Book reviewed in this article: Can't We Make Moral Judgements? By Mary Midgley.

This paper advances a new paradigm in clinical ethics education that not only emphasizes development of individual cli but also focuses on the institutional context within which health care professionals work. This approach has been applied to the goal of improving the care provided to critically and terminally ill adults. The model has been adopted by about thirty hospitals and nursing homes; additional institutions will soon join the program, entitled Decisions Near the End of Life. Here, we describe the history (...) and rationale for this approach, its goals, pedagogical assumptions, and design. (shrink)

Even to begin discussing the ethics of animal experimentation we must locate our place in the “ethical three‐ring circus” of the debate among “human welfarists,” “animal rightists” and those in the “troubled middle.” A philosophy of “nature alive,” recognizing that some animals are more equal than others, can inform the troubled middle and ethically justify judicious animal research.

The philanthropist and philosopher Strachan Donnelley (1942--2008) devoted his life to studying the complex relationship between humans and nature. Founder and first president of the Center for Humans and Nature, Donnelley was a pioneer in the exploration and promotion of the idea that human beings individually and collectively have moral and civic responsibilities to natural ecosystems. In this wide-ranging volume, Donnelley traces the connections between influential figures such as Aldo Leopold and Charles Darwin, as well as lesser-known but original thinkers (...) that he met during the course of a full life -- ministers at his church, friends with whom he fished, and colleagues who shared his passion for research and writing. He grounds his work in classic philosophers such as Descartes, Spinoza, and Whitehead and reinterprets their writings about the natural world to develop a conservation-centered philosophy, which he dubs "democratic ecological citizenship." Edited by his daughter, Ceara Donnelley, and Bruce Jennings, Frog Pond Philosophy illuminates the dominant strands of Donnelley's intellectual identity as a philosopher, naturalist, agitator, and spiritualist. Despite his often grim depiction of the current state of the environment, Donnelly never surrenders his faith in humanity's ability to meet its ethical obligations to conserve, respect, and nurture the complexity and diversity of the natural world. His vivid and personal essays, rooted in everyday experiences, offer a distinctive perspective on questions of urgent contemporary importance. (shrink)

Mayr from biology, Jonas from philosophy, both worked their way—against the philosophical current—toward a biologically informed philosophy that both draws from the natural sciences and reflects a responsibility toward nature.

This series of articles by Charles Dougherty, Robert Berenson, and Kathleen Powderly and Elaine Smith, as well as “Cost Containment: Challenging Fidelity and Justice” by E. Haavi Morreim (Hastings Center Report, December 1988), result from a Hastings Center project, “Ethics and Prospective Payment Systems: DRGs.” The two-year project was jointly funded by The General Electric Foundation and the American Medical Association Education and Research Foundation.The project tried to gauge the systematic effects of the introduction of cost containment strategies, prospective payment (...) by Diagnostic Related Groups in particular, on the provision of health care and the ethical practice of medicine. Cost containment strategies, no matter how necessary in curbing spiraling medical costs, leave no sector or participants in the health care system untouched—hospitals and other health care institutions; doctors, nurses, social workers and other health care professionals; patients, their families, and the thirty-six to forty million medically indigent. The articles discuss the several and interrelated ethical issues raised by the DRG prospective payment system (Dougherty); its particular affect on the doctor-patient relationship and how it is transforming the ethical practice of medicine (Berenson and Morreim); and its specific impact on the professions and professional ethics of nursing and social work (Powderly and Smith). The overall message of the articles is that the health professions, their provision of care, and the ethics of their practices—as driven by economic considerations and realities—are in the midst of a more or less radical sea change. (shrink)

Bioethical principles and theories rest on fundamental philosophic conceptions of the human self that usually go unexamined. Reconsideration of our philosophic understanding of a human self requires that health practitioners broaden their ethical concern for patients decidedly beyond respect for decision‐making autonomy and gaining informed consent for medical procedures.

Book reviewed in this article: Can't We Make Moral Judgements? By Mary Midgley.