This paper discusses the views of 17 healthcare practitioners involved with transplantation on the ethics of live liver donations . Donations between emotionally related donor and recipients increased the acceptability of an LLD compared with those between strangers. Most healthcare professionals disapproved of altruistic stranger donations, considering them to entail an unacceptable degree of risk taking. Participants tended to emphasise the need to balance the harms of proceeding against those of not proceeding, rather than calculating the harm-to-benefits ratio of donor (...) versus recipient. Participants’ views suggested that a complex process of negotiation is required, which respects the autonomy of donor, recipient and HCP. Although they considered that, of the three, donor autonomy is of primary importance, they also placed considerable weight on their own autonomy. Our participants suggest that their opinions about acceptable risk taking were more objective than those of the recipient or donor and were therefore given greater weight. However, it was clear that more subjective values were also influential. Processes used in live kidney donation were thought to be a good model for LLD, but our participants stressed that there is a danger that patients may underestimate the risks involved in LLD if it is too closely associated with LKD. (shrink)

In this book, the author examines the ethical implications of Artificial Intelligence systems as they integrate and replace traditional social structures in new sociocognitive-technological environments. She discusses issues related to the integrity of researchers, technologists, and manufacturers as they design, construct, use, and manage artificially intelligent systems; formalisms for reasoning about moral decisions as part of the behavior of artificial autonomous systems such as agents and robots; and design methodologies for social agents based on societal, moral, and legal values. Throughout (...) the book the author discusses related work, conscious of both classical, philosophical treatments of ethical issues and the implications in modern, algorithmic systems, and she combines regular references and footnotes with suggestions for further reading. This short overview is suitable for undergraduate students, in both technical and non-technical courses, and for interested and concerned researchers, practitioners, and citizens. (shrink)

Virginia Held assesses the ethics of care as a promising alternative to the familiar moral theories that serve so inadequately to guide our lives. The ethics of care is only a few decades old, yet it is by now a distinct moral theory or normative approach to the problems we face. It is relevant to global and political matters as well as to the personal relations that can most clearly exemplify care. This book clarifies just what the ethics of (...) care is: what its characteristics are, what it holds, and what it enables us to do. It discusses the feminist roots of this moral approach and why the ethics of care can be a morality with universal appeal. Held examines what we mean by "care," and what a caring person is like. Where other moral theories demand impartiality above all, the ethics of care understands the moral import of our ties to our families and groups. It evaluates such ties, focusing on caring relations rather than simply on the virtues of individuals. The book proposes how such values as justice, equality, and individual rights can "fit together" with such values as care, trust, mutual consideration, and solidarity. In the second part of the book, Held examines the potential of the ethics of care for dealing with social issues. She shows how the ethics of care is more promising than Kantian moral theory and utilitarianism for advice on how expansive, or not, markets should be, and on when other values than market ones should prevail. She connects the ethics of care with the rising interest in civil society, and considers the limits appropriate for the language of rights. Finally, she shows the promise of the ethics of care for dealing with global problems and seeing anew the outlines of international civility. (shrink)

This paper offers an ethical framework for the development of robots as home companions that are intended to address the isolation and reduced physical functioning of frail older people with capacity, especially those living alone in a noninstitutional setting. Our ethical framework gives autonomy priority in a list of purposes served by assistive technology in general, and carebots in particular. It first introduces the notion of “presence” and draws a distinction between humanoid multi-function robots and non-humanoid robots to suggest that (...) the former provide a more sophisticated presence than the latter. It then looks at the difference between lower-tech assistive technological support for older people and its benefits, and contrasts these with what robots can offer. This provides some context for the ethical assessment of robotic assistive technology. We then consider what might need to be added to presence to produce care from a companion robot that deals with older people’s reduced functioning and isolation. Finally, we outline and explain our ethical framework. We discuss how it combines sometimes conflicting values that the design of a carebot might incorporate, if informed by an analysis of the different roles that can be served by a companion robot. (shrink)

COVID-19 continues to dominate 2020 and is likely to be a feature of our lives for some time to come. Given this, how should health systems respond ethically to the persistent challenges of responding to the ongoing impact of the pandemic? Relatedly, what ethical values should underpin the resetting of health services after the initial wave, knowing that local spikes and further waves now seem inevitable? In this editorial, we outline some of the ethical challenges confronting those running health services (...) as they try to resume non-COVID-related services, and the downstream ethical implications these have for healthcare professionals’ day-to-day decision making. This is a phase of recovery, resumption and renewal; a form of reset for health services.1 This reset phase will define the ‘new normal' for healthcare delivery, and it offers an opportunity to reimagine and change services for the better. There are difficulties, however, healthcare systems are already weakened by austerity and the first wave of COVID-19 and remain under stress as the pandemic continues. The reset period is operating alongside, rather than at the end, of the pandemic and this creates difficult ethical choices. ### Balancing the greater good with individual care Pandemics—and public health emergencies more generally—reinforce approaches to ethics that emphasise or derive from the interests of communities, rather than those grounded in the claims of the autonomous individual. The response has been to draw on more public health focused ethics, ‘if demand outstrips the ability to deliver to existing standards, more strictly utilitarian considerations will have to be applied, and decisions about how to meet the individual's need will give way to decisions about how to maximise overall benefit’.2 Alongside this, effective …. (shrink)

Considerable research on helpers-at-the-nest demonstrates the positive effects of firstborn daughters on a mother’s reproductive success and the survival of her children compared with women who have firstborn sons. This research is largely restricted to agricultural settings. In the present study we ask: “Does ‘daughter first’ improve mothers’ reproductive success in a hunting and gathering context?” Through an analysis of 84 postreproductive women in this population we find that the sex of the first- or second-born child has no effect on (...) a mother’s fertility or the survival of her offspring. We conclude that specific environmental and economic factors underlay the helpers-at-the-nest phenomenon. (shrink)

How is feminism changing the way women and men think, feel, and act? Virginia Held explores how feminist theory is changing contemporary views of moral choice. She proposes a comprehensive philosophy of feminist ethics, arguing persuasively for reconceptualizations of the self of relations between the self and others and of images of birth and death, nurturing and violence. Held shows how social, political, and cultural institutions have traditionally been founded upon masculine ideals of morality. She then identifies a distinct (...) feminist morality that moves beyond culturally embedded notions about motherhood and female emotionality. Examining the effects of this alternative moral and ethical system on changing social values, Held discusses its far-reaching implications for altering standards of freedom, democracy, equality, and personal development. Ultimately, she concludes, the culture of feminism could provide a fresh perspective on--even solutions to--contemporary social problems. Feminist Morality makes a vital contribution to the ongoing debate in feminist theory on the importance of motherhood. For philosophers and other readers outside feminist theory, it offers a feminist moral and social critique in clear and accessible terms. (shrink)

Virginia Held assesses the ethics of care as a promising alternative to the familiar moral theories that serve so inadequately to guide our lives. The ethics of care is only a few decades old, yet it is by now a distinct moral theory or normative approach to the problems we face. It is relevant to global and political matters as well as to the personal relations that can most clearly exemplify care. This book clarifies just what the ethics of (...) care is: what its characteristics are, what it holds, and what it enables us to do. It discusses the feminist roots of this moral approach and why the ethics of care can be a morality with universal appeal. Held examines what we mean by "care," and what a caring person is like. Where other moral theories demand impartiality above all, the ethics of care understands the moral import of our ties to our families and groups. It evaluates such ties, focusing on caring relations rather than simply on the virtues of individuals. The book proposes how such values as justice, equality, and individual rights can "fit together" with such values as care, trust, mutual consideration, and solidarity. In the second part of the book, Held examines the potential of the ethics of care for dealing with social issues. She shows how the ethics of care is more promising than Kantian moral theory and utilitarianism for advice on how expansive, or not, markets should be, and on when other values than market ones should prevail. She connects the ethics of care with the rising interest in civil society, and considers the limits appropriate for the language of rights. Finally, she shows the promise of the ethics of care for dealing with global problems and seeing anew the outlines of international civility. (shrink)

In Europe, telecare is the use of remote monitoring technology to enable vulnerable people to live independently in their own homes. The technology includes electronic tags and sensors that transmit information about the user's location and patterns of behavior in the user's home to an external hub, where it can trigger an intervention in an emergency. Telecare users in the United Kingdom sometimes report their unease about being monitored by a ?Big Brother,? and the same kind of electronic tags that (...) alert telecare hubs to the movements of someone with dementia who is ?wandering? are worn by terrorist suspects who have been placed under house arrest. For these and other reasons, such as ordinary privacy concerns, telecare is sometimes regarded as an objectionable extension of a ?surveillance state.? In this article, we defend the use of telecare against the charge that it is Orwellian. In the United States, the conception of telecare primarily as telemedicine, and the fact that it is not typically a government responsibility, make a supposed connection with a surveillance state even more doubtful than in Europe. The main objection, we argue, to telecare is not its intrusiveness, but the danger of its deepening the isolation of those who use it. There are ways of organizing telecare so that the independence and privacy of users are enhanced, but personal isolation may be harder to address. As telecare is a means of reducing the cost of publicly provided social and health care, and the need to reduce public spending is growing, the correlative problem of isolation must be addressed alongside the goal of promoting independence. (shrink)

Hastings Center Report, Volume 51, Issue 5, Page 51-53, September‐October 2021.

We created Justice: The Game, an educational, role-immersion game designed to be used in philosophy courses. We seek to describe Justice in sufficent detail so that it is understandable to readers not already familiar with role-immersion pedagogy. We hope some instructors will be sufficiently interested in using the game. In addition to describing the game we also evaluate it, thereby highlighting the pedagogical potential of role-immersion games designed to teach political philosophy. We analyze the game by drawing on our observations (...) as designers and playtesters of Justice, along with feedback from students obtained in focus-groups conducted shortly after playtesting ended. We present evidence that Justice, compared to conventional instructional methods alone, plausibly enhances student learning of philosophical skills and content by requiring them to practice those skills and put their content-area knowledge to use in a highly-motivating and engaging context. (shrink)

Past research (Lawson, 2004; Nonis & Swift, 2001) has revealed a correlation between academic and business ethics. Using a sample survey, this study extends this inquiry by examining the role of dispositional variables (neuroticism, extraversion, and conscientiousness) and academic honesty on business ethics perceptions. Results indicate that (1) neuroticism and conscientiousness were positively related to more ethical perceptions in a work context, and (2) academic honesty partially mediated the relationship between conscientiousness and business ethics. Implications to business practitioners and educators (...) are discussed as well as directions for future research. (shrink)

Healthcare workers are often assumed to have a duty to work, even if faced with personal risk. This is particularly so for professionals. However, the health service also depends on non-professionals, such as porters, cooks and cleaners. The duty to work is currently under scrutiny because of the ongoing challenge of responding to pandemic influenza, where an effective response depends on most uninfected HCWs continuing to work, despite personal risk. This paper reports findings of a survey of HCWs conducted across (...) three National Health Service trusts in the West Midlands, UK, to establish whether HCWs’ likelihood of working during a pandemic is associated with views about the duty to work. The sense that HCWs felt that they had a duty to work despite personal risk emerged strongly regardless of professional status. Besides a strong sense that everyone should pull together, all kinds of HCWs recognised a duty to work even in difficult circumstances, which correlated strongly with their stated likelihood of working. This suggests that HCWs’ decisions about whether or not they are prepared to work during a pandemic are closely linked to their sense of duty. However, respondents’ sense of the duty to work may conflict with their sense of duty to family, as well as other factors such as a perceived lack of reciprocity from their employers. Interestingly, nearly 25% of doctors did not consider that they had a duty to work where doing so would pose risks to themselves or their families. (shrink)

There are many different forms and interpretations of rewilding: the concept and its practice vary from country to country, with distinct interpretations according to its geographical location. Despite the term rewilding having been present in the lexicon for three decades, the concept of rewilding in England has experienced a prolonged developmental stage. This paper argues that a unique form of English rewilding is now emerging, which is distinct from rewilding in other parts of the world. Compared to other locations rewilding (...) in England operates at smaller spatial scales; its ambitions to increase biodiversity, restore ecosystem functioning and increase natural autonomy are somewhat curtailed; it involves higher levels of human intervention; and, perhaps most tellingly of all, it goes by another name - 'wilding', 'wild' or 'wilder' with little mention of the much-maligned prefix 're'. This conclusion has been developed following a comparative case study of two English 'rewilding' sites (the Avalon Marshes and Wild Ennerdale) involving 49 semi-structured interviews: twelve expert interviews and nineteen and eighteen stakeholder/practitioner interviews at the Avalon Mashes and Wild Ennerdale respectively. (shrink)

Nearly two hundred years ago, Mary Wollstonecraft wrote what is considered to be the first major work of feminist political theory: A Vindication of the Rights of Women . Much has been written about this work, and about Wollstonecraft as the intellectual pioneer of feminism, but the actual substance and coherence of her political thought have been virtually ignored. Virginia Sapiro here provides the first full-length treatment of Wollstonecraft's political theory. Drawing on all of Wollstonecraft's works and treating them (...) thematically rather than sequentially, Sapiro shows that Wollstonecraft's ideas about women's rights, feminism, and gender are elements of a broad and fully developed philosophy, one with significant implications for contemporary democratic and liberal theory. The issues raised speak to many current debates in theory, including those surrounding interpretation of the history of feminism, the relationship between liberalism and republicanism in the development of political philosophy, and the debate over the canon. For political scientists, most of whom know little about Wollstonecraft's thought, Sapiro's book is an excellent, nuanced introduction which will cause a reconsideration of her work and her significance both for her time and for today's concerns. For feminist scholars, Sapiro's book offers a rounded and unconventional analysis of Wollstonecraft's thought. Written with considerable charm and verve, this book will be the starting point for understanding this important writer for years to come. (shrink)

In this article we distinguish between philosophical bioethics (PB), descriptive policy orientated bioethics (DPOB) and normative policy oriented bioethics (NPOB). We argue that finding an appropriate methodology for combining empirical data and moral theory depends on what the aims of the research endeavour are, and that, for the most part, this combination is only required for NPOB. After briefly discussing the debate around the is/ought problem, and suggesting that both sides of this debate are misunderstanding one another (i.e. one side (...) treats it as a conceptual problem, whilst the other treats it as an empirical claim), we outline and defend a methodological approach to NPOB based on work we have carried out on a project exploring the normative foundations of paternal rights and responsibilities. We suggest that given the prominent role already played by moral intuition in moral theory, one appropriate way to integrate empirical data and philosophical bioethics is to utilize empirically gathered lay intuition as the foundation for ethical reasoning in NPOB. The method we propose involves a modification of a long-established tradition on non-intervention in qualitative data gathering, combined with a form of reflective equilibrium where the demands of theory and data are given equal weight and a pragmatic compromise reached. (shrink)

Bioethics, Volume 35, Issue 7, Page 623-633, September 2021.

Bruno and Arora (2018) present a range of important ethical issues emerging from the development of procedures for uterine transplant (UT). They approach those issues by drawing on parallels to oth...

Intellectuals such as William James and Aldous Huxley have thought it possible to develop a technique to apply to this world the mystical-type insights gained during drug-enabled experiences. Particularly, Huxley claimed that the visionary experience triggered by psychedelics could help us rethink our relationship with technology and promote a much-needed cultural change. In this article, we explore this hypothesis. To do so, we build a philosophical framework based on Günther Anders's philosophy of technique, presenting human beings as morally blind when (...) facing technological development. Mystical experiences are then proposed as a means to improve our moral faculties—and psychedelic drugs as tools to enable them. We finally explore the empirical feasibility of such a hypothesis by thoroughly reviewing the recent scientific literature on the nature of the psychedelic experience, concluding that the long-term effects in the personality domain openness and in nature relatedness point to the emergence of a morally improved agent, thus providing substance to an application of mysticism. (shrink)

This paper critically compares the philosophy of Günther Anders and the contemporary transhumanists, like Julian Savulescu, Ingmar Persson, or Thomas Douglas. The Andersian concepts of moral blindness, promethean gap, and promethean shame will be discussed in order to understand human beings’ outdatedness; parallel to this, we will also expose the transhumanist analysis on the unfitness of human beings in evolutive and cognitive terms. We will show that much of the transhumanist analysis is a reformulation of the Andersian thesis, now under (...) scientific terminology. Finally, we will approach the transhumanist proposal of moral enhancement, explaining and confronting some critics raised on the grounds of freedom and moral responsibility. (shrink)

Background Informed consent is a requirement for all research. It is not, however, clear how much information is sufficient to make an informed decision about participation in research. Information on an online questionnaire about childhood development was provided through an unfolding electronic participant sheet in three levels of information. Methods 552 participants, who completed the web-based survey, accessed and spent time reading the participant information sheet (PIS) between July 2008 and November 2009. The information behaviour of the participants was investigated. (...) The first level contained less information than might be found on a standard PIS, the second level corresponded to a standard PIS, and the third contained more information than on a standard PIS. The actual time spent on reading the information provided in three incremental levels and the participants' evaluation of the information were calculated. Results 77% of the participants chose to access the first level of information, whereas 12% accessed the first two levels, 6% accessed all three levels of information and 23% participated without accessing information. The most accessed levels of information were those that corresponded to the average reading times. Conclusion The brief information provided in the first level was sufficient for participants to make informed decisions, while a sizeable minority of the participants chose not to access any information at all. This study adds to the debate about how much information is required to make a decision about participation in research and the results may help inform the future development of information sheets by providing data on participants' actual needs when deciding about questionnaire surveys. (shrink)

Analizo algunos aspectos clave del modelo médico del parto, centrándome especialmente en los presupuestos que parece albergar sobre la relación mente-cuerpo. En primer lugar, examino las visiones del modelo médico como un modelo dualista ontológico. En contra de las críticas habituales a este dualismo, que sostienen que ha llevado a tratar el cuerpo de parto como una máquina, defiendo que el problema no reside en el propio dualismo, sino en que se obvia la interacción mente-cuerpo: son las propias personas de (...) parto quienes se tratan como máquinas. En segundo lugar, analizo la centralidad de la noción de riesgo en el modelo médico del parto y defiendo que en ella trasluce nuevamente una escisión entre lo mental y lo corporal. Defiendo, además, una concepción construccionista del riesgo, pues este no resulta independiente de los discursos y prácticas médicas, sino que estos factores tienen un impacto causal en él. En tercer y último lugar, abordo brevemente el descrédito de los testimonios de las personas de parto, remitiéndolo nuevamente a esa escisión entre cuerpo y mente. (shrink)

Objectives: Mindful parenting, measured by the Interpersonal Mindfulness in Parenting scale, is beneficial for parents and children. However, the IMP has not been validated in English-speaking parents. Further, little is known about whether mindful parenting is similar in parents of children vs. infants, or how it reduces child internalizing problems. We sought to validate the IMP in English-speaking mothers of children and infants, and to examine relationships between the facets of mindful parenting, child internalizing problems and parent variables related to (...) internalizing.Methods: Using confirmatory factor analyses, we examined the fit of various models of mindful parenting in English-speaking community-recruited mothers of children aged 3–18 years and infants aged 0–2 years. We used regression analyses to investigate relationships between the facets of mindful parenting, child internalizing problems, and parent variables including parental experiential avoidance, unhelpful beliefs about child anxiety and accommodation of child anxiety.Results: Mindful parenting can be measured in English-speaking mothers, using either a 5- or 6-factor, 29-item version of the IMP. These versions of the IMP operate similarly for mothers of children and infants. Child internalizing problems and related parent variables were best predicted by non-judgmental acceptance of parenting in mothers of children, and emotional self-awareness and non-reactivity in mothers of infants.Conclusions: The IMP is a valid measure of mindful parenting in English-speaking mothers of children and infants. Mindful parenting predicts child internalizing problems and related parent variables, suggesting that mindful parenting programs could benefit families of children with internalizing problems, potentially by reducing parental experiential avoidance, unhelpful beliefs about or accommodation of child anxiety. (shrink)

Many strategies have been proposed to address the supply of bespoke essays and other assignments by companies often described as ‘Essay Mills’ with the act of supply and use being invariably described as ‘contract cheating’. These proposals increasingly refer to the law as a solution in common with other action. In this article, the lead author revisits work undertaken in 2016 as a result of recent legal and extra-legal developments to assess whether the UK Fraud Act (2006) might now be (...) used to tackle some of the activities of the companies involved, by comparing their common practises, and their Terms and Conditions, with the Act. It was previously found that all sites have disclaimers regarding the use of their products but there were some obvious contradictions in the activities of the sites which undermined those disclaimers, for example plagiarism-free guarantees for the work. In this article, we ask and consider the question whether this is still the case having regard to the impact of a change in the law by the UK supreme court and recent action of the UK Advertising Standards Authority. We also consider whether a call for a new offence to be created which specifically targets the undesirable behaviours of these companies is still justified. (shrink)

Altruism has long been taken to be the guiding principle of ethical organ donation in the UK, and has been used as justification for rejecting or allowing certain types of donation. We argue that, despite this prominent role, altruism has been poorly defined in policy and position documents, and used confusingly and inconsistently. Looking at how the term has been used over recent years allows us to define ‘organ donation altruism’, and comparing this with accounts in the philosophical literature highlights (...) its theoretical shortcomings. The recent report from the Nuffield Council on Bioethics reaffirmed the importance of altruism in organ donation, and offered a clearer definition. This definition is, however, more permissive than that of altruism previously seen in UK policy, and as a result allows some donations that previously have been considered unacceptable. We argue that while altruistic motivation may be desirable, it is not necessary. (shrink)

The phenomenon of contract cheating presents, potentially, a serious threat to the quality and standards of Higher Education around the world. There have been suggestions, cited below, to tackle the problem using legal means, but we find that current laws are not fit for this purpose. In this article we present a proposal for a specific new law to target contract cheating, which could be enacted in most jurisdictions.We test our proposed new law against a number of issues that would (...) need to be considered before any legal approach could be successful; would changing the legal status of contract cheating make it less likely to happen? Could this be achieved in a specific way? If so, who should actually be prosecuted and what offence are they committing? Would it actually address the causes of contract cheating? We suggest some answers to these questions, but then also identify a number of unintended potential consequences. We therefore additionally consider whether a legal approach is possible or even desirable.We conclude that a legal approach to contract cheating is possible, and, on balance, appropriate. Using UK law as an example, we offer a specific suggestion to lawmakers, around the world, for how this might be achieved, and conclude that the most successful approach would be to focus largely on a law targeting the providers of contract cheating, in particular commercial services. (shrink)

Despite increased attention to the question of how best to evaluate clinical ethics consultations and emphasis on external evaluation, there has been little sustained focus on how we, as clinicians, make sense of and learn from our own experiences in the midst of any one consultation. Questions of how we evaluate the request for, unfolding of, and conclusion of any specific ethics consultation are often overlooked, along with the underlying question of whether it is possible to give an accurate account (...) of clinical ethics consultants’ experience as experienced by ethics consultants. Before the challenge of submitting one’s accounts or case reports for review and evaluation from others, there is an underlying challenge of understanding and evaluating our own accounts. To highlight this crucial and deeply challenging dimension of actual clinical ethics practice, we present an account of a complex consultation, explicitly constructed to engage the reader in the unfolding experience of the consultant by emphasizing the multiple perspectives unfolding within the consultant’s experience. Written in script format, the three perspectives presented—prototypical clinically descriptive account; didactically reflective and self-evidentiary account often seen in journal presentations; highly self-critical reflective account emphasizing uncertainties inherent to clinical ethics practice—reflect different manners for responding to the ways actual clinical involvement in ethics consultation practice accentuates and refocuses the question of how to understand and evaluate our own work, as well as that of our colleagues. (shrink)

Medical student learning is dependent on an unwritten agreement between patients and the medical profession, in which students “practise” upon real patients in order that, when they are doctors, those same patients will benefit from the doctors’ skills. Given the increasing propensity for patients to refuse to take part in such learning, there is a danger that doctors will qualify without being truly competent. As patients, we must all ask ourselves, when asked to take part in medical teaching: if this (...) student/trainee doesn’t learn now, on me and under supervision, how will the person be truly competent next time, when this is for real, and the patient might be me or my loved one?We argue that a new and more explicit agreement is needed, in which the default should be that all patients are willing to help in the education of medical students, while we ensure that all such students are already competent in simulation before first practising upon real patients. (shrink)