Recent theorists have suggested that human altruism toward non-family members evolved because of the tremendous benefits of reciprocity. Developing further the notion that evolutionary theory can help to explain moral sentiments, Howard Kahane proposes that a sense of fair play is essential to ethics and argues that moral obligation, too narrowly construed, prevents us from living rationally. He brings his account of fair play to bear on the ethics of various domains of social life including friendship, taxes, civil (...) rights, and nation states. (shrink)

David Gauthier is one of the most outstanding and influential philosophers working in moral theory today, and his book Morals by Agreement has established him as a preeminent defender of contractarian moral theory. This volume brings together a selection of his best essays on contractarianism, many of which have become difficult to find.

Psychotherapists and counsellors confront several ethical dilemmas as they tend to provide effective services. There has been much debate among psychotherapists and counsellors alike around the utility of therapeutic contracts. Some view contracts as being restrictive to the therapeutic process and often hindering the work done in sessions. In contrast, many counsellors and psychotherapists use those agreements to revisit specific therapeutic topics and establish the guidelines necessary for this professional arrangement. No matter the opinion or preference of contracts, the development (...) of written and/or verbal consent of specific topics in psychotherapy remains essential. This remains one of the formal features of the arrangement and starting relationship in current counselling and psychotherapy practice. This paper aims to discuss the necessity and ethical demand of therapeutic contract in counselling and psychotherapy practice. (shrink)

This article explores what an ethicfor organic animal husbandry might look like,departing from the assumption that organicfarming is substantially based in ecocentricethics. We argue that farm animals arenecessary functional partners in sustainableagroecosystems. This opens up additional waysto argue for their moral standing. We suggestan ethical contract to be used as acomplementary to the ecocentric framework. Weexpound the content of the contract and end bysuggesting how to apply this contract inpractice. The contract enjoins us to share thewealth (...) created in the agroecosystem (by ourjoint contributions) by enjoining us to carefor the welfare and needs of the individualanimal, and to protect them from exploitation(just as human co-workers should not beexploited). The contract makes promoting goodanimal welfare a necessary condition forbenefiting farm animals. Animals for their partare guaranteed coverage under the contract solong as they continue to contribute to thesystem with products and services. (shrink)

Long used as a tool for medical compliance and adhering to treatment plans, behavior contracts have made their way into the in-patient healthcare setting as a way to manage the “difficult” patient and family. The use of this tool is even being adopted by healthcare ethics consultants (HECs) in US hospitals as part of their work in navigating conflict at the bedside. Anecdotal evidence of their increasing popularity among clinical ethicists, for example, can be found at professional bioethics meetings (...) and conversations and idea-sharing among practitioners on HEC social media. While there are a handful of papers gesturing toward a bioethical critique of behavior contracts of various types, the use of behavior contracts in the context of interpersonal conflict has not been vetted by bioethicists to determine their ethical legitimacy or efficacy. In this paper, we highlight a set of ethical concerns that we believe must be addressed before continuing or widespread implementation of behavior contracts to manage the “difficult” patient or family. (shrink)

Extant social contracts, deriving from communities of individuals, constitute a significant source of ethical norms in business. When found consistent with general ethical theories through the application of a filtering test, these real social contracts generate prima facie duties of compliance on the part of those who expressly or impliedly consent to the terms of the social contract, and also on the part of those who take advantage of the instrumental value of the social contracts. Businesspeople typically participate in (...) multiple communities and, as a consequence, encounter conflicting ethical norms. Priority rules can be devised to resolve such conflicts. The framework of extant social contracts merges normative and theoretical research in business ethics and specifies a domain for empirical studies. (shrink)

The pervasive use of contracts in healthcare is a source of unease for many healthcare ethicists and patient advocates. This commentary examines the use of such contracts with individuals in rehabilitation settings who have complex medical and behavioural issues. The goals of this paper are to examine the many factors that can lead to contract use, to discuss some legal and ethical implications of contract use, and to assess contract use in light of concerns about health equity. (...) The paper concludes with some practical alternatives to the use of such contracts, and refers specifically to tools that might be borrowed from the field of behavioural therapy. (shrink)

Artificially intelligent (AI) technologies are increasingly being used in many workplaces. It is recognised that there are ethical dimensions to the ways in which organisations implement AI alongside, or substituting for, their human workforces. How will these technologically driven disruptions impact the employee–employer exchange? We provide one way to explore this question by drawing on scholarship linking Integrative Social Contracts Theory (ISCT) to the psychological contract (PC). Using ISCT, we show that the macrosocial contract’s ethical AI norms of (...) beneficence, non-maleficence, autonomy, justice, and explicability can feed into national- and organisational-level microsocial contracts. We also outline the role of employees’ technology frames in this process. We then use an illustrative example to demonstrate how this multilevel normative background helps to inform the content of individuals’ PCs in the context of working with AI technologies. (shrink)

The economic costs to the insurers of complementary routine genetic testing would outweigh the benefits. However, should testing technology in future be refined so as to produce a cheap and reliable test, there is no reason why insurers might not take up predictive testing as part of the normal underwriting process. It is this possibility which justifies formulating a pre-emptive policy. At the very least, there are reasons for promoting and protecting the welfare of the proposer so as to redress (...) the bargaining positions between him or her as a consumer of a service and the insurer as a commercial concern. Further considerations relate to the social purpose of insurance as a social mechanism, and the need to find ways of avoiding undermining this in light of Human Genome Project. (shrink)

This chapter contains sections titled: Background: mapping the field of business ethics The evolution of social contract approaches to business ethics Integrative social contracts theory (ISCT) Remaining issues and promising research directions for contractarian business ethics.

In this paper, the nature of the contract of employment is explored from an ethical point of view. It is argued that certain normative arguments should be taken into account in order to justify such a contract. Furthermore, an argument is developed against the claim that (a) the individual’s freedom of decision and (b) the practice of institutional arrangements are sufficient to justify a contract of employment. The dimensional analysis offered shows that further conditions are needed: (a) (...) must be elaborated and interpreted to the extent that this condition is not sufficient – rather sub-criteria regarding the agent’s state of knowledge must be met; and (b) should be supplemented by a demand for fairness. A tentative analysis of existing work contracts is the starting point for the ethical analysis. The aim is to show what a legitimate, or reasonable, contract of employment will require. Finally, some important normative implications and consequences regarding the contract’s normative status are discussed. (shrink)

Fiester and Yuan discuss important ethical concerns regarding the use of behavior contracts in addressing conflict with patients and families labeled as “difficult” (Fiester and Yuan 2023). We agre...

Alan Reynolds: This paper is divided into three sections. First, I describe the wide plurality of views on issues of animal ethics, showing that our disagreements here are deep and profound. This fact of reasonable pluralism about animal ethics presents a political problem. According to the dominant liberal tradition of political philosophy, it is impermissible for one faction of people to impose its values upon another faction of people who reasonably reject those values. Instead, we are obligated to (...) justify our political actions to each other using reasons that everyone can accept. Thus, in the second section I suggest that our condition of reasonable pluralism inspires us to turn toward some form of contractarianism. The social contract tradition emerged precisely as an attempt to think about how a society characterized by deep moral disagreement could nonetheless agree about the basic principles of justice. I will show, in this section, that although the social contract tradition would seem to contain the best tools for thinking about how to deal with moral disagreement, it fails to help us think through the important issues of animal ethics. In the concluding section, I suggest some ways in which political philosophy might move beyond contractarianism when thinking about this issue, including embracing an agonistic style of politics. -/- Cet article est divisé en trois sections. Tout d’abord, je décris la grande pluralité des opinions existant sur les questions de l’éthique animale, montrant que nos désaccords sur le sujet sont profonds. Cette réalité du pluralisme raisonnable en matière d’éthique animale pose un problème politique. Selon la tradition libérale dominante de la philosophie politique, une faction de personnes ne peut imposer ses valeurs à une autre faction qui rejette raisonnablement ces valeurs. Au lieu de cela, nous sommes obligés de justifier nos actions politiques en utilisant des raisons que tout le monde peut accepter. Ainsi, dans la seconde section, je suggère que notre condition de pluralisme raisonnable nous mène à une forme de contractualisme. La tradition du contrat social est justement apparue comme une tentative de réfléchir à la façon dont une société caractérisée par un profond désaccord moral peut néanmoins s’entendre sur les principes fondamentaux de la justice. Dans cette section, je montre que, bien que la tradition du contrat social semble offrir les meilleurs outils pour définir la manière de traiter le désaccord moral, elle ne parvient pas à nous aider à réfléchir aux questions essentielles de l’éthique animale. Dans la dernière section, je suggère quelques façons susceptibles de permettre à la philosophie politique de dépasser le contractualisme dans sa réflexion sur cette question, ceci comprenant l’adoption d’un style de politique agonistique. (shrink)

Under present accounting rules, lessees frequently structure contracts for leased assets, in situations where they enjoy benefits similar to outright ownership, in a way that keeps both the leased assets and related liabilities off their books. This method of accounting creates off-balance sheet financing and is called operating lease accounting. The paper debates the ethicality of intentionally structuring lease contracts to avoid disclosing leased asset and liability amounts and describes the “slippery slope” of rule-based accounting for synthetic leases and special (...) purpose entities, that, in the author’s opinion, led to the accounting debacles at Enron and other companies. The ethical intent that is implicit in the Securities and Exchange Commission and Financial Accounting Standards Board regulations is discussed and suggestions for improving the ethicality of financial reporting are provided. (shrink)

Despite significant ethical advances in recent years, including professional developments in ethical review and codification, research deception continues to be a pervasive practice and contentious focus of debate in the behavioral sciences. Given the disciplines' generally stated ethical standards regarding the use of deceptive procedures, researchers have little practical guidance as to their ethical acceptability in specific research contexts. We use social contract theory to identify the conditions under which deception may or may not be morally permissible and formulate (...) practical recommendations to guide researchers on the ethical employment of deception in behavioral science research. (shrink)

This article provides an ISCT analysis of commercial bribery focused on transaction cost economics. In the language of Antitrust, commercial bribery is a form of vertical arrangement subject to the same efficiency analysis that has found other vertical arrangements potentially beneficial to consumers. My analysis shows that actions condemned as commerical bribery in the Honda case may well have benefited Honda's dealer network once promotional free riding and other forms of rent seeking by dealers are considered. I propose that the (...) term "commercial bribery" should be avoided until after an ISCT analysis shows that the community is likely to have been harmed. The term "third-party payments" is a more ethically neutral term with which to begin the analysis. (shrink)

Social values and beliefs systems are playing an increasingly influential role in shaping the attitudes and behavior of individuals and organizations towards the employment relationship. Many individuals seek a broader meaning in their work that will let them feel that they are contributing to the broader community. For many organizations, a willingness to behave ethically and assume responsibility for social and environmental consequences of their activities has become essential to maintaining their 'license to operate.' The appearance of these trends in (...) individual and organizational behavior towards outcomes that are more explicitly congruent with ethical and social values has significant implications for understanding the psychological contracts being created today. In this paper, we examine issues associated with the psychological contract and ethical standards of behavior, focusing on both the individual and organizational levels. (shrink)

Countless contracts have been undermined by the COVID-19 pandemic of 2020 as well as government orders to contain it. Flights have been canceled, concerts have been called off, and dorms have been closed, just to name a few. Do these all count as breaches of contract—or are the parties excused due to the extraordinary circumstances? And how should the losses be allocated between the parties? The law provides one set of answers to these questions; ethics offers another. With (...) a focus on American law and Jewish ethics, this paper shows that the two systems are in accord with some respects and differ in others: Both law and Jewish ethics would excuse a party who cannot complete his contract due to a force beyond his control, like the COVID-19 pandemic. Yet Jewish ethics would require that the excused party still be paid, while American law would not. (shrink)

This study explores the legal and ethical issues associated with contract pricing. In particular, it focuses on a set of legal precedents which have addressed the enforceability of allegedly unfair contract prices. Traditionally, the common law has emphasized the consent of the parties. If the parties consented to a given price; it is presumptively fair and enforceable. The cases reviewed in this study, however, seem to draw upon alternative moral conceptions of fairness not normally associated with the common (...) law. The analysis begins by distinguishing the traditional legal conception of fairness from alternative moral conceptions. The cases are then read with a critical eye so as to tease out the underlying principles which best explain them. The analysis illustrates that, notwithstanding judicial rhetoric to the contrary, the courts continue to employ the traditional legal notion of fairness, to the exclusion of alternative moral concerns. The study clarifies an otherwise murky area of the law and illustrates that the legal meaning of fairness differs greatly from the moral one. (shrink)

The outsourcing of medical research has become a strategic imperative in the global pharmaceutical industry. Spurred by the challenges of competition, the need for speed in drug development, and increasing domestic costs, pharmaceutical companies across the globe continue to outsource critical parts of their value chain activities, namely contract clinical research and drug testing, to sponsors across the globe, typically into emerging markets. While it is clear that important ethical issues arise with this practice, unraveling moral responsibility and the (...) allocation of responsibility is not so clear, considering that contracts, by their very definition transfer responsibility from the principal to the agent. This research provides a framework for exploring some of the ethical issues, including attributions of moral responsibility associated with Contract Medical Research. Using a theory of strategic and moral behavior, the research shows that both clients and sponsors in contract research have individual and collective responsibility to ensure that due care and diligence is exercised in the performance of clinical research. The research suggests some guidelines for stakeholder action. (shrink)

Although people establish norms that enable them to live together, some of these have to be coupled with a system of enforcement. This conforms to broad social contract theory and can also be applied to the international sphere. The international community is also based on a system of norms. However, unlike the domestic context, there is no overreaching authority to direct states on what they should do. Rather it is left to states themselves to police this framework. However, this (...) has resulted in one of the conditions envisaged by social contract theorists, namely a stasis between the command order and the state of nature. This may explain, for instance, the indifference to some modern human rights violations. Hence the current system of International law, with its insistence on the Westphalian principle of equality of states has caused a substantial fracture in the enforcement of international law, particularly when it comes to serious human rights breaches, and caused something akin to the state of nature envisaged by social contract theorists. While it may be practically impossible to provide a command system in the international sphere similar to the one in the domestic life, there is some hope that a revised deontological ethic founded on global integration may provide one impetus for change. (shrink)

In this paper we cast light on one form of dishonest behaviour in academia – contract cheating services. We examine how an agreement between a student and a contract cheating services provider is viewed from ethical and legal perspectives. For this purpose we carried out an analysis of contract cheating services as an agreement which, in Lithuania, is currently facing the challenge of implementing laws regarding contract cheating services as a violation of academic ethics. Taking (...) into consideration recent jurisprudence, together with social media articles, we conclude that while any agreement for contract cheating services is severely criticized in terms of ethics, the courts either do not regard this type of agreement as a violation of legal norms, or they inadequately apply legal remedies when such an agreement is deemed to be void. (shrink)

The traditional military-territorial model of the nation state defines international duties in terms of protecting citizens' property from foreign threats. In this 1992 book about the principles of the US agricultural policy and foreign aid, Professor Thompson replaces this model with the notion of the trading state that sees its role in terms of the establishment of international institutions that stabilize and facilitate cultural and intellectual, as well as commercial, exchanges between nations. The argument focuses on protectionist challenges to foreign (...) aid and development assistance programs, and engages with the views of a variety of economists, commodity organizations, and philosophers on world hunger and development. What emerges is a new interpretation of social contract theory that can determine goals for international trade and development policy. (shrink)

Golden parachutes are often viewed as a form of excessive compensation because they provide senior management with substantial payouts following an acquisition while other stakeholders are subjected to layoffs, disrupted business relationships and other negative externalities. Using a sample of S&P 500 firms, an economic and ethical justification for this type of contract is given. Golden parachutes ensure effective corporate governance that, in turn, preserve the firm's value for all stakeholders. Boards of directors enter into parachute agreements to protect (...) recently hired CEOs' human capital during periods of financial uncertainty and, thus, potential takeover activity. From an ethics viewpoint, golden parachutes are valuable to all stakeholders because they encourage merger or acquisition in lieu of bankruptcy. (shrink)

This article begins with a detailed analysis of how the choice situation of a social contract for international business ethics can be constructed and justified. A choice situation is developed by analyzing conceptions of the multinational firm and the domain of international business. The result is a hypothetical negotiation between two fictional characters, J. Duncan Grey and Elizabeth Redd, who respectively represent the interests of businesses and communities seeking to engage in international trade. The negotiators agree on ethical (...) principles governing wages, the environment, and compliance social and cultural norms. These principles are then shown to rest in wide reflective equilibrium with considered moral judgments on international business ethics, which are drawn from international agreements, such as the UN Declaration on Human Rights, and voluntary business initiatives, such as the Global Sullivan Principles and the UN Global Compact. (shrink)

The central question which I address is whether appeal to a hypothetical contract between moral persons is acceptable as a method for justifying basic ethical principles. ;My first two substantive chapters concern general issues in metaethics, particularly the shortcomings of both standard naturalist and noncognitivist theories of evaluative language; some conditions of acceptability for methods of moral justification are proposed and supported as well. Firth's and Hare's methods fail to satisfy these criteria, while Brandt's present approach and Rawls' method (...) of reflective equilibrium largely succeed. Rawls, quite correctly, intends his contract argument to apply only within the framework of this more basic method. ;Major aspects of Rawls' contract theory are examined at length in Chapter IV. My central concern is with the reasons Rawls gives for regarding his interpretation of the initial contract situation as the "rationally preferred" one. The concepts of impartiality, neutrality, and fairness are discussed at the outset. I then proceed to explain and criticize Rawls' reasons for imposing a "thick veil of ignorance" on the contractors. The argument that natural assets and social contingencies are "morally arbitrary" and hence should not influence the choice of principles of justice is found to be open to serious objection and to rest upon a specific type of egalitarian moral commitment. Rawls' "Kantian" argument is shown to lack sufficient support and to involve an unwarranted exclusion of certain deontological, perfectionist, and other teleological theories from serious consideration. ;Grice's contract theory, which omits the "veil," is examined in Chapter V, together with his account of prudential reasoning and his argument for a necessary connection between moral obligation and rationality. His type of contract approach is demonstrated to be unworkable due to vague description of the initial situation. Moreover, it has unacceptable implications and cannot serve as an appropriate basis for moral justification in any case. ;I conclude that the ideal contract method is at best a very conditional procedure of moral justification, far more suitable for some types of moral conceptions than for others. It seems unlikely, furthermore, that achievement of wide reflective equilibrium or "full rationality" in Brandt's sense would result in a consensus favoring any one description of the initial contract situation. (shrink)

Jehovah’s Witnesses should be required to sign transfusion contracts in order to be eligible for transplant.Human donor organs continue to be in short supply, and many potential transplant recipients die while waiting for an allograft to become available.1 Because the organ supply is so limited and the offering of organs is based on the generosity of patients and families, proper stewardship of these organs is an ethical obligation for transplant teams, as well as organ recipients. Preventable graft loss must be (...) protected against, and factors that foster preventable graft loss—for example, non-compliance must be proactively contemplated when patients are reviewed as potential transplant candidates. Post-transplant treatment refusal is one example of behaviour that can compromise transplant success.JEHOVAH’S WITNESSES AS TRANSPLANT RECIPIENTSIt is widely known that one of the most significant teachings of the Jehovah’s Witness church is abstinence from receiving blood transfusions.2 Believers derive this tenet from the Bible verse: “You are to abstain from …blood”.3 While blood loss is a risk of transplant surgery, some centres do not view patient refusal of blood transfusion as a transplant exclusion criterion. The first published case of transplantation of a Jehovah’s Witness appeared in 1986 from the University of California Los Angeles heart transplant team.4 Since then, numerous other cases have been published, including liver,5 kidney,6 pancreas,6 and lung.7 For experienced centres with superior blood management skills, transplant can indeed be a surgical success; however, optimal blood management before and during surgery are only two thirds of the patient’s clinical time clock. In the remaining third, the post-transplant period, the patient has received his/her organ, yet the potential for clinical need of blood transfusion remains.THE DILEMMAWhether due to postoperative complication, or future illness or trauma, all transplant recipients have …. (shrink)

Fragile states and developing countries increasingly contract out health services to non-state providers (NSPs) (such as non-governmental organisations, voluntary sector and private sector). The paper identifies ethical issues when contracts involve devolution of health services to NSPs and proposes procedures to prevent or resolve these ethical dilemmas. Ethical issues were identified by examining processes of contracting out. Health needs could be used to select areas to be contracted out and to identify service needs. Health needs comprise “disease-burden-related needs”, “health-service (...) needs”, and “urgency of health-service needs”. The mix of services should include an analysis of cost-effectiveness. NSPs should be selected fairly, without bias, and conflicts of interest during their work must be avoided. The population’s views must be respected and accountability structures established. Devolved health services should ensure equity of access to healthcare. The services ought to be sustainable and evaluated objectively. Of these issues, conflicts of interest among NSPs and sustainability of health services have not attracted attention in the literature on ethics of health policy. Fair procedures could address these ethical issues—for example, public consultation on issues; decisions based on the public consultation and made on evidence; principles of decisions stated and reasonable; decisions given adequate publicity; a mechanism established to challenge decisions; assurance that mechanisms meet the above conditions; and regular review of the policies. These procedures are complemented by improving self-governance of NSPs, countries’ development of guidelines for devolving health services, and measures to educate the public of the client countries on these issues. (shrink)

In the past, the Hague Conference on Private International Law has shaped how people can become the legal parents of children born in countries other than their own. It did so by creating the 1993 Hague Convention on Intercountry Adoption. It is now interested in developing a convention on international contract pregnancy. We discuss in this commentary what such a convention would have to include for it to be ethically consistent with the Convention on Adoption.

Possible distributive justice frameworks for providing health care by general practitioners are discussed. The ethical considerations before and after the recent changes to the British National Health Service are contrasted, with particular emphasis on a possible ethical divide that has been produced between fund-holding and non-fund-holding general practitioners. It is argued that general practitioners in non-fund-holding practices can continue as ethical advocates for their patients and distribute health care within an egalitarian framework. However, those in fund-holding practices may now be (...) seen as interest advocates and may have to practise utilitarian distributive justice. Patient groups may be needed to ensure that these general practitioners are seen to act justly in the distribution of the health care resources for which they are now responsible. (shrink)

ISCT arguably forms the most promising impetus to a contractarian theory of business ethics presently available. In this article, I want to pay tribute to the lasting significance of Dunfee's contribution to the field of business ethics by analyzing the vital role of the idea of extant social contracts (ESCs) in the conceptual set up of the ISCT project. The construct of ESCs can be shown to shape the problem statement from which the ISCT project proceeds – indeed (...) it helps to conceptualize the basic question which defines and delineates the domain of business ethics. (shrink)

Abstract:This paper develops a framework for examining decision making about ethical issues and tests the applicability of a social contract perspective. Using two separate samples of students and salespeople, we determine that community members (salespeople) tend to judge a potentially unethical act to constitute a violation of an implicit social contract and non-community members (students) do not. Also, consistent with the emphasis on context specificity of integrative social contracts theory, situational variables influence perceptions of ethicality for the community (...) members, but do not affect the perceptions of individuals outside the community. The study finds considerable support for the use of a social contractarian perspective in the study of decision-making processes about ethical issues. (shrink)

Integrative social contracts theory (ISCT) has been an influential theory in normative business ethics for well over a decade, drawing attention both as an object of criticism and as a source of inspiration. In this paper I argue that, despite this attention, the fact that it is a genuinely pluralistic theory, in the tradition of pluralistic theories of political philosophy, is often overlooked. It is in the notion of moral free space that this pluralism is most clearly expressed. This (...) oversight is unfortunate for two reasons. Firstly, it prevents the potential of ISCT, as a normative theory of business ethics, from being appreciated fully; secondly, it leads us to ignore resources that could help tackle its most problematic flaws. In this second respect, I show how some of these flaws could be addressed by paying closer attention to the similarities between ISCT and John Rawls' theory of Political Liberalism. (shrink)

This article provides an ISCT analysis of commercial bribery focused on transaction cost economics. In the language of Antitrust, commercial bribery is a form of vertical arrangement subject to the same efficiency analysis that has found other vertical arrangements potentially beneficial to consumers. My analysis shows that actions condemned as commerical bribery in the Honda case (1996) may well have benefited Honda's dealer network once promotional free riding and other forms of rent seeking by dealers are considered. I propose that (...) the term "commercial bribery" should be avoided until after an ISCT analysis shows that the community is likely to have been harmed. The term "third-party payments" is a more ethically neutral term with which to begin the analysis. (shrink)

The ‘no-suicide contract’ is a frequently utilized tool in both the assessment and dispersal of suicidal patients. However, little attention has been given to questioning whether suicidal persons are able to give informed consent to enter such a contract. This article utilizes both the existing literature on no-suicide contracts and the results of recent research into the effects of this tool, to examine whether its use is consistent with the legal and ethical doctrine of informed consent. Particular attention (...) is given to issues of competence, fullness of information, voluntariness and paternalistic intervention when no-suicide contracts are used. This analysis finds the tool to be problematic and suggests that individual patients’ ability to give informed consent about a no-suicide contract needs to be carefully considered by clinicians. (shrink)