Some people oppose abortion on the grounds that fetuses have full moral status and thus a right to not be killed. We argue that special obligations that hold between mother and fetus also hold between parents and their children. We argue that if these special obligations necessitate the sacrifice of bodily autonomy in the case of abortion, then they also necessitate the sacrifice of bodily autonomy in the case of organ donation. If we accept the argument that it is obligatory (...) to override a woman’s bodily autonomy for the sake of an unborn child’s survival, we must continue to override the bodily autonomy of parents to ensure the survival of their living children, until the parent no longer has a special obligation to their child to the same degree as their special obligation to the fetus. And if the life of a child is truly more important than the bodily autonomy of its parents, as must be the case to force women to carry unwanted pregnancies to term, this should remain true until such a time that their children are no longer considered their responsibility. Thus, parity of reasoning suggests that policies compelling the gestation of a fetus should be accompanied by policies compelling organ donation. (shrink)

Debates on humanitarian intervention have focused on the permissibility question. In this paper, I ask whether intervention can be a moral duty, and if it is a moral duty, how this duty is to be distributed and assigned. With respect to the first question, I contemplate whether an intervention that has met the "permissibility" condition is also for this reason necessary and obligatory. If so, the gap between permission and obligation closes in the case of humanitarian intervention. (...) On the second question, I propose 'institutionalizing" the duty to intervene. In this way, an otherwise imperfect obligation to intervene can be made "perfect" and specific to some agent. (shrink)

Just war theorists who argue that war is morally justified under certain circumstances infer implicitly that establishing the military institutions needed to wage war is also morally justified. In this paper, I mount a case in favor of a standing military establishment: to the extent that going to war is a way to discharge duties to protect fellow citizens and distant strangers from grievous harms, we have a duty to set up the institutions that enable us to discharge (...) that duty. I then respond to four objections drawn from Ned Dobos's recent book Ethics, Security, and the War-Machine. (shrink)

Mental health professionals rightfully experience significant anxiety regarding their duty to protect when working with potentially dangerous individuals. This work dispels myths and provides readers with a resource addressing the situations where a duty to protect may apply.

Recent years have heralded increasing attention to the role of multinational corporations in regard to human rights violations. The concept of complicity has been of particular interest in this regard. This article explores the conceptual differences between silent complicity in particular and other, more "conventional" forms of complicity. Despite their far-reaching normative implications, these differences are often overlooked.Rather than being connected to specific actions as is the case for other forms of complicity, the concept of silent complicity is tied to (...) the identity, or the moral stature of the accomplice. More specifically, it helps us expose multinational corporations in positions of political authority. Political authority breeds political responsibility.Thus, corporate responsibility in regard to human rights may go beyond "doing no harm" and include apositive obligation to protect. Making sense of this duty leads to a discussion of the scope and limits of legitimate human rights advocacy by corporations. (shrink)

This paper addresses The Ends of Harm by Victor Tadros. In it, I attempted to explore some of the implications of Tadros’s theory of punishment, particularly those following from the uneasy relationship between punishment of the offender and D’s duty to protect the victim from future harm. Among my concerns were: the apparent underinclusiveness of Tadros’s theory of punishment; the vague and unpredictable scope of D’s liabilities; the taking away by the state of V’s right to be protected; (...) and the lack of inherent limitations on the appropriate forms and amounts of punishment. I also questioned the true meaning of the duty incurred by D as a result of D’s wrongdoing and suggested that protection of Vs from future harm may not be as essential to Tadros’s justification of punishment as he has argued. (shrink)

In 1998 Ghia Van Eeden was sexually assaulted by a serial rapist who had escaped from police custody due to the negligence of the South African police authorities. Claiming that the State owed a common law duty of care to potential victims to protect them from violent crimes, Van Eeden sought damages for the harm she had suffered. In a path-breaking decision, the Supreme Court of Appeal (S.C.A.) found that a duty of care did indeed exist and (...) that its execution had to be considered in line with the constitutional requirement to protect women's right to be free from violence and the constitutional obligation to develop the common law so as to promote the spirit, purport and objects of the South African Bill of Rights. Examining the Van Eeden decision in terms of its substantial development of the circumstances in which the State may be judged liable for a wrongful omission, this note positions the S.C.A.'s decision in the context of the evolving case law of the Constitutional Court on sexual violence and ultimately questions its practical significance for addressing the prevalent abuse of women in South Africa. (shrink)

This paper demonstrates how ubuntu relational philosophy may be used to ground beneficial coercive care without necessarily violating a patient’s dignity. Specifically, it argues that ubuntu philosophy is a useful theory for developing necessary conditions for determining a patient’s potential dangerousness; setting reasonable limits to the duty to protect; balancing the long-term good of providing unimpeded therapy for patients who need it with the short-term good of protecting at-risk parties; and advancing a framework for future case law and (...) appropriate regulations in the care of psychotherapy patients. Issues regarding the decision to breach medical confidentiality in psychotherapeutic care are ultimately reserved for the courts. Professional assessment might be an important first step in this process, and court rulings govern most aspects of this assessment. However, current case law, especially in the United States, places an unreasonable expectation on psychotherapists to protect all at-risk parties or foresee that a patient intends to follow through on said threats. It has largely failed to guarantee psychotherapy patients unlimited access to care, while potentially inhibiting future honest communication between patients and health professionals and endangering the safety of others. Of these decisions, the two most prominent are the 1976 Tarasoff decision and the 2016 Volk decision. This paper argues for the possibility of grounding good laws in ubuntu African philosophy in a way that protects others from harm and ensures unimpeded access to care without necessarily breaching medical confidentiality. (shrink)

People freely disclose vast quantities of personal and personally identifiable information. The central question of this Meador Lecture in Morality is whether they have a moral (or ethical) obligation (or duty) to withhold information about themselves or otherwise to protect information about themselves from disclosure. Moreover, could protecting one’s own information privacy be called for by important moral virtues, as well as obligations or duties? Safeguarding others’ privacy is widely understood to be a responsibility of government, business, and (...) individuals. The “virtue” of fairness and the “duty” or “obligation” of respect for persons arguably ground other-regarding responsibilities of confidentiality and data security. But is anyone ethically required—not just prudentially advised—to protect his or her own privacy? If so, how might a requirement to protect one’s own privacy and to display ethical virtues of reserve, modesty and temperance properly influence everyday choices, public policy, or the law? I test the idea of an ethical mandate to protect one’s own privacy, while identifying the practical and philosophical problems that bear adversely on the case. I consider “conceptual” and “libertarian” objections to the view that each individual indeed has a moral obligation to safeguard his or her own privacy. Government and industry are not off the hook if privacy is a duty of self-care and self-respect: they have responsibilities and are freshly viewed as partners in moral agents’ quest for ethical goodness. (shrink)

This article addresses the tensions between the sense of responsibility that university administrators feel to protect student privacy with the requirement to be accountable and transparent to the public. This discussion is placed in the context of the history and purpose of post-secondary education.

In this response to Johnson, Oh reaffirms the scholarly vision of Kelsay and Twiss, elaborates upon Muslim perspectives on human rights, and questions the emphasis on violent humanitarian interventions as part of the Responsibility to Protect mandate. Oh suggests that, in light of the historical relationship between Muslim and non-Muslim states and the aftermath of the second Iraq War, more consideration be given to the rebuilding of Muslim-majority societies. Oh also highlights the concept of duty as a religiously (...) based ideal to which governments of Muslim nations ought to be held. (shrink)

Many environmental harms are produced by the consequences of too many people doing acts which taken together have collective bad consequences, e.g. overuse of an underground aquifer or acid rain 'killing' a lake. If such acts are wrong, what should a conscientious moral agent do in such circumstances? Examples of such harms have the general feature that they are produced by individual acts, which taken by themselves may be innocent and morally permissible, but which have disastrous consequences when too many (...) people perform them. Philosophers once thought that the generalisation argument, "If the consequences of everyone's doing acts of kind a are undesirable, then no one ought to do a," was the appropriate principle to guide a conscientious moral agent in such circumstances. However, there has been considerable literature discussing the shortcomings of this principle. Nevertheless, a proper understanding of the GA suggests that whole groups of people have collective duties to prevent such harms, which duties then provide clues to individual duties to protect the environment. In this paper I consider some major deficiencies of the generalisation argument, the collective duty which follows from the salvageable part of the argument, and the distribution of individual duties a conscientious moral agent has with regard to such environmental harms as a consequence. These duties turn out to be peculiarly political in nature with the result that conscientious moral agents may have a number of political duties to protect the environment heretofore unrealised. (shrink)

This chapter analyses competing claims on dignity in constitutional judgments about abortion that impose on government a constitutional duty to protect unborn life. Over decades of debate, courts deciding abortion cases have adopted different approaches to reconciling commitments to dignity as liberty, dignity as equality, and dignity as life. Courts vary over time and across borders in the ways they require respect for dignity in the regulation of abortion, as the essay shows by comparing leading German abortion judgments (...) and cases of several other jurisdictions. This analysis suggests that evolving conceptions of women as deliberative agents play a role in the abortion case law, even in jurisdictions that constitutionalize a duty to protect unborn life. Attention to the ways law coordinates competing claims on dignity in the abortion cases offers a fascinating window on the roles dignity can play in mediating conflict within a constitutional community. (shrink)

In this book Shrader-Frechette reveals how politicians, campaign contributors, and lobbyists--and their power over media, advertising, and public relations--have conspired to cover up environmental disease and death.

The International Commission on Intervention and State Sovereignty's report, The Responsibility to Protect, argues that when a state is unable or unwilling to uphold its citizens? basic human rights, such as in cases of genocide, ethnic cleansing, and crimes against humanity, the international community has a responsibility to protect these citizens by undertaking humanitarian intervention. An essential issue, however, remains unresolved: which particular agent in the international community has the duty to intervene? In this article, I critically (...) examine four ways of assigning this duty. Although I highlight the benefits of institutionalising the responsibility to protect, I argue that we should adopt, in the short term at least, a consequentialist solution: humanitarian intervention should be the responsibility of the intervener that will be the most effective. (shrink)

This article considers the duty to undertake humanitarian intervention. It first examines the arguments for the duty to intervene and questions the possibility of supererogatory humanitarian intervention. It then considers the leading objections to this duty which, it is argued, are largely unpersuasive. In the final section, the article considers the duty to intervene in the context of the responsibility to protect doctrine, which provides the framework within which debates about humanitarian intervention now in large (...) part occur. (shrink)

Kristin Shrader-Frechette: Taking Action, Saving Lives: Our Duties to Protect Environmental and Public Health Content Type Journal Article Pages 1-4 DOI 10.1007/s11948-011-9267-1 Authors Matthew Benjamin Reisman, Environmental Studies, The University of Colorado at Boulder, Boulder, USA Journal Science and Engineering Ethics Online ISSN 1471-5546 Print ISSN 1353-3452.

This paper outlines the moral contours of human relationships with companion animals. The paper details three sources of duties to and regarding companion animals: (1) from the animal’s status as property, (2) from the animal’s position in relationships of care, love, and dependency, and (3) from the animal’s status as a sentient being with a good of its own. These three sources of duties supplement one another and not only differentiate relationships with companion animals from wild animals and other categories (...) of domestic animals such as livestock, but they also overlap to provide moral agents with additional reasons for preventing and avoiding harm to companion animals. The paper concludes that not only do owners and bystanders have direct and indirect duties to protect companion animals from harm, but also that these duties have the potential, in some circumstances, to clash with duties owed to the state and fellow citizens. (shrink)

Healthcare professionals’ capacity to protect themselves, while caring for infected patients during an infectious disease pandemic, depends on their ability to practise universal precautions. In turn, universal precautions rely on the availability of personal protective equipment (PPE). During the SARS-CoV2 outbreak many healthcare workers across the globe have been reluctant to provide patient care because crucial PPE components are in short supply. The lack of such equipment during the pandemic was not a result of careful resource allocation decisions in (...) the global north, where the short supply could be explained through their high cost. Instead, they were the result of democratically elected governments prioritising low tax regimes over an adequate resourcing of their healthcare delivery systems. Such decisions were made despite global health experts warning about the high probability of pandemics like SARS-CoV2 occurring during our lifetimes. Avoidable allocation decisions by democratically elected political leaders resulted in a lack of sufficient PPE for healthcare professionals. After discussing and discounting various ethical arguments in support of a professional obligation to treat, even without or with suboptimal PPE, I conclude that these policy decisions were sufficiently grave that they provide a sound ethical rationale to justify healthcare workers’ refusal to provide care to infected patients. (shrink)

The state has a duty to protect individuals from violations of their basic rights to life and liberty. But does the state have a duty to criminalize such violations? Further, if there is a duty on the part of the state to criminalize violations, should the duty be constitutionally entrenched? This paper argues that the answer to both questions is positive. The state has a duty not merely to effectively prevent violations of our rights (...) to life and liberty, but also to criminalize such violations. Further, the duty to criminalize ought to be constitutionally entrenched. In the absence of criminal prohibitions on violations of the right to life and liberty individuals live ‘at the mercy’ of others. In the absence of a constitutional duty to criminalize, life and liberty of individuals is contingent upon the judgments and inclinations of the legislature. In both cases citizens’ rights are ‘at the mercy of others’. I also show that the decisions of the German Constitutional Court concerning abortion can be justified on such grounds. (shrink)

Although there is consensus on the fact that ionizing radiation used in radiological examinations can affect health, the stochastic nature of risk makes it difficult to anticipate and assess specific health implications for patients. The issue of radiation protection is peculiar as any dosage received in life is cumulative, the sensitivity to radiation is highly variable from one person to another, and between 20 % and 50 % of radiological examinations appear not to be necessary. In this context, one might (...) reasonably assume that information and patient consent would play an important role in regulating radiological practice. However, there is to date no clear consensus regarding the nature and content of—or even need for—consent by patients exposed to ionizing radiation. While law and ethics support the same principles for respecting the dignity of the person, in the context of radiology practice, they do not provide a consistent message to guide clinical decision-making. This article analyzes the issue of healthcare professionals’ duty to inform and obtain patient consent for radiological examinations. Considering that both law and ethics have as one of their aims to protect vulnerable populations, it is important that they begin to give greater attention to issues raised by the use of ionizing radiation in medicine. While the situation in Canada serves as a backdrop for a reflective analysis of the problem, the conclusions are pertinent for professional practice in other jurisdictions because the principles underlying health law and jurisprudence are fairly general. (shrink)

If you can vote, you are morally obligated to do so. As political theorist Julia Maskivker argues, voting in order to improve our fellow citizens' lot is a duty of justice. It does not matter that individual votes may rarely tilt elections: the act of voting is a valuable contribution to a collective activity whose outcome is good governance, and we must do it in order to protect the rights and interests of our fellow citizens.

In his classic article, Famine, Affluence, and Morality, pp. 229–243), Peter Singer claimed that affluent people in the developed world are morally obligated to transfer large amounts of resources to poor people in the developing world. For present purposes I will not call Singers argument into question. While people can reasonably disagree about exactly how demanding morality is with respect to duties to the desperate, there is little question in my mind that it is much more demanding than common sense (...) morality or our everyday behavior suggests. Even someone who disagrees with this might still find some interest in seeing what a demanding morality would imply for well-off residents of the rich countries of the world. I proceed in the following way. First, I survey humanitarian aid, development assistance, and intervention to protect human rights as ways of discharging duties to the desperate. I claim that we should be more cautious about such policies than is often thought. I go on to suggest two principles that should guide our actions, based on an appreciation of our roles, relationships, and the social and political context in which we find ourselves. (shrink)

When weighing up which inhaler to prescribe, a doctor may prioritise a patient’s preferences over the expected harms from the associated carbon emissions. Parker argues that this is wrong.1 Doctors have a pro-tanto duty to switch from a high-carbon metered-dose inhaler (MDI) to a low-carbon dry-powdered inhaler (DPI)—even though this provides no direct patient benefit—unless switching would undermine trust or significantly worsen a patient’s health. He goes on to state that even if DPIs are more expensive for the National (...) Health Service (NHS) then this is justified so long as it does not ‘significantly threaten’ the NHS’ ability to protect and promote health. This may appear to be a radical proposal, challenging the ethical principles of autonomy, health entitlements and justly distributed resources. However, we will claim that it is only radical in so far as one perceives (A) patient autonomy and healthcare entitlements as existing within a vacuum, unrelated to other foundational ethics concerns and (B) the health consequences of a given healthcare budget are limited solely to the designated recipients rather than all affected parties. Here, we test the claim that our responsibility for promoting patient autonomy …. (shrink)

Participants in some clinical trials are at risk of being harmed and sometimes are seriously harmed as a result of not being provided with available, relevant risk information. We argue that this situation is unacceptable and that there is a moral duty to disclose all adverse clinical trial results to participants in clinical trials. This duty is grounded in the human right not to be placed at risk of harm without informed consent. We consider objections to disclosure grounded (...) in considerations of commercial interest, and we argue that these concerns are insufficient to override the moral duty to disclose adverse clinical trial results. However, we also develop a proposal that enables commercial interests to be protected, while promoting the duty to disclose adverse clinical trial results. (shrink)

Many people find the manipulation of the human germline—editing the DNA of sperm or egg cells such that these genetic changes are passed to the resulting offspring—to be morally impermissible. In this paper, I argue for the claim that editing the human germline is morally permissible. My argument starts with the claim that outcome uncertainty regarding the effects of germline editing shows that the duty to not harm cannot ground the prohibition of germline editing. Instead, if germline editing is (...) wrong, it is wrong because it violates a duty to protect. However, we also have an epistemic duty to gather evidence regarding the effects of editing the human germline which overrides any moral duty to protect future generations. Thus, we have a duty to gather evidence regarding the effects of editing the human germline, which is to say that we have a duty to edit the human germline. (shrink)

In this chapter, we turn our attention to the effects of the attention economy on our ability to act autonomously as a group. We begin by clarifying which sorts of groups we are concerned with, which are structured groups (groups sufficiently organized that it makes sense to attribute agency to the group itself). Drawing on recent work by Purves and Davis (2022), we describe the essential roles of trust (i.e., depending on groups to fulfill their commitments) and trustworthiness (i.e., the (...) property of a group that makes trusting them fitting) in autonomous group action, with particular emphasis on democratic institutions (which we view as group agents) and democratic legitimacy (which depends on trust and trustworthiness). We then explain how engagement maximization promotes polarization, which is detrimental to trust and trustworthiness and, in turn, democratic legitimacy and democratic institutions. We close by considering what groups might do to protect themselves from the threat posed to them by the attention economy. (shrink)

In this paper, I will discuss a children’s rights-based argument for the duty of states, as a joint effort, to establish an effective program to help bring children out of conflict zones, such as parts of Syria, and to a safe haven. Children are among the most vulnerable subjects in violent conflicts who suffer greatly and have their human rights brutally violated as a consequence. Furthermore, children are also a group whose capacities to protect themselves are very limited, (...) while their chance to flee is most often only slim. I will then discuss three counterarguments: the first counterargument would be that, instead of getting the children out of a particular country, it would be better to improve their situation in their home countries. A second counterargument could be that those states, which have such a duty to bring children to a safe haven, would be overburdened by it. Finally, the third counterargument I want to discuss states that such a duty would also demand a military intervention, which could worsen the situation even further. (shrink)

The clinical trial is the major investigational tool of clinical medicine. Two recent reports highlight the fact that the most often quoted mechanisms for the protection of research subjects, viz., research ethics board review and eligibility criteria, are insufficient to achieve this end. In this paper, we argue that the prime mechanism for the protection of persons in clinical trials should be the clinical judgement of the physician-investigator. The clinical investigator has a duty to protect subjects from both (...) harm and undue risk. It is argued that the clinical investigator has a duty to screen for, and exclude, potential research subjects who may be unduly vulnerable to the risks of a particular clinical trial. In order to fulfill this obligation, the investigator should personally screen each potential research subject at the time of accrual. In larger trials in which this is not feasible, this task could be delegated to another appropriately qualified health care professional, with the principal investigator retaining personal responsibility. To reinforce and make explicit this legal and moral duty, we propose that the investigator sign a statement, appended to each subject's consent form, to attest that this duty has been responsibly discharged. (shrink)

The 'business judgement rule ' requires corporate directors only to act with honesty and reasonable care in the interest of shareholders. A stronger ' fiduciary ' duty is required where one party requires protection from another. This paper argues that where corporations take risks with the environment, directors are fiduciaries. Stakeholders are in that case the general public, future generations and other species, which have not voluntarily accepted risk and cannot limit liability. Recognition of fiduciary duty in such (...) cases is consistent with recent trends in the law of equity. It would require all economic activities to move from open to closed systems. (shrink)

A variety of ethical objections have been raised against the military employment of uninhabited aerial vehicles (UAVs, drones). Some of these objections are technological concerns over UAVs abilities’ to function on par with their inhabited counterparts. This paper sets such concerns aside and instead focuses on supposed objections to the use of UAVs in principle. I examine several such objections currently on offer and show them all to be wanting. Indeed, I argue that we have a duty to (...) class='Hi'>protect an agent engaged in a justified act from harm to the greatest extent possible, so long as that protection does not interfere with the agent's ability to act justly. UAVs afford precisely such protection. Therefore, we are obligated to employ UAV weapon systems if it can be shown that their use does not significantly reduce a warfighter's operational capability. Of course, if a given military action is unjustified to begin with, then carrying out that act via UAVs is wrong, just as it would be with any weapon. But the point of this paper is to show that there is nothing wrong in principle with using a UAV and that, other things being equal, using such technology is, in fact, obligatory. (shrink)

Healthcare systems around the world are struggling to maintain a sufficient workforce to provide adequate care during the COVID-19 pandemic. Staffing problems have been exacerbated by healthcare workers refusing to work out of concern for their families. I sketch a deontological framework for assessing when it is morally permissible for HCWs to abstain from work to protect their families from infection and when it is a dereliction of duty to patients. I argue that it is morally permissible for (...) HCWs to abstain from work when their duty to treat is outweighed by the combined risks and burdens of that work. For HCWs who live with their families, the obligation to protect one’s family from infection contributes significantly to those burdens. There are, however, a range of complicating factors including the strength of duty to treat which varies according to the HCW’s role, the vulnerability of family members to the disease, the willingness of family members to risk infection and the resources available to the HCW to protect their family. In many cases, HCWs in ‘frontline’ roles with a weak duty to treat and families at home will be morally permitted to abstain from work given the risks posed by COVID-19; therefore, society should provide additional incentives to maintain sufficient staff in these roles. (shrink)

In a series of reports the United Nations Special Representative on the issue of Human Rights and Transnational Corporations has emphasized a tripartite framework regarding business and human rights that includes the state “duty to protect,” the TNC “responsibility to respect,” and “appropriate remedies” for human rights violations. This article examines the recent history of UN initiatives regarding business and human rights and places the tripartite framework in historical context. Three approaches to human rights are distinguished: moral, political, (...) and legal. It is argued that the tripartite framework’s grounding of the responsibility of TNCs to respect human rights is properly understood as moral and not merely as a political or legal duty. A moral account of the duty of TNCs to respect basic human rights is defended and contrasted with a merely strategic approach. The main conclusion of the article is that only a moral account of the basic human rights duties of TNCs provides a sufficiently deep justification of “the corporate responsibility to respect human rights” feature of the tripartite framework. (shrink)

In the current framework of international protection, refugees almost invariably live in states where they hold no formal political status: they cannot vote, they cannot run for office, and they mu...

In contemporary debates on euthanasia, physician assisted suicide and withholding and withdrawing life prolonging treatments, besides commonly used reasons, which are based on presumption of freedom and avoidance of pain, there is also an idea of a duty to die. Given that individuals are also members of society, and that they have families and loved ones, it is necessary to discuss cases when illness causes severe burdens for lives of loved ones. We consider that patient’s just assessment of (...) class='Hi'>duty to die can be legitimate candidate for justification of procedure of acceleration of death, taken care of necessary conditions of justified social support for patients and necessary aliment from family and society. In this paper we examine main features of duty to die thesis, extract objections, and offer guidelines for continued discussion. We also want to express the importance of establishing social circumstances and preconditions for protecting the individuals.U suvremenim raspravama o eutanaziji i liječnički potpomognutom samoubojstvu, te odustajanju od tretmana, osim uobičajenih razloga koji se temelje na slobodi i izbjegavanju patnje osobe koja traži ubrzavanje smrti, postoji i teza o dužnosti umiranja. S obzirom na to da je pojedinac ujedno i član zajednice, odnosno da ima obitelj i voljene, nužno je raspraviti o slučajevima kada bolest izaziva značajne teškoće za život njegovih bližnjih. Smatramo kako i pacijentova pravedna prosudba o dužnosti umiranja može biti legitiman kandidat za opravdanje postupaka ubrzavanja smrti, uz nužne preduvjete pravedne društvene podrške pacijentu i dužne skrbi od strane obitelji i društva. U ovom tekstu razlažemo osnovne značajke teze o dužnosti umiranja, izdvajamo prigovore i dajemo smjernice za nastavak rasprave te izražavamo važnost ustanovljavanja društvenih okolnosti i preduvjete za zaštitu pojedinaca. (shrink)

The 2010 Patient Protection and Affordable Care Act was designed to increase health insurance coverage in the United States. Its most controversial feature is the requirement that US residents purchase health insurance. Opponents of the mandate argue that requiring people to contribute to the collective good is inconsistent with respect for individual liberty. Rather than appeal to the collective good, this Viewpoint argues for a duty to buy health insurance based on the moral duty individuals have to reduce (...) certain burdens they pose on others. When some people have a duty to rescue, others may have a duty to take rescue precautions, in this case, to purchase health insurance to cover acute and emergency care needs. Requiring that individuals meet this obligation is consistent with respect of individual liberty. (shrink)

BackgroundNormally, physicians understand they have a duty to treat patients, and they perform accordingly consistent with codes of medical practice, standards of care, and inner moral motivation. In the case of COVID-19 pandemic in a developing country such as Bangladesh, however, the fact is that some physicians decline either to report for duty or to treat patients presenting with COVID-19 symptoms. At issue ethically is whether such medical practitioners are to be automatically disciplined for dereliction of duty (...) and gross negligence; or, on the contrary, such physicians may legitimately claim a professional right of autonomous judgment, on the basis of which professional right they may justifiably decline to treat patients.MethodsThis ethical issue is examined with a view to providing some guidance and recommendations, insofar as the conditions of medical practice in an under-resourced country such as Bangladesh are vastly different from medical practice in an industrialized nation such as the USA. The concept of moral dilemma as discussed by philosopher Michael Shaw Perry and philosopher Immanuel Kant’s views on moral appeal to “emergency” are considered pertinent to sorting through the moral conundrum of medical care during pandemic.ResultsOur analysis allows for conditional physician discretion in the decision to treat COVID-19 patients, i.e., in the absence of personal protective equipment (PPE) combined with claim of duty to family. Physicians are nonetheless expected to provide a minimum of initial clinical assessment and stabilization of a patient before initiating transfer of a patient to a “designated” COVID-19 hospital. The latter is to be done in coordination with the national center control room that can assure admission of a patient to a referral hospital prior to ambulance transport.ConclusionsThe presence of a moral dilemma (i.e., conflict of obligations) in the pandemic situation of clinical care requires institutional authorities to exercise tolerance of individual physician moral decision about the duty to care. Hospital or government authority should respond to such decisions without introducing immediate sanction, such as suspension from all clinical duties or termination of licensure, and instead arrange for alternative clinical duties consistent with routine medical care. (shrink)