Cancer screening programmes cause harm to individuals via overdiagnosis and overtreatment, even where they confer population-level benefit. Screening thus appears to violate the principle of non-maleficence, since it entails medically unnecessary harm to individuals. Can consent to screening programmes negate the moral significance of this harm? In therapeutic medical contexts, consent is used as a means of rendering medical harm morally permissible. However, in this paper, I argue that it is unclear that the model of consent used within therapeutic (...) medicine can be applied unproblematically to preventive medicine. Invitation to screening changes the pragmatic norms and expectations of the patient–doctor encounter such that two key principles of consent may be violated. First, the pragmatics of a medical invitation are such that patients may fail to be adequately informed, since patients appear to assume medical invitations are made with their best interests in mind, even where information to the contrary is outlined. Second, screening invitations may place pressure on patients; in the context of a medical encounter, to make an invitation to screening may constitute an inducement to accept. In order to be sure that a patient’s consent to a screening invitation is valid, we must make clear to patients that their decision to accept screening may be shaped not only by how information about screening is presented, but by the pragmatic form of the invitation itself. (shrink)

The principle of non-maleficence, primum non nocere, has deep roots in the history of moral philosophy, being endorsed by John Stuart Mill, W. D. Ross, H. L. A. Hart, Karl Popper and Bernard Gert. And yet, this principle is virtually absent from current debates on social justice. This article suggests that non-maleficence is more than a moral principle; it is also a principle of social justice. Part I looks at the origins of non-maleficence as a principle of (...) ethics, and medical ethics in particular. Part II introduces the idea of non-maleficence as a principle of social justice. Parts III and IV define the principle of justice as non-maleficence in terms of its scope and coherence, while Part V argues that the motivation of not doing harm makes this principle an alternative to two well-established paradigms in the literature on social justice: justice as mutual advantage (David Gauthier) and justice as impartiality (Brian Barry). (shrink)

Important advances in biomedical and behavioral research ethics have occurred over the past few decades, many of them centered on identifying and eliminating significant harms to human subjects of research. Comprehensive attention has not been paid to the totality of harms experienced by animal subjects, although scientific and moral progress require explicit appraisal of these harms. Science is a public good and the prioritizing within, conduct of, generation of, and application of research must soundly address questions about which research is (...) morally defensible and valuable enough to support through funding, publication, tenure, and promotion. Likewise, educational pathways of re-imagined science are critical. (shrink)

Disability activists' redefinition of “disability” as a social, rather than a medical, problem attempts to reassign causality. We explicate the untenable implications of this approach and argue this definition is maleficent, unjust, and inconsistent. Thus, redefining disability as a socially caused phenomenon is, from a moral point of view, ill-advised.

An abundance of data unequivocally shows that exercise can be an effective tool in the fight against obesity and its associated co-morbidities. Indeed, physical activity can be more effective than widely-used pharmaceutical interventions. Whilst metformin reduces the incidence of diabetes by 31% (as compared with a placebo) in both men and women across different racial and ethnic groups, lifestyle intervention (including exercise) reduces the incidence by 58%. In this context, it is notable that a group of prominent medics and exercise (...) scientists recently sent a well-publicised letter to the General Medical Council and Medical Schools Council calling for the introduction of evidence-based lifestyle education into all medical curricula. The letter warns that there is a lack of understanding of the impact that exercise and nutrition can have on physical health amongst doctors. In the absence of an educational overhaul, the signatories warn that the government is likely to fail to reach its goal of preventing tens of thousands of premature deaths from heart disease and cancer by 2020. Whilst we agree with the need to address this apparent lack of understanding, we argue that the ethical justification of doing so is not limited to this broadly beneficence-based justification. There is also a justification grounded in the duty of non-maleficence, that is, the duty to avoid unreasonably harming patients. This duty requires that doctors refrain from (i) preventing patients from undergoing beneficial treatment without good reason, (ii) exposing patients to unreasonable risks and (iii) reducing the therapeutic effect of an effective medical intervention. This requires an understanding of the physical impact of exercise. (shrink)

New reproductive technologies allow parents some choice over their children. Various moral principles have been suggested to regulate such choices. This article starts from a discussion of Julian Savulescu's Principle of Procreative Beneficence, according to which parents ought to choose the child expected to have the best quality of life, before combining two previously separate lines of attack against this principle. First, it is suggested that the appropriate moral principles of guiding reproductive choices ought to focus on general wellbeing rather (...) than prioritizing that of the child and, second, that they ought to be non-maximizing. Though neither of these suggestions is entirely novel, combining them results in a new, and arguably more plausible, principle to regulate procreative choices, which I call the Principle of Generalized Procreative Non-Maleficence. According to this principle, the primary obligation on parents is not to cause harm to other people through their reproductive choices. (shrink)

In “IRBs and The Protection Inclusion Dilemma: Finding a Balance,” Friesen et al. (2023) argue that IRBs ought to attend more, and better, to the need for the inclusion of under-researched populati...

Higher education institutions are increasingly relying on learning analytics to collect voluminous amounts of data ostensibly to inform student learning interventions. The use of learning analytics, however, can result in a tension between the Council for the Advancement of Standards in Higher Education (CAS) principles of autonomy and non-malfeasance on the one hand, and the principle of beneficence on the other. Given the complications around student privacy, informed consent, and data justice in addition to the potential to do harm, many (...) current practices around learning analytics within higher education can be considered to be in violation of CAS standards. This paper aims to explore this tension in greater detail and argues that the student voice offers a promising way to ensure that students’ autonomy is respected, harm is reduced, and that higher education institutions can still fulfil the principle of beneficence. (shrink)

Artificial Intelligence (AI) is already having a major impact on society. As a result, many organizations have launched a wide range of initiatives to establish ethical principles for the adoption of socially beneficial AI. Unfortunately, the sheer volume of proposed principles threatens to overwhelm and confuse. How might this problem of ‘principle proliferation’ be solved? In this paper, we report the results of a fine-grained analysis of several of the highest-profile sets of ethical principles for AI. We assess whether these (...) principles converge upon a set of agreed-upon principles, or diverge, with significant disagreement over what constitutes ‘ethical AI.’ Our analysis finds a high degree of overlap among the sets of principles we analyze. We then identify an overarching framework consisting of five core principles for ethical AI. Four of them are core principles commonly used in bioethics: beneficence, non-maleficence, autonomy, and justice. On the basis of our comparative analysis, we argue that a new principle is needed in addition: explicability, understood as incorporating both the epistemological sense of intelligibility (as an answer to the question ‘how does it work?’) and in the ethical sense of accountability (as an answer to the question: ‘who is responsible for the way it works?’). In the ensuing discussion, we note the limitations and assess the implications of this ethical framework for future efforts to create laws, rules, technical standards, and best practices for ethical AI in a wide range of contexts. (shrink)

In this paper, I respond to the (infamous) causal impotence objection to the standard arguments for ethical vegetarianism. The paper defends a non-consequentialist response to this objection, one that draws on an account of the principle of non-maleficence inspired by Ross.

Nearly all Disney movies represent to people mere possibilities. One can conceive of scenarios with genies, wooden puppets coming to life, flying elephants, and mermaids. And there certainly seems to be no special problem in conceiving of a scenario where all the author's experiences are a mere dream induced by a Maleficent‐like evil genius. The problem in the present context is that the possibility of a dream‐inducing Maleficent‐like evil genius guarantees that how things appear would be no different, whether she (...) is dreaming or not. But maybe there is a difference: does it not appear to her that there is a difference between dreaming and wakefulness? The very fact that she is aware of such a distinction at all suggests the distinction is real. People prefer a real life over an experientially identical dream life, or even a more pleasurable dream life, because there is more to life than just experience. (shrink)

The principles of biomedical ethics – autonomy, non-maleficence, beneficence, and justice – are of paradigmatic importance for framing ethical problems in medicine and for teaching ethics to medical students and professionals. In order to underline this significance, Tom L. Beauchamp and James F. Childress base the principles in the common morality, i.e. they claim that the principles represent basic moral values shared by all persons committed to morality and are thus grounded in human moral psychology. We empirically investigated the (...) relationship of the principles to other moral and non-moral values that provide orientations in medicine. By way of comparison, we performed a similar analysis for the business & finance domain. (shrink)

Purpose: To survey the attitudes of the general public in Sweden to biobank research and to discuss the findings in the light of some well-known ethical principles.Methods: A questionnaire was used to survey the opinions of the general public in Sweden, and an ethical analysis (using the principles of autonomy, non-maleficence, beneficence and justice) was performed to discuss the possible conditions of such research.Findings: Between 3 and 9% answered that they did not want their samples to be collected and (...) stored in a biobank. Many respondents required information about the purpose of the research and wanted to be able to consent or refuse. About one third of the respondents said they would have answered differently if financial gain was involved and those who commented indicated a more negative attitude. The principle of autonomy maintains that the right to self-determination should be respected, and the principles of non-maleficence and beneficence that the probable harms and benefits resulting from a particular project by using samples from a biobank should be balanced. The general public disagree about how these principles are to be balanced. Interpretation: In the light of the findings different interpretations of the situation as well as possible alternatives are discussed in this paper. (shrink)

“Violence” and “nonviolence” are, increasingly, misleading translations for the Sanskrit words hiṃsā and ahiṃsā—used by Gandhi as the basis for his philosophy of satyāgraha. I argue for rereading hiṃsā as “maleficence” and ahiṃsā as “beneficence.” These two more mind-referring English words capture the primacy of intention implied by Gandhi’s core principles. Reflecting a political turn in moral accountability detectable through linguistic data, both the scope and the usage of the word “violence” have expanded dramatically, making it harder to convincingly (...) characterize people and actions as “nonviolent.” New terminology could clarify the distinction between hiṃsā and ahiṃsā, and, thereby, prevent misunderstandings of Gandhi. Training in beneficence would reflect Gandhi’s psychological path to reducing avoidable harm: ego-detachment, universal love, and seeking truth by experiment. -/- NOTE: An extended, unpublished version, with additional arguments and evidence, is also available on PhilPapers as "The Primacy of Intention and the Duty to Truth: A Gandhi-Inspired Argument for Retranslating Hiṃsā and Ahiṃsā, with Connections to History, Ethics, and Civil Resistance". (shrink)

The words "violence" and "nonviolence" are increasingly misleading translations for the Sanskrit words hiṃsā and ahiṃsā -- which were used by Gandhi as the basis for his philosophy of satyāgraha. I argue for re-reading hiṃsā as “maleficence” and ahiṃsā as “beneficence.” These two more mind-referring English words – associated with religiously contextualized discourse of the past -- capture the primacy of intention implied by Gandhi’s core principles, better than “violence” and “nonviolence” do. Reflecting a political turn in moral accountability (...) detectable through linguistic data, both the scope and the usage of the word “violence” have expanded dramatically. The expanded scope of “violence” reflects greater consciousness of the various forms that serious harm can take, but also makes it harder to convincingly characterize people and actions as “nonviolent.” New translations could clarify the distinction between hiṃsā and ahiṃsā, and thereby prevent some misunderstandings of Gandhi. Training in beneficence would reflect Gandhi’s psychological path to reducing avoidable harm: detachment from the ego, learning to love universally, and seeking truth by experiment. (shrink)

Background: Ethical frameworks for organ donation following circulatory death (DCD) were established >20 years ago. However, considerable variation exists among these, indicating consensus has not been reached on all issues. Additionally, advances such as cardiac DCD transplants and normothermic regional perfusion (NRP) may have reignited old debates.Methods: We reviewed the English-language literature addressing ethical issues in DCD from 1993 to 2022, examining changes in frequency with which ethical principles and their sub-themes identified within each, were addressed.Results: Non-maleficence was the (...) most frequently addressed principle (192 of 199 articles), as well as the most varied, with 9 subthemes (versus 2-4 within each of the other bioethical principles).Conclusions: There were several changes in the terminology used to refer to DCD over time, and substantial interest in cardiac DCD and NRP in recent publications, arising in 11 and 19 of the 30 publications from 2018 to 2022. (shrink)

Organizations such as the EU High-Level Expert Group on AI and the IEEE have recently formulated ethical principles and (moral) values that should be adhered to in the design and deployment of artificial intelligence (AI). These include respect for autonomy, non-maleficence, fairness, transparency, explainability, and accountability. But how can we ensure and verify that an AI system actually respects these values? To help answer this question, I propose an account for determining when an AI system can be said to (...) embody certain values. This account understands embodied values as the result of design activities intended to embed those values in such systems. AI systems are here understood as a special kind of sociotechnical system that, like traditional sociotechnical systems, are composed of technical artifacts, human agents, and institutions but—in addition—contain artificial agents and certain technical norms that regulate interactions between artificial agents and other elements of the system. The specific challenges and opportunities of embedding values in AI systems are discussed, and some lessons for better embedding values in AI systems are drawn. (shrink)

Machine intelligence already helps medical staff with a number of tasks. Ethical decision-making, however, has not been handed over to computers. In this proof-of-concept study, we show how an algorithm based on Beauchamp and Childress’ prima-facie principles could be employed to advise on a range of moral dilemma situations that occur in medical institutions. We explain why we chose fuzzy cognitive maps to set up the advisory system and how we utilized machine learning to train it. We report on the (...) difficult task of operationalizing the principles of beneficence, non-maleficence and patient autonomy, and describe how we selected suitable input parameters that we extracted from a training dataset of clinical cases. The first performance results are promising, but an algorithmic approach to ethics also comes with several weaknesses and limitations. Should one really entrust the sensitive domain of clinical ethics to machine intelligence? (shrink)

Analyzes the moral problems confronting health care practitioners from a wide variety of perspectives, especially those connected by four major ethical principles--respect for autonomy, beneficence, non-maleficence and justice.

This paper will examine the social and ethical impacts of using artificial intelligence (AI) in the agricultural sector. It will identify what are some of the most prevalent challenges and impacts identified in the literature, how this correlates with those discussed in the domain of AI ethics, and are being implemented into AI ethics guidelines. This will be achieved by examining published articles and conference proceedings that focus on societal or ethical impacts of AI in the agri-food sector, through a (...) thematic analysis of the literature. The thematic analysis will be divided based on the classifications outlined through 11 overarching principles, from an established lexicon (transparency, justice and fairness, non-maleficence, responsibility, privacy, beneficence, freedom and autonomy, trust, dignity, sustainability, and solidarity). While research on AI agriculture is still relatively new, this paper aims to map the debate and illustrate what the literature says in the context of social and ethical impacts. It aim is to analyse these impacts, based on these 11 principles. This research will contrast which impacts are not being discussed in agricultural AI and which issues are not being discussed in AI ethics guidelines, but which are discussed in relation to agricultural AI. The aim of this is to identify gaps within the agricultural literature, and gaps in AI ethics guidelines, that may need to be addressed. (shrink)

Epistemic injustice has undergone a steady growth in the medical ethics literature throughout the last decade as many ethicists have found it to be a powerful tool for describing and assessing morally problematic situations in healthcare. However, surprisingly scarce attention has been devoted to how epistemic injustice relates to physicians’ professional duties on a conceptual level. I argue that epistemic injustice, specifically testimonial, collides with physicians’ duty of nonmaleficence and should thus be actively fought against in healthcare encounters on the (...) ground of professional conduct. I do so by fleshing out how Fricker’s conception of testimonial injustice conflicts with the duty of nonmaleficence as defined in Beauchamp and Childress on theoretical grounds. From there, I argue that testimonial injustice produces two distinct types of harm, epistemic and non-epistemic. Epistemic harms are harms inflicted by the physician to the patient qua knower, whereas non-epistemic harms are inflicted to the patient qua patient. This latter case holds serious clinical implications and represent a failure of the process of due care on the part of the physician. I illustrate this through examples taken from the literature on fibromyalgia syndrome and show how testimonial injustice causes wrongful harm to patients, making it maleficent practice. Finally, I conclude on why nonmaleficence as a principle will not be normatively enough to fully address the problem of epistemic injustice in healthcare but nevertheless may serve as a good starting point in attempting to do so. (shrink)

Traditional medical practices and relationships are changing given the widespread adoption of AI-driven technologies across the various domains of health and healthcare. In many cases, these new technologies are not specific to the field of healthcare. Still, they are existent, ubiquitous, and commercially available systems upskilled to integrate these novel care practices. Given the widespread adoption, coupled with the dramatic changes in practices, new ethical and social issues emerge due to how these systems nudge users into making decisions and changing (...) behaviours. This article discusses how these AI-driven systems pose particular ethical challenges with regards to nudging. To confront these issues, the value sensitive design approach is adopted as a principled methodology that designers can adopt to design these systems to avoid harming and contribute to the social good. The AI for Social Good factors are adopted as the norms constraining maleficence. In contrast, higher-order values specific to AI, such as those from the EU High-Level Expert Group on AI and the United Nations Sustainable Development Goals, are adopted as the values to be promoted as much as possible in design. The use case of Amazon Alexa's Healthcare Skills is used to illustrate this design approach. It provides an exemplar of how designers and engineers can begin to orientate their design programs of these technologies towards the social good. (shrink)

How are we to appraise new technological developments that may bring revolutionary social changes? Currently this is often done by trying to predict or anticipate social consequences and to use these as a basis for moral and regulatory appraisal. Such an approach can, however, not deal with the uncertainties and unknowns that are inherent in social changes induced by technological development. An alternative approach is proposed that conceives of the introduction of new technologies into society as a social experiment. An (...) ethical framework for the acceptability of such experiments is developed based on the bioethical principles for experiments with human subjects: non-maleficence, beneficence, respect for autonomy, and justice. This provides a handle for the moral and regulatory assessment of new technologies and their impact on society. (shrink)

The principles of autonomy, beneficence, non-maleficence, and justice are well established ethical principles in health research. Of these principles, justice has received less attention by health researchers. The purpose of this article is to broaden the discussion of health research ethics, particularly the ethical principle of justice, to include societal considerations — who and what are studied and why? — and to critique current applications of ethical principles within this broader view. We will use a feminist intersectional approach in (...) the context of health disparities research to firmly establish inseparable links between health research ethics, social action, and social justice. The aim is to provide an ethical approach to health disparities research that simultaneously describes and seeks to eliminate health disparities. (shrink)

In response to recent debates on the need to abandon the Dead Donor Rule (DDR) to facilitate vital-organ transplantation, I claim that, through a detailed philosophical analysis of the Uniform Determination of Death Act (UDDA) and the DDR, some acts that seem to violate DDR in fact do not, thus DDR can be upheld. The paper consists of two parts. First, standard apparatuses of the philosophy of language, such as sense, referent, truth condition, and definite description are employed to show (...) that there exists an internally consistent and coherent interpretation of UDDA which resolves the Reduction Problem and the Ambiguity Problem that allegedly threaten the UDDA framework, and as a corollary, the practice of Donation after the Circulatory Determination of Death (DCDD) does not violate DDR. Second, an interpretation of the DDR, termed ‘No Hastening Death Rule’ (NHDR), is formulated so that, given that autonomy and non-maleficence principles are observed, the waiting time for organ procurement can be further shortened without DDR being violated. (shrink)

How are we to appraise new technological developments that may bring revolutionary social changes? Currently this is often done by trying to predict or anticipate social consequences and to use these as a basis for moral and regulatory appraisal. Such an approach can, however, not deal with the uncertainties and unknowns that are inherent in social changes induced by technological development. An alternative approach is proposed that conceives of the introduction of new technologies into society as a social experiment. An (...) ethical framework for the acceptability of such experiments is developed based on the bioethical principles for experiments with human subjects: non-maleficence, beneficence, respect for autonomy, and justice. This provides a handle for the moral and regulatory assessment of new technologies and their impact on society. (shrink)

We argue that while digital health technologies (e.g. artificial intelligence, smartphones, and virtual reality) present significant opportunities for improving the delivery of healthcare, key concepts that are used to evaluate and understand their impact can obscure significant ethical issues related to patient engagement and experience. Specifically, we focus on the concept of empowerment and ask whether it is adequate for addressing some significant ethical concerns that relate to digital health technologies for mental healthcare. We frame these concerns using five key (...) ethical principles for AI ethics (i.e. autonomy, beneficence, non-maleficence, justice, and explicability), which have their roots in the bioethical literature, in order to critically evaluate the role that digital health technologies will have in the future of digital healthcare. (shrink)

This paper examines whether the modern bioethical principles of respect for autonomy, beneficence, non-maleficence, and justice proposed by Beauchamp and Childress are existent in, compatible with, or acceptable to the leading Chinese moral philosophy—the ethics of Confucius. The author concludes that the moral values which the four prima facie principles uphold are expressly identifiable in Confucius’ teachings. However, Confucius’ emphasis on the filial piety, family values, the “love of gradation”, altruism of people, and the “role specified relation oriented ethics” (...) will inevitably influence the “specification” and application of these bioethical principles and hence tend to grant “beneficence” a favourable position that diminishes the respect for individual rights and autonomy. In contrast, the centrality of respect for autonomy and its stance of “first among equals” are more and more stressed in Western liberal viewpoints. Nevertheless, if the Confucian “doctrine of Mean” and a balanced “two dimensional personhood” approach are properly employed, this will require both theorists and clinicians, who are facing medical ethical dilemmas, of searching to attain due mean out of competing moral principles thus preventing “giving beneficence a priority” or “asserting autonomy must triumph”. (shrink)

This book provides a framework for approaching ethical and policy dilemmas in research with human subjects from the perspective of trust. It explains how trust is important not only between investigators and subjects but also between and among other stakeholders involved in the research enterprise, including research staff, sponsors, institutions, communities, oversight committees, government agencies, and the general public. The book argues that trust should be viewed as a distinct ethical principle for research with human subjects that complements other principles, (...) such as autonomy, beneficence, non-maleficence, and justice. The book applies the principle of trust to numerous issues, including informed consent, confidentiality, risk minimization, risks and benefits, protection of vulnerable subjects, experimental design, research integrity, and research oversight.This work also includes discussions of the history of research involving human subjects, moral theories and principles, contemporary cases, and proposed regulatory reforms. The book is useful for undergraduate and graduate students studying ethical policy issues related to research with human subjects, as well as for scientists and scholars who are interested in thinking about this topic from the perspective of trust. (shrink)

Principlism, the bioethical theory championed by Tom Beauchamp and James Childress, is centered on the four moral principles of beneficence, non-maleficence, respect for autonomy, and justice. Two key processes related to these principles are specification—adding specific content to general principles—and balancing—determining the relative weight of conflicting principles. I argue that both of these processes necessarily involve an appeal to human goods and evils, and therefore require a theory of the good. A significant problem with principlism is that it lacks (...) a theory of the good and consequently does not have an adequate solution to the problems of specification and balancing. My conclusion is that principlism must adopt some account of human well-being in order to be a satisfactory bioethical framework. (shrink)

Gilles de la Tourette syndrome (TS) is a childhood neuropsychiatric disorder characterised by the presence of motor and vocal tics. Patients with malignant TS experience severe disease sequelae; risking morbidity and mortality due to tics, self-harm, psychiatric comorbidities and suicide. By definition, those cases termed ‘malignant’ are refractory to all conventional psychiatric and pharmacological regimens. In these instances, deep brain stimulation (DBS) may be efficacious. Current 2015 guidelines recommend a 6-month period absent of suicidal ideation before DBS is offered to (...) patients with TS. We therefore wondered whether it may be ethically justifiable to offer DBS to a minor with malignant TS. We begin with a discussion of non-maleficence and beneficence. New evidence suggests that suicide risk in young patients with TS has been underestimated. In turn, DBS may represent an invaluable opportunity for children with malignant TS to secure future safety, independence and fulfilment. Postponing treatment is associated with additional risks. Ultimately, we assert this unique risk-benefit calculus justifies offering DBS to paediatric patients with malignant TS. A multidisciplinary team of clinicians must determine whether DBS is in the best interest of their individual patients. We conclude with a suggestion for future TS-DBS guidelines regarding suicidal ideation. The importance of informed consent and assent is underscored. (shrink)

Technological approaches are increasingly discussed as a solution for the provision of support in activities of daily living as well as in medical and nursing care for older people. The development and implementation of such assistive technologies for eldercare raise manifold ethical, legal, and social questions. The discussion of these questions is influenced by theoretical perspectives and approaches from medical and nursing ethics, especially the principlist framework of autonomy, non-maleficence, beneficence, and justice. Tying in with previous criticism, the present (...) contribution is taking these principles as a starting point and as a frame of reference to be critically re-examined. It thus aims to outline how existing ethical frameworks need to be extended or reconsidered to capture the ethical issues posed by technological developments regarding care for older people. In a first step, we provide a brief overview of assistive technologies in eldercare according to their purposes and functions. In the next step, we discuss how the questions and problems raised by new technologies in eldercare call for an expansion, re-interpretation, and revision of the principlist framework. We underline that the inclusion of ethical perspectives from engineering and computer science as well as a closer consideration of socio-political dimensions and fundamental anthropological and praxeological questions are needed. (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- (...) class='Hi'>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)

Significant disagreement remains in ethics about the duties we have towards wild animals. This paper aims to mediate those disagreements by exploring how they are supported by, or diverge from, the common-sense ethical principles of non-maleficence, beneficence, autonomy and justice popular in medical ethics. We argue that these principles do not clearly justify traditional conservation or a ‘hands-off ’ approach to wild-animal welfare; instead, they support natural negative duties to reduce the harms that we cause as well as natural (...) positive duties to promote the welfare of wild animals. (shrink)

Background There have been different ethical approaches to the issues in the history of philosophy. Two American philosophers Beachump and Childress formulated some ethical principles namely 'respect to autonomy', 'justice', 'beneficence' and 'non-maleficence'. These 'Four Principles' were presented by the authors as universal and applicable to any culture and society. Mawlana, a great figure in Sufi tradition, had written many books which not only guide people how to worship God to be close to Him, but also advise people how (...) to lead a good life to enrich their personality, as well as to create a harmonious society and a peaceful world. Methods In this study we examined the major works of Mawlana to find out which of these 'Four Principles of Bioethics' exist in Mawlana's ethical understanding. Results We have found in our study that all these principles exist in Mawlana's writings and philosophy in one form or another. Conclusions We have concluded that, further to Beachump and Childress' claim that these principles are universal and applicable to any culture and society, these principles have always existed in different moral traditions in different ways, of which Mawlana's teaching might be presented as a good example. (shrink)

In vitro fertilisation ‘add-ons’ are therapeutic or diagnostic tools developed in an endeavour to improve the success rate of infertility treatment. However, there is no conclusive evidence that these interventions are a beneficial or effective adjunct of assisted reproductive technologies. Additionally, IVF add-ons are often implemented in clinical practice before their safety can be thoroughly ascertained. Yet, patients continue to request and pay large sums for such additional IVF tools. Hence, this essay set out to examine if it is ethical (...) to provide IVF add-ons when there is no evidence of a benefit if the patient requests it. In order to determine what is ethical—namely, morally good and righteous, the question was considered in relation to three key values of medical ethics—autonomy, beneficence and non-maleficence. It was determined that providing IVF add-ons might be morally acceptable in specific circumstances, if true informed consent can be given, there is a potential of cost-effective physiological or psychological benefit and the risk of harm is minimal, particularly with regard to the unborn child. (shrink)

In this paper, we argue that ‘good care’ in residential nursing homes is enacted through different care practices that are either inspired by a ‘professional logic of care’ that aims for justice and non-maleficence in the professional treatment of residents, or by a ‘relational logic of care’, which attends to the relational quality and the meaning of interpersonal connectedness in people’s lives. Rather than favoring one care logic over the other, this paper indicates how important aspects of care are (...) constantly negotiated between different care practices. Based on the intricate everyday negotiations observed during an ethnographic field study at an elderly nursing home in Germany, the paper puts forth the argument that care is always a matter of tinkering with different, sometimes competing ‘goods’. This tinkering process, which unfolds through ‘intuitive deliberation’, ‘situated assessment’ and ‘affective juggling’ is then theorized along the conceptualization of a ‘practical ethics of care’: an ethics which makes no a priori judgments of what may be considered as good or bad care, but instead calls for momentary judgments that are pliable across changing situations. (shrink)

The four principles approach to biomedical ethics (4PBE) has, since the 1970s, been increasingly developed as a universal bioethics method. Despite its wide acceptance and popularity, the 4PBE has received many challenges to its cross-cultural plausibility. This paper first specifies the principles and characteristics of ancient Chinese medical ethics (ACME), then makes a comparison between ACME and the 4PBE with a view to testing out the 4PBE's cross-cultural plausibility when applied to one particular but very extensive and prominent cultural context. (...) The result shows that the concepts of respect for autonomy, non-maleficence, beneficence and justice are clearly identifiable in ACME. Yet, being influenced by certain socio-cultural factors, those applying the 4PBE in Chinese society may tend to adopt a "beneficence-oriented", rather than an "autonomy-oriented" approach, which, in general, is dissimilar to the practice of contemporary Western bioethics, where "autonomy often triumphs". (shrink)

Much has been written on witchcraft by historians, theologians, philosophers, and anthropologists, but nothing by scientists. This book aims to reappraise witchcraft by applying to it the advances in cognitive sciences. The book is divided into four parts. Part One: Deep History deals with human emotions and drives to deepen the phenomenology of evil witchcraft agency and its female feature. Part Two: Historical Times focuses on the natural control of malefice that engendered rare state and church repressions. Surprisingly, Islamic lands (...) remained immune from stakes. Modern urbanizations are considered a blow to the persistence of rural civilizations that embedded witchcraft in their vision. Part Three: In the Laboratory applies neurosciences to specific case studies such as the personalization of misfortune, the millenary stereotype witch=woman, the reality of evil, and the contagious meme of treasure hunts. Part Four: Millennials wonders whether intentional malefic hatred is a closed chapter in the history of humanity. An Anatomy of Witchcraft is ideal reading for students and scholars. Given its interdisciplinary nature, the book will be of interest to scholars from many fields including evolutionary psychology, anthropology, women's history, and cognitive sciences. (shrink)

Toujours, les révolutions s'inversent en terreur, la libération fait naître la domination, le pouvoir abuse, ment, échoue... Pourquoi continue-t-on pourtant à croire que le gouvernement des hommes a pour but de transformer la société alors qu'il se réduit souvent à une gestion de la situation? C'est cette question qui résonne singulièrement en ces temps de changement de gouvernance que lance ici Etienne Tassin, se reposant sur une formule de Merleau-Ponty : "On veut oublier un problème que l'Europe soupçonne depuis les (...) Grecs : n'y a-t-il pas un maléfice de la vie à plusieurs?" Les Grecs seront donc nos guides pour éclairer notre démocratie contemporaine, Oreste pour appréhender la question de la justice, Oedipe celle du maléfice, Antigone la dissidence, Socrate l'utopie, Caton les révolutions, Gygès les oubliés du régime libéral, Achille le courage, Diogène la question des migrants... Ils nous aideront à affronter cette idée tragique : il n'y a pas de bonne solution, la politique n'est pas une affaire de réussite ou d'échec mais de risque, celui de vivre à plusieurs. Elle est la condition humaine. (shrink)

It is widely maintained that a clinical trial is ethical only if some form of equipoise between the treatments being compared obtains. To be in equipoise between two treatments A and B is to be cognitively indifferent between the statement ‘A is strictly more effective than B’ and its negation. It is natural to claim that equipoise regarding A and B is necessary for randomised assignment to treatments A and B to be beneficent and non‐maleficent and is sufficient for such (...) an assignment to be fair. Cashing this out precisely is difficult, and various forms of equipoise have been discussed which consider whose equipoise is relevant to the decision. This is to make judgement of equipoise something to be managed socially, while its prima facie significance is supposedly cognitive. Recent reconstructions of equipoise‐like concepts in epistemology give clues about how to understand equipoise cognitively. In this paper I examine some of this work and discuss how successful it has been. I suggest that while this work is promising, it still has far to go, and that while equipoise remains the best theory we have of the cognitive justification for clinical trials, it is nonetheless incoherent. (shrink)

Through the exponential growth in digital devices and computational capabilities, big data technologies are putting pressure upon the boundaries of what can or cannot be considered acceptable from an ethical perspective. Much of the literature on ethical issues related to big data and big data technologies focuses on separate values such as privacy, human dignity, justice or autonomy. More holistic approaches, allowing a more comprehensive view and better balancing of values, usually focus on either a design-based approach, in which it (...) is tried to implement values into the design of new technologies, or an application-based approach, in which it is tried to address the ways in which new technologies are used. Some integrated approaches do exist, but typically are more general in nature. This offers a broad scope of application, but may not always be tailored to the specific nature of big data related ethical issues. In this paper we distil a comprehensive set of ethical values from existing design-based and application-based ethical approaches for new technologies and further focus these values to the context of emerging big data technologies. A total of four value lists were selected for this. The integrated list consists of a total of ten values: human welfare, autonomy, non-maleficence, justice, accountability, trustworthiness, privacy, dignity, solidarity and environmental welfare. Together, this set of values provides a comprehensive and in-depth overview of the values that are to be taken into account for emerging big data technologies. (shrink)

As a result of the increase in genetic testing and the fear of discrimination by insurance companies, employers, and society as a result of genetic testing, the disciplines of ethics, public health, and genetics have converged. Whether relatives of someone with a positive predictive genetic test should be notified of the results and risks is a matter urgently in need of debate. Such a debate must encompass the moral and ethical obligations of the diagnosing physician and the patient. The decision (...) to inform or not will vary depending on what moral theory is used. Utilising the utilitarian and libertarian theories produces different outcomes. The principles of justice and non-maleficence will also play an important role in the decision. (shrink)

The publication of the latest contribution to the alcohol-in-pregnancy debate, and the now customary flurry of media attention it generated, have precipitated the renewal of a series of ongoing debates about safe levels of consumption and responsible prenatal conduct. The University College London (UCL) study’s finding that low levels of alcohol did not contribute to adverse behavioural outcomes—and may indeed have made a positive contribution in some cases—is unlikely to be the last word on the subject. Proving a negative correlation (...) is notoriously difficult (technically, impossible), and other studies have offered alternative claims. The author is not an epidemiologist, and the purpose of this article is not to evaluate the competing empirical claims. However, the question of what information and advice healthcare practitioners ought to present to pregnant women, or prospectively or potentially pregnant women, in a situation of uncertainty is one to which healthcare ethicists may have a contribution to make. In this article, it is argued that the total abstinence policy advocated by the UK’s Department of Health, and even more stridently by the British Medical Association, sits uneasily with recent data and is far from ethically unproblematic. In particular, the “precautionary” approach advocated by these bodies displays both scant regard for the autonomy of pregnant and prospectively pregnant women and a confused grasp of the principles of beneficence and non-maleficence. (shrink)

Advances in psychopharmacology raise the prospects of enhancing neurocognitive functions of humans by improving attention, memory, or mood. While general ethical reflections on psychopharmacological enhancement have been increasingly published in the last years, ethical criteria characterizing physicians’ role in neurocognitive enhancement and guiding their decision-making still remain highly unclear. Here it will be argued that also in the medical domain the use of cognition-enhancing drugs is not intrinsically unethical and that, in fact, physicians should assume an important role in gating (...) their usage. For finding normative orientation, concepts of disease, normality or medicine will not be helpful since—due to their cryptonormative nature—they rather hamper than allow targeted discussion and decision-making. As an alternative, the common and widely accepted bioethical criteria of beneficence, non-maleficence, autonomy and distributive justice allow a clinically applicable, highly differentiated context- and case-sensitive approach. By embedding decision-making in a participative physician–patient relationship extrinsic objections against neurocognitive enhancement (e.g. invalid perceptions about efficacy, benefit or risk; questionable voluntariness; restrained decision-making capacity) can be curtailed. (shrink)

In their Target Article, Rahimzadeh et al. (2023) discuss the virtues and vices of employing ChatGPT in ethics education for healthcare professionals. To this end, they confront the chatbot with a moral dilemma and analyse its response. In interpreting the case, ChatGPT relies on Beauchamp and Childress’ four prima-facie principles: beneficence, non-maleficence, respect for patient autonomy, and justice. While the chatbot’s output appears admirable at first sight, it is worth taking a closer look: ChatGPT not only misses the point (...) when applying the principle of non-maleficence; its response also fails, in several places, to honour patient autonomy – a flaw that should be taken seriously if large language models are to be employed in ethics education. I therefore subject ChatGPT’s reply to detailed scrutiny and point out where it went astray. (shrink)

Getting people not to harm others is a central goal of morality. But while it is commonly perceived that those who benefit others merit gratitude, those who do not harm others are not ordinarily thought to merit anything. I attempt to argue against this, claiming that all the arguments against gratitude to the non-maleficent are unsuccessful. Finally, I explore the difference it would make if we thought that we owe gratitude to those who do not harm us.

The modern doctor-patient relationship displays a patient-centred, mutual-participation characteristic rather than the former active-passive or guidance-cooperation models in terms of medical decision making. Respecting the wishes of patients, amounting to more than mere concern for their welfare, has become the feature central to certain modern bioethics theories. A group of ethical principles such as respect for autonomy, beneficence, non-maleficence, and justice has been proposed by bioethicists and widely adopted by many medical societies as an ethical guide to how doctors, (...) in their daily practice, should treat their patients. However, seeing patients as persons who are rational, self-conscious beings capable of valuing their own lives, and who are consequently entitled to the liberty and rights to choose for themselves, is in general the backbone of Western bioethical principles.Since Confucian philosophy has long been a representative of the East-Asia cultural tradition and Confucian bioethics has recently been developed as a theory of applied ethics, examining Confucius's idea of “persons” may shed some light on the current bioethical debates. Confucius's concept of persons, which is best interpreted via his theories of “chun-tze”, encapsulating a two-dimensional approach, , provides a more comprehensive model regarding what a person is and how he/she should be treated. This two-dimensional approach sees a person not only as a rational, autonomous agent but also as a relational, altruistic identity whose self actualisation involves incessant participating in and promoting of the welfare of his fellow persons. Hence this may balance the current bioethical trend whereby “respect for autonomy” often triumphs. (shrink)