Self-control has gained enormous attention in recent years both in philosophy and the mind sciences, for it has profound implications on so many aspects of human life. Overcoming temptation, improving cognitive functioning, making life-altering decisions, and numerous other challenges all depend upon self-control. But recent developments in the philosophy of mind and in action theory, as well as in psychology, are now testing some of the assumptions about the nature of self-control previously held on purely a priori grounds. New essays (...) in this volume offer fresh insights from a variety of angles: neuroscience; social, cognitive, and developmental psychology; decision theory; and philosophy. While much of the literature on self-control is spread across distinct disciplines and journals, this volume presents for the first time a thorough and truly interdisciplinary exploration of the topic. The essays address four central topics: what self-control is and how it works; temptation and goal pursuit; self-control, morality, and law; and extending self-control. They take up an array of complex and important questions. What is self-control? How is self-control related to willpower? How does inhibitory control work? What are the cultural and developmental origins of beliefs about self-control? How are attempts at self-control hindered or helped by emotions? How do our beliefs about our own ability to deal with temptation influence our behavior? What does the ability to avoid temptation depend on? How should juvenile responsibility be understood, and how should the juvenile justice system be reformed? Can an account of self-control help us understand free will? Combining the most recent scientific research with new frontiers in the philosophy of mind, this volume offers the most definitive guide to self-control to date. (shrink)

I deal with the issue of the environmental crisis from the perspective of a phenomenologically embedded qualitative social ontology. The first point I make is that our environment is a «personal world», and not a «naturalistic world»: a world that is experienced in the «personalistic attitude» and as such is an ontologically qualitative world, in which both natural and social entities are given to us as essentially constituted by value-qualities and meanings, and not as merely material things. The second point (...) I argue for is that our environment is also a «common-surrounding world» whose personal collectives are its essential correlate: «common-surrounding world» and personal collectives existentially depend on one another, and human persons, both individual and collective, are responsible for the existence of their environment and its entities. I apply the tools of phenomenological eidetics to the ideas of «personal world» and «common-surrounding world», and inquire into the ontologically qualitative implications that they have for our environment and its crisis. (shrink)

Continuous deep sedation at the end of life is a practice that has been the topic of considerable ethical debate, for example surrounding its perceived similarity or dissimilarity with physician-assisted dying. The practice is generally considered to be legal as a form of symptom control, although this is mostly only assumed. France has passed an amendment to the Public Health Act that would grant certain terminally ill patients an explicit right to continuous deep sedation until they pass away. Such a (...) framework would be unique in the world. In this paper we will highlight and reflect on four relevant aspects and shortcomings of the proposed bill. First, that the bill suggests that continuous deeps sedation should be considered as a sui generis practice. Second, that it requires that sedation should always be accompanied by the withholding of all artificial nutrition and hydration. In the most recently amended version of the legal proposal it is stated that life sustaining treatments are withheld unless the patient objects. Third, that the French bill would not require that the suffering for which continuous deep sedation is initiated is unbearable. Fourth, the question as to whether the proposal should be considered as a way to avoid having to decriminalise euthanasia and/or PAS or, on the contrary, as a veiled way to decriminalise these practices. The French proposal to amend the Public Health Act to include a right to continuous deep sedation for some patients is a unique opportunity to clarify the legality of continuous deep sedation as an end-of-life practice. Moreover, it would recognize that the practice of continuous deep sedation raises ethical and legal issues that are different from those raised by symptom control on the one hand and assisted dying on the other hand. Nevertheless, there are still various issues of significant ethical concern in the French legislative proposal. (shrink)

This chapter reviews fundamental ethical controversy surrounding the ongoing effort to revise the Uniform Determination of Death Act in the United States. Instead of focusing on the process of the revision itself, the chapter explores the underlying ethical debate over brain death that has been ongoing for many decades and finally culminated in this revision. Three issues are focused: the requirement for consent and personal exemptions before applying brain death for the diagnosis of death; redefining the areas of the brain (...) that have ceased to function in the definition of brain death; and codifying the American Academy of Neurology as the authority to issue the standards of the diagnosis of brain death. The chapter concludes that allowing the personal choice of death determination gives a pragmatic compromise to the disputed definition and practice of diagnosing brain death. So long as all risks and imperfections of the diagnosis are accepted through the consenting process, there is nothing ethically objectionable to continuing the current practice of diagnosing brain death as a successful tool to facilitate heart-beating organ donation without violating the dead-donor rule. By contrast, precluding personal choice and imposing legal restrictions to consent and exemptions would further erode public trust. (shrink)

Continuous deep sedation at the end of life is a practice that has been the topic of considerable ethical debate, for example surrounding its perceived similarity or dissimilarity with physician-assisted dying...

Gianni Vattimo, one of Europe's foremost contemporary philosophers and most famously associated with the concept of weak thought, explores theoretical and practical issues flowing from his fundamental rejection of the traditional Western understanding of Being as an absolute, unchanging, and transcendent reality. The essays in this book move within the surroundings of Being without constructing a systematic, definitive analysis of the topic. In Being and Its Surroundings, Vattimo continues his career-long exploration of the philosophy of Martin Heidegger, in (...) particular his repudiation of metaphysics with its presupposition of the existence of permanent, universal truth, and that of Friedrich Nietzsche, with its promotion of nihilism. One consequence of problematizing the idea of an attainable truth is the relativization of values and cultures. In the face of the death of God – or the absence of a transcendent guarantor of the validity of human judgments – we have the postmodern tendency to see all value systems and assertions of truth as purely subjective, and to suggest that "anything goes," which Nietzsche called passive nihilism. Vattimo advocates a more active response as he challenges all forms of authoritarianism in the world today. He brings his intellectual acumen to bear on such urgent issues as globalization, the clash of civilizations and terrorism, the crisis of democracy, and the relevance of orthodox religion. Rather than endorse dogmatism or indifference and detachment from social engagement in the name of relativism, Vattimo opts for the path of meaningful dialogue and a search for a mediated consensus based on reason, with all its limitations. (shrink)

The history of evolution is a history of development from less to more complex organisms. This growth in complexity of organisms goes hand in hand with a concurrent growth in complexity of environments and of organism-environment relations. It is a concern with this latter aspect of evolutionary development that motivates the present paper. We begin by outlining a theory of organism-environment relations. We then show that the theory can be applied to a range of different sorts of cases, both biological (...) and non-biological, in which objects are lodged or housed within specific environments, or niches. Biological science is interested in types—for example in genotypes, phenotypes, and environment types—in regularities that can serve as the basis for the formulation of laws or general principles. Types, however, can exist only through their corresponding tokens. Our theory of token environments is meant to plug this gap and to provide a first step towards a general theory of causally relevant spatial volumes. (shrink)

This cutting-edge volume showcases work supported by a four-year, 4.4 million dollar project on free will and science. In fourteen new articles and an introduction, contributors explore the subject of free will from the perspectives of neuroscience; social, cognitive, and developmental psychology; and philosophy.

At this historical moment, few terms are as charged and powerful as the omnipresent term environment. It has become a strategic tool for politics and theories alike, crossed the borders of the disciplines of biology and ecology, and left the manifold field of environmentalism. This article explores the first steps on this path of expansion, in which the term becomes an argumentative resource and achieves a plausibility that transforms it into a universal tool. It is not self-evident to describe ubiquitous (...) media, cinematic spaces, or augmented realities as environments. To understand how the term gained this plausibility, it is necessary to distinguish it from two other terms: the French milieu and the German Umwelt. When these three terms substitute one another and are used as translations, they lose their historical specificity and depth, and three different theoretical and philosophical traditions merge into indifference. Consequently, a conceptual history of the term environment and its relation to milieu and Umwelt—as well as terms such as medium, atmosphere, ambiance, and climate—can help us to understand the potentials and dangers of the term’s plausibility. In this sense, the article argues for a new perspective on epistemologies of surrounding that relate that which surrounds to that which is surrounded. (shrink)

This article examines discourses invoked in the UK debates about prostitution and trafficking in women. The authors suggest that there are three striking features about these discourses: the absence of the sex work discourse, the dominance of the public nuisance discourse in relation to kerb-crawling and the dominance of moral order discourses in relation to trafficking. At a time when the UK is about to revise its sex laws, it is important to consider the discourses that frame prostitution policies in (...) other European countries, with a view to broadening the range of policy options. In this context, the authors compare the UK with the Netherlands, where a sex work discourse has framed debates. This comparison indicates that UK prostitution discourses could be shaped by discourses other than those of public nuisance and moral order and may open up new policy options. (shrink)

This volume showcases cutting-edge scholarship from The Big Questions in Free Will project, funded by a grant from the John Templeton Foundation and directed by Alfred R. Mele. It explores the subject of free will from the perspectives of neuroscience; social, cognitive, and developmental psychology; and philosophy. The volume consists of fourteen new articles and an introduction from top-ranked contributors, all of whom bring fresh perspectives to the question of free will. They investigate questions such as: How do children conceive (...) of free will and how does their concept of free will develop? How does lowered or raised confidence in the existence of free will affect our behavior? What modifies our power to resist temptation? What do lay folk mean by free will? What brain processes underlie decisions? How does the conscious experience of voluntary action contribute to the neural control of behavior? What are the neural differences between deliberate choosing and arbitrary picking? How do neuroscientific studies of decision making in monkeys bear on human free will? Is determinism compatible with free will? What can a proper understanding of causation tell us about free will? What is moral responsibility? Readers interested in the current and future direction of scholarship on free will find this volume essential reading. (shrink)

One of the key responsibilities of public institutions in liberal democracies is to formulate recommendations for decision makers. However, public institutions realize that decision makers will often partly ignore their recommendations. This situation of “partial compliance” with recommendations raises a number of philosophical issues for institutions. Based on an analysis of 570 recommendations drawn from 40 Quebec public-sector documents and reports, we identify two issues surrounding the structure of public-policy recommendations.

Disasters and public health emergencies raise a variety of ethical dilemmas, often including those that require balancing the best interests of individuals against those of groups or communities. The on-going COVID-19 pandemic provides examples of these ethical conflicts, as do other recent outbreaks. Decisions and actions in this context must address different ethical issues, ranging from those directly related to autonomy, consent, privacy and confidentiality to those related to interventions and technologies, such as efficacy, effectiveness, safety and fair access. This (...) paper aims to identify ethical conflicts with complex resolutions involving aspects related to values, rights and needs of individuals and the collective, and to suggest how such challenges could lead to more positive experiences and outcomes when confronted in future emergencies. (shrink)

This book identifies the impact of globalization, advanced technology, and international collaboration on ethical research methods and practice.

This book serves as an interdisciplinary base of scholarly contributions on the subject of technoethics, a field that deals with current and future problems that arise at the intersection of science, technological innovation, and human life and society.

Concussions in professional sports have received increased attention, which is partly attributable to evidence that found concussion incidence rates were much higher than previously thought. Further to this, professional hockey players articulated how their concussion symptoms affected their professional careers, interpersonal relationships, and qualities of life. Researchers are beginning to associate multiple/repeated concussions with Chronic Traumatic Encephalopathy, a structural brain injury that is characterized by tau protein deposits in distinct areas of the brain. Taken together, concussions impact many people in (...) the sporting community from current and former professional athletes and their families to medical and health professionals and researchers. In light of the growing awareness and sensitivity towards concussions, the purpose of this paper is to provide recommendations that are designed to improve player safety in professional hockey and address the ethical issues surrounding these suggestions. (shrink)

The Internet appears to offer psychologists doing research unrestricted access to infinite amounts and types of data. However, the ethical issues surrounding the use of data and data collection methods are challenging research review boards at many institutions. This article illuminates some of the obstacles facing researchers who wish to take advantage of the Internet's flexibility. The applications of the APA ethical codes for conducting research on human participants on the Internet are reviewed. The principle of beneficence, as well as (...) privacy and confidentiality, informed consent, deception, and avoiding harm are all illustrated through the use of a hypothetical online study. (shrink)

Much of today’s international trade is conducted according to trade agreements that involve substantial and uniform protections of intellectual property rights. Intellectual property rights are a socio‐economic tool that create a temporary monopoly for inventor firms and enable such firms to charge prices for their innovations that are many times higher than the marginal cost of production of the innovations. This allows the inventor firms to salvage their research‐costs and secure a profit on their innovations. A large body of contemporary (...) philosophical and interdisciplinary literature suggests that intellectual property rights give rise to a number of ethical problems. This review paper seeks to give an overview of what these problems are. It also offers an outline of proposals as to how these problems might be alleviated, and it briefly explains the two classical defenses of the ethical permissibility of intellectual property rights. The ethical issues surrounding intellectual property rights are most pertinent when it is socially valuable goods that are given intellectual property protection. The discussions in this paper revolve around just one product type in order to bring out the broader ethical issues surrounding intellectual property rights. In line with much contemporary literature on the ethical dimensions of intellectual property rights, the product type in question is life‐saving medicines. (shrink)

(1995). Theoretical issues surrounding interdisciplinary interpenetration. Social Epistemology: Vol. 9, Boundary Rhetorics and the Work of Interdisciplinarity, pp. 175-187.

The Internet appears to offer psychologists doing research unrestricted access to infinite amounts and types of data. However, the ethical issues surrounding the use of data and data collection methods are challenging research review boards at many institutions. This article illuminates some of the obstacles facing researchers who wish to take advantage of the Internet's flexibility. The applications of the APA ethical codes for conducting research on human participants on the Internet are reviewed. The principle of beneficence, as well as (...) privacy and confidentiality, informed consent, deception, and avoiding harm are all illustrated through the use of a hypothetical online study. (shrink)

Controlled human infection challenge studies (CHIs) involve intentionally exposing research participants to, and/or thereby infecting them with, micro‐organisms. There have been increased calls for more CHIs to be conducted in low‐ and middle‐income countries (LMICs) where many relevant diseases are endemic. This article is based on a research project that identified and analyzed ethical and regulatory issues related to endemic LMIC CHIs via (a) a review of relevant literature and (b) qualitative interviews involving 45 scientists and ethicists with relevant expertise. (...) In this article we argue that though there is an especially strong case for conducting CHIs in endemic (LMIC) settings, certain ethical issues related to the design and conduct of such studies (in such settings) nonetheless warrant particularly careful attention. We focus on ethical implications of endemic LMIC CHIs regarding (a) potential direct benefits for participants, (b) risks to participants, (c) third‐party risks, (d) informed consent, (e) payment of participants, and (f) community engagement. We conclude that there is a strong ethical rationale to conduct (well‐designed) CHIs in endemic LMICs, that certain ethical issues warrant particularly careful consideration, and that ethical analyses of endemic LMIC CHIs can inform current debates in research ethics more broadly. (shrink)

The paper presents a program to construct a non-relativistic relational Bohmian theory, that is, a theory of N moving point-like particles that dispenses with space and time as fundamental background structures. The relational program proposed is based on the best-matching framework originally developed by Julian Barbour. In particular, the paper focuses on the conceptual problems that arise when trying to implement such a program. It is argued that pursuing a relational strategy in the Bohmian context leads to a more parsimonious (...) ontology than that of standard Bohmian mechanics without betraying the original motivations for adopting a primitive ontology approach to quantum physics. It is also shown how a relational Bohmian approach might clarify the issue of the timelessness of the dynamics resulting from the quantization of a classical relational system of particles. (shrink)

Readers have much to consider when evaluating Greenblum and Hubbard’s conclusion that ‘physicians have no business doing theology’.1 The two central arguments the authors offer are fairly convincing within the confines they set for themselves, the provisos they stipulate and their notions of ‘privacy’ and ‘public reason’. However, I would ask readers to consider two questions, the answers to which I believe the authors leave opaque. First, what is theological negotiation? Second, what makes chaplains the singular group of healthcare professionals (...) responsible for theological negotiation? In this Commentary, I explore these questions not with the goal of rejecting the authors’ conclusion, but rather with the goal of highlighting relevant considerations when evaluating the authors’ central tenets. First, I would like readers to consider Greenblum and Hubbard’s descriptions of theological negotiation. They categorise theological negotiation into metaphysical, normative and alternative responses, and hold that this kind of negotiation is, for the most part, impermissible for healthcare professionals, save chaplains.1 The examples of Dr Chatterjee and Dr Thompson expand theological negotiation to include instances where physicians add a theological veneer to their clinical recommendations. In both the examples, the physician has made the case for accepting or rejecting a certain intervention—for Dr Chatterjee, accepting …. (shrink)

Research on small-to-medium enterprises (SMEs) and the ethical dimension of their internationalization initiatives has not been sufficiently undertaken, with research in international business and business ethics focusing primarily on multinational enterprises and their corresponding social responsibilities. This paper addresses this lacuna by discussing the ethical issues surrounding the process by which such firms utilize network-expanding strategies to legitimate themselves to foreign networks and partners. Through a longitudinal grounded theory approach, this paper illustrates how SME internationalization is a relationally-influenced and ethically-laden (...) process that needs careful deliberation and reflection. Because their internationalization initiatives give rise to issues that do not diminish one’s responsibility for ethical behavior, SMEs need to create an ethical infrastructure that, while cognizant of their resource constraints, enables them to develop and sustain a strong sense of character and integrity to deal with the challenges surrounding SME internationalization. (shrink)

The papers in this volume question how perceptions of space influenced understandings of the body and its functions, illness and treatment, and the surrounding natural and built environments in relation to health in the classical and ...

Approaches to Nietzsche’s political philosophy abound. In this article, however, we explore the possibility of identifying not only a political philosophy, but also a political-theological reading in Nietzsche’s texts. In fact, such a political-theological reading already has something of a genealogy. In the 1960s, “radical theology” appropriated the Nietzschean topic of the death of God, which engendered a transferred radical political theology consisting in radical democracy. The first part of this article explores twentieth-century political theologies surrounding the death of God. (...) We ask herein if this is the only possible political-theological reading of Nietzsche’s texts. The second part argues that, in fact, we can ascribe to Nietzsche a “theological” intention that is transferable to his political theory in a way that differs from the attempts of radical political theology and other political theologies surrounding the death of God. We conclude that, in any case, Nietzsche’s political theology aims to counterbalance St. Paul’s nihilism more than to constitute a determined political view. (shrink)

Pro-Ana's are young women who proclaim themselves to be proudly anorexic, and they have created a vibrant community online. This article will examine the nature of the Pro-Ana sites, analyzing their discursive community, and discuss the ethical issues surrounding the sites, wherein many have been censured or shut down by commercial website hosting sites, which has raised issues of censorship versus freedom of speech.

This contribution to a symposium on an article by Roy Baumeister, A. William Crescioni, and Jessica Alquist focuses on a tension between compatibilist and incompatibilist elements in that article. In their discussion of people’s beliefs about free will, Baumeister et al. sometimes sound like incompatibilists; but in their presentation of their work on psychological processes of free will, they sound more like compatibilists than like incompatibilists. It is suggested that Baumeister and coauthors are attempting to study free will in a (...) metaphysically neutral way and that, because this is so, the incompatibilist elements of the article are out of place. (shrink)

Explanation of the reason of ecological crisis – a key to development of a valuable paradigm new to the western mentality. The western variant of development has led to accident of self-destruction of the person or its exit on autotrophic stay out of the Earth. The dream cosmists (Tsiolkovsky, Vernadsky, Teilhard de Chardin, etc.) is half carried out, say, in connection with an exit racketeers in space. In traditional culture this exit was always: «Dao», the Buddhism, and shamanism. In traditional (...) culture the relation to an inhabitancy was regulated always by the developed system of a taboo and the restrictions producing internalinterfacing space unities. Time puts a problem of judgement of this unity for an exit from environmental problems. (shrink)

This paper examines the relationship between modern theories of microeconomics and macroeconomics and, more generally, it evaluates the prospects of theoretically reducing macroeconomics to microeconomics. Many economists have shown strong interest in providing "microfoundations" for macroeconomics and much of their work is germane to the issue of theoretical reduction. Especially relevant is the work that has been done on what is called The Problem of Aggregation. On some accounts, The Problem of Aggregation just is the problem of reducing macroeconomics to (...) microeconomics. I show how to separate these problems and then try to determine to what extent particular kinds of solutions to The Problem of Aggregation succeed in reducing macroeconomics to microeconomics as well. I argue that reduction is not possible by this means given the current state of microeconomics. I also describe how reduction may be possible by means of (dis)aggregation if microeconomics is supplemented in a certain way with the results of experimental research on individual economic agents. (shrink)

In a recent article in this journal our unit was accused of a number of errors of judgment in applying covert video surveillance (CVS) to infants and children suspected of life-threatening abuse. The article implied, that on moving from the Royal Brompton Hospital in London to North Staffordshire Hospital, we failed to present our work to the Research Ethics Committee (REC). We did send our protocol to the REC though we did not consider that, after a total of 16 patients (...) had been documented as being the subject of life-threatening abuse, this was research. The REC in Staffordshire agreed with us. We were also accused of undertaking work that should be pursued by the Police. We agree with this. However, unlike the Metropolitan Police the Staffordshire Police would not undertake CVS. We fail to agree that 'working together' with parents is necessarily practical or safe when trying to protect children from life-threatening abuse of this kind. (shrink)

Since their introduction as ‘no code’ in the 1980s and their later formalisation to ‘do not resuscitate’ orders, such directions to withhold potentially life-extending treatments have been accompanied by multiple ethical issues. The arguments for when and why to instigate such orders are explored, including a consideration of the concept of futility, allocation of healthcare resources, and reaching a balance between quality of life and quality of death. The merits and perils of discussing such decisions with patients and/or their relatives (...) are reviewed and the unintended implications of ‘do not attempt resuscitation’ orders are examined. Finally, the paper explores some alternative methods to approaching the resuscitation decision, and calls for empirical evaluation of such methods that may reduce the ethical dilemmas physicians currently face. (shrink)

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

In their discussions and criticisms of the idea that language use is essentially a matter of following rules, Davidson and Cavell both invoke as counterexamples instances of intelligible linguistic innovation. Davidson’s favorite examples are malapropisms. Cavell focuses instead on what he calls projections. This paper clarifies some important differences between malapropisms and projections, conceived as paradigmatic forms of linguistic innovation. If malapropisms are treated as exemplary it will be natural to conclude, with Davidson, that a shared practice, be it rule-governed (...) or not, matters only instrumentally – as something that may enhance but is neither necessary nor sufficient for successful communication. By contrast, if Cavellian projections are seen as exemplary, a shared practice will be conceived not only as essential to the possibility of meaningful linguistic innovation, but as already permeated by the sort of creativity of which projections are only particularly striking examples. It is also argued that malapropisms are not particularly convincing as counterexamples to the sort of view Davidson wants to reject. Cavellian projections, on the other hand, are powerful as counterexamples, and reflecting on the nature of their inventiveness is crucial to understanding and seeing the plausibility of Cavell’s own conception of language. (shrink)

ABSTRACTIt has been estimated that more than 80% of people in Africa use traditional medicine . With the HIV/AIDS epidemic claiming many lives in Africa, the majority of people affected rely on TM mainly because it is relatively affordable and available to the poor populations who cannot afford orthodox medicine. Whereas orthodox medicine is practiced under stringent regulations and ethical guidelines emanating from The Nuremburg Code,1 African TM seems to be exempt from such scrutiny. Although recently there have been calls (...) for TM to be incorporated into the health care system, less emphasis has been placed on ethical and regulatory issues.In this paper, an overview of the use of African TM in general, and for HIV/AIDS in particular, is given, followed by a look at: the relative laxity in the application of ethical standards and regulatory requirements with regards to TM; the importance of research on TM in order to improve and demystify its therapeutic qualities; the need to tailor‐make intellectual property laws to protect traditional knowledge and biodiversity. A framework of partnerships involving traditional healers’ associations, scientists, policy makers, patients, community leaders, members of the communities, and funding organizations is suggested as a possible method to tackle these issues. It is hoped that this paper will stimulate objective and constructive debate that could enhance the protection of patients’ welfare. (shrink)

BackgroundPrevention of mother to child transmission of HIV remains a key public health priority in most developing countries. The provider Initiated Opt – Out Prenatal HIV Screening Approach, recommended by the World Health Organization lately has been adopted and translated into policy in most Sub – Saharan African countries. To better ascertain the ethical reasons for or against the use of this approach, we carried out a literature review of the ethics literature.MethodsPapers published in English and French Languages between 1990 (...) and 2015 from the following data bases were searched: Pubmed, Cochrane literature, Embase, Cinhal, Web of Science and Google Scholar. After screening from 302 identified relevant articles, 21 articles were retained for the critical review.DiscussionMost authors considered this approach ethically justifiable due to its potential benefits to the mother, foetus and society. The breaching of respect for autonomy was considered acceptable on the grounds of libertarian paternalism. Most authors considered the Opt - Out approach to be less stigmatizing than the Opt - In. The main arguments against the Opt - Out approach were: non respect of patient autonomy, informed consent becoming a meaningless concept and the HIV test becoming compulsory, risk of losing trust in health care providers, neglect of social and psychological implications of doing an HIV test, risk of aggravation of stigma if all tested patients are not properly cared for and neglect of sociocultural peculiarities.ConclusionsThe Opt – Out approach could be counterproductive in case gender sensitive issues within the various sociocultural representations are neglected, and actions to offer holistic care to all women who shall potentially test positive for HIV were not effectively ascertained. The Provider Initiated Opt – Out Prenatal HIV Screening option remains ethically acceptable, but deserves caution, active monitoring and evaluation within the translation of this approach into to practice. (shrink)