London Review of Books is an example of a turn—a different way of looking at things that involves a redefinition of the kind of thing higher education is and how it should be provided. It is a turn away from a public good perspective—the opposite, it might be said, of the kind of turn addressed in this article.

Recent discussions of genomics and international justice have adopted the concept of ‘global public goods’ to support both the view of genomics as a benefit and the sharing of genomics knowledge across nations. Such discussion relies on a particular interpretation of the global public goods argument, facilitated by the ambiguity of the concept itself. Our aim in this article is to demonstrate this by a close examination of the concept of global public goods with particular reference to its use in (...) the context of genomic databases. We contend that the argument for construing genomics as a global public good depends on seeing it as a natural good by focusing on features intrinsic to genomics knowledge. We shall argue that social and political arrangements are relevant and that recognising this opens the door to construing the use of global public goods language as a strategic one. (shrink)

Dupras and Bunnik take on the particular privacy risks of multi-omics, in particular via a contrast and comparison of genomics and epigenomics, followed by a consideration of the issues in r...

This paper explores some ways in which Immanuel Kant’s ethical theory can be brought to bear on professional and health care ethics. Health care professionals are not mere individuals acting upon their own ends. Rather, their principles of action must be defined in terms of participation in a cooperative endeavor. This generates complex questions as to how well their roles mesh with one another and whether they comprise a well-formed collective agent. We argue that Kant’s ethics therefore, and perhaps surprisingly, (...) requires us to consider the institutions, procedures, and politics that decide who should play what part in a complex collective enterprise. Likewise, professional responsibility involves – alongside a readiness to play one’s individual part – a concern for these collective aspects of healthcare. (shrink)

The possibilities of genetic engineering, particularly as applied to human beings, have provoked considerable debate for over two decades, but more recently the focus of public concern, at least, has turned to genetically modified (GM) food. Food has occasionally caught the attention of philosophers (Telfer, 1996) and bioethicists (Mepham, 1996) but is now ripe for further attention in the light of the implications of GM for policy in health, economics and politics. Macer has identified opposing reactions to novel foods—to prefer (...) to eat down the food chain, on the one hand, and to embrace technology, on the other (Macer, 1997). One question that has given rise to some interest is why consumer attitudes to genetically modified food have been so much more strongly adverse in Europe, particularly in the UK, than in the USA. This paper explores the ways in which the food ethics debate has been constructed in recent debates in the UK, with special reference to the similarities to and differences from what are on the face of it analogous debates in medical ethics. What is special about food, as opposed to drugs, which makes it appropriate or inappropriate to construct the arguments in the terms that currently predominate? This will involve looking in particular at the application of the principle of autonomy and the argument from consumer choice. (shrink)

The possibilities of genetic engineering, particularly as applied to human beings, have provoked considerable debate for over two decades, but more recently the focus of public concern, at least, has turned to genetically modified food. Food has occasionally caught the attention of philosophers and bioethicists but is now ripe for further attention in the light of the implications of GM for policy in health, economics and politics. Macer has identified opposing reactions to novel foods—to prefer to eat down the food (...) chain, on the one hand, and to embrace technology, on the other. One question that has given rise to some interest is why consumer attitudes to genetically modified food have been so much more strongly adverse in Europe, particularly in the UK, than in the USA. This paper explores the ways in which the food ethics debate has been constructed in recent debates in the UK, with special reference to the similarities to and differences from what are on the face of it analogous debates in medical ethics. What is special about food, as opposed to drugs, which makes it appropriate or inappropriate to construct the arguments in the terms that currently predominate? This will involve looking in particular at the application of the principle of autonomy and the argument from consumer choice. (shrink)

This volume contains essays which cover a range of aspects in the debate over genetic testing. It looks at both the advantages and disadvantages involved in knowing or not knowing whether one is a carrier of certain genetic traits.

Every body cell of an animal or human being contains the same complete set of genes. In theory any of these cells can be used to start a new embryo. The technique has been employed in the case of frogs. The nucleus is taken out of a body cell of a frog and implanted in an enucleated frog's egg. The resulting egg cell is stimulated to develop into a normal frog, and will be an exact copy of that frog which (...) provided the nucleus with all the genetic information. In normal sexual reproduction, two parents each contribute half their genes, but in the case of cloning, one parent passes on all his or her genes. (shrink)

Analysis and comparison of genetic screening programs shows that the extent of development of programs varies widely across Europe. Regional variations are due not only to genetic disease patterns but also reflect the novelty of genetic services. In most countries, the focus for genetic screening programs has been pregnant women and newborn children. Newborn children are screened only for disorders which are treatable. Prenatal screening when provided is for conditions for which termination may be offered. The only population screening programs (...) for adults are those for thalassaemia carrier status in Cyprus, Greece and Italy. Social responses to genetic screening range from acceptance to hostility. There is a fundamental tension between individual and communi ty in the debates in various European countries about implementation of screening programs. Opposition to genetic screening is frequently expressed in terms of arguments about "eugenics" with insufficient regard to the meaning of the term and its implications. Only a few countries have introduced explicit legislation on genetic screening. Legislation to address discrimination may provide more safeguards than legislation protecting genetic information itself. (shrink)

This collection examines how the field of ethics has developed over the past fifty years, by bringing together those articles that have been seminal in the development of the subject. Each of the six volumes carries an introduction presenting the historical context of the material, and a new index is provided to identify key philosophical themes and trends within the collection. The volumes are organized thematically, and include: * Vol.1: Nature and Scope * Vol. 2: Ethical Issues in Medicine, Technology (...) and the Life Sciences * Vol. 3: Ethical Issues in Medicine, Technology and the Life Sciences II * Vol. 4: Environment * Vol. 5: Business/Economics * Vol. 6: Politics. (shrink)

This authoritative Handbook brings together experts with backgrounds in philosophy, sociology, law, public policy and the health professions and reflects the increasing impact of globalization and the dynamic advances in the fields of ...

The prelims comprise: Introduction Commerce, Ethics, and Science: Gene Sequencing Commercial Marketing of Genetic Tests Conclusion.

This collection brings together many of the most influential criticisms of Kantian philosophy, from his own time to the present day. Volume I is historical, including Kant criticism from Schiller to Buchdahl. It contains some previously untranslated material. Volumes II, III and IV include recent essays on Kant, covering the major aspects of his work. Volume II looks at the Critique of Pure Reason, Volume III at Kant's moral and political philosophy, and Volume IV at the Critique of Judgement and (...) the relation of the third Critique to the other two. The volumes will be of great value to anyone with a serious interest in Kant's philosophy. (shrink)

This collection brings together many of the most influential criticisms of Kantian philosophy, from his own time to the present day. Volume I is historical, including Kant criticism from Schiller to Buchdahl. It contains some previously untranslated material. Volumes II, III and IV include recent essays on Kant, covering the major aspects of his work. Volume II looks at the Critique of Pure Reason, Volume III at Kant's moral and political philosophy, and Volume IV at the Critique of Judgement and (...) the relation of the third Critique to the other two. The volumes will be of great value to anyone with a serious interest in Kant's philosophy. (shrink)

In this article I shall examine the concept of professional ethics with reference to three headings: how we should understand the notion of a profession; how we should characterize the problems of professional ethics; and whether we should develop professional ethics from a standpoint internal or external to the profession. I shall then proceed to speculate on the future of professional ethics with reference to each of these headings, having regard to the trends identified.