This paper argues that there are two irreducibly distinct negative concepts of liberty: freedom as non-prevention, and freedom as non-coercion. Contemporary proponents of the negative view, such as Matthew Kramer and Ian Carter, have sought to develop the Hobbesian idea that freedom is essentially a matter of physical non-prevention. Accordingly, they have sought to reduce the freedom-diminishing effect of coercion to that of prevention by arguing that coercive threats function to diminish freedom by preventing people from performing certain combinations of (...) actions. Against this, this paper argues that coercion diminishes people’s freedom in ways that cannot be fully captured in terms of prevention. Focusing on two types of case, those involving coercive threats and those involving coercive preference manipulation, it argues that non-coercion and physical non-prevention are importantly different goods. It concludes that a complete negative account of liberty must draw not only on the (Hobbesian) ‘non-prevention’ strand of the negative tradition but also on its (Hayekian) ‘non-coercion’ strand. (shrink)

Many of us think human extinction would be a very bad thing, and that we have moral reasons to prevent it. But there is disagreement over what would make extinction so bad, and thus over what grounds these moral reasons. Recently, several theorists have argued that our reasons to prevent extinction stem not just from the value of the welfare of future lives, but also from certain additional values relating to the existence of humanity itself (for example, humanity's “final” value, (...) or the value of humanity in itself). In this paper, I argue against these “additional value” views. Despite their initial appeal, these views will inevitably face conflicts between the additional values to which they appeal, and the value of the welfare of future lives. And, I argue, the views cannot plausibly resolve these conflicts. In contrast, these conflicts do not arise for a rival view, on which our reasons to prevent extinction stem just from the value of the welfare of future lives. I conclude that this gives us reason to prefer the latter view, despite the greater initial plausibility of additional value views. (shrink)

As the ball flew towards us I leapt to my left to catch it. But it was you, reacting more rapidly than I, who caught the ball just in front of the point at which my hand was poised. Fortunate for us that you took the catch. The ball was headed on a course which, unimpeded, would have taken it through the glass window of a nearby building. Your catch prevented the window from being broken.

This book arises from a three-year study of Preventive Justice directed by Professor Andrew Ashworth and Professor Lucia Zedner at the University of Oxford. The study seeks to develop an account of the principles and values that should guide and limit the state's use of preventive techniques that involve coercion against the individual. States today are increasingly using criminal law or criminal law-like tools to try to prevent or reduce the risk of anticipated future harm. Such measures include criminalizing conduct (...) at an early stage in order to allow authorities to intervene; incapacitating suspected future wrongdoers; and imposing extended sentences or indefinate on past wrongdoers on the basis of their predicted future conduct - all in the name of public protection and security. The chief justification for the state's use of coercion is protecting the public from harm. Although the rationales and justifications of state punishment have been explored extensively, the scope, limits and principles of preventive justice have attracted little doctrinal or conceptual analysis. This book re-assesses the foundations for the range of coercive measures that states now take in the name of prevention and public protection, focussing particularly on coercive measures involving deprivation of liberty. It examines whether these measures are justified, whether they distort the proper boundaries between criminal and civil law, or whether they signal a larger change in the architecture of security. In so doing, it sets out to establish a framework for what we call 'Preventive Justice'. (shrink)

The chapter focuses on cases of assisted suicide and voluntary euthanasia in relation to the rarely discussed notion of indirect paternalism. Indirect paternalism involves not just a paternalistic intervener and a person whose welfare is supposed to be protected, but also another party, whom I call “assistant.” Indirect paternalism interferes with an assistant in order to prevent harm to another person. I will introduce a strategy that paternalists can pursue to justify indirect paternalism. It specifically targets an element of assistance (...) cases, namely the fact that people do not necessarily have a justified claim or entitlement to demand such assistance. To prevent people from providing assistance seems normatively different from preventing a person to do something to herself by her own means. I critically discuss arguments from the goals of medicine and from the conscientious objection. These aspects are not deemed decisive when considering the case of indirect paternalistic intervention. Finally, I argue against the rationale of indirect paternalism by showing that there are at least two situations where it does not succeed. One such situation that undermines the justification of indirect paternalism is present when the offered service is itself harmless, another pertinent situation consists of a person necessarily requiring assistance to be really free. At least in some cases, these very conditions are given when contemplating assistance to die. (shrink)

Are preventive justice measures justified? Do they needlessly blur the boundaries between criminal and civil law, signalling a change in the architecture of security? The contributors in this volume re-assess the foundations for the range of coercive measures that states now take in the name of prevention and public protection.

Prevention is a pervasive phenomenon. It is about blocking an effect before it happens or stopping it as it unfolds: vaccines prevent (the unfolding of) diseases; seat belts prevent events causing serious injuries; circuit breaks prevent the manifestation of overcurrents. Many disciplines in the information sciences deal with modeling and reasoning about prevention. Examples include risk and security management as well as medical and legal informatics. Having a proper conceptualization of this phenomenon is crucial for devising proper modeling mechanisms and (...) tools to support these disciplines. Forming such a conceptualization is a matter of Formal Ontology. In fact, prevention and related notions have become a topic of interest in this area. In this paper, with the support of Unified Foundational Ontology (UFO), we conduct an ontological analysis of this and other related notions, namely, the notions of countermeasures and countermeasure mechanisms, including the notion of antidotes. As a result of this conceptual clarification process, we propose an ontology-based reusable module extending UFO and capturing the relations between these elements. Finally, we employ this module to address a few cases in risk management. (shrink)

In these twelve papers notable ethicists use the resources of ethical theory to illuminate important theoretical and practical topics, including the nature of public health, notions of community, population bioethics, the legitimate role of law, the use of cost-effectiveness as a methodology, vaccinations, and the nature of infectious disease.

Through a theoretical examination of the preventive turn in criminal law and justice which has gained momentum in Anglo-American criminal justice systems since the late-twentieth century, The Preventive Turn in Criminal Law demonstrates how recent transformations in criminal law and justiceare intrinsically related to and embedded in the way liberal society and liberal law have been imagined, developed, and conditioned by its social, political, and historical context. Henrique Carvalho identifies a tension between the idea of punishment as an expression of (...) individual justice, andprevention as a manifestation of the need for security and the promotion of welfare. Tracing this tension back to an intrinsic ambivalence within the modern conception of individual liberty, which is both repressed and preserved by liberal conceptions of responsibility and punishment, Carvalhoproves that as long as this ambivalence remains unexamined, liberal law has the potential to both promote and undermine individual justice.Engaging with the dominant contemporary literature on criminal law, prevention, risk, security, and criminalisation, this volume deploys a theoretical perspective developed through a critical analysis of both classical and contemporary works of social and political theory. The book reveals that thepervasiveness of prevention in 21st century criminal justice systems represents not only the consequence of new and unprecedented features of contemporary politics and society, but also the manifestation of essential aspects of the liberal legal and political tradition. (shrink)

In some jurisdictions, the institutions of criminal justice may subject individuals who have committed crimes to preventive detention. By this, I mean detention of criminal offenders (i) who have already been punished to (or beyond) the point that no further punishment can be justified on general deterrent, retributive, restitutory, communicative or other backwardlooking grounds, (ii) for preventive purposes—that is, for the purposes of preventing the detained individual from engaging in further criminal or otherwise socially costly conduct. Preventive detention, thus understood, (...) shares many features with the quarantine measures sometimes employed in the context of infectious disease control. Both interventions involve imposing (usually severe) constraints on freedom of movement and association. Both interventions are standardly undeserved: in quarantine, the detained individual deserves no detention (or so I will, for the moment, assume), and in preventive detention, the individual has already endured any detention that can be justified by reference to desert. Both interventions are, in contrast to civil commitment under mental health legislation, normally imposed on more-or-less fully autonomous individuals. And both interventions are intended to reduce the risk that the constrained individual poses to the public. Yet despite these similarities, preventive detention and quarantine have received rather different moral report cards. (shrink)

This essay makes three claims about preventive war, which is demarcated from preemptive war and is part of a broader class of ?anticipatory? wars. Anticipatory wars, but especially preventive war, are ?hard cases? for traditional Just War theory; other puzzles for this tradition include nuclear deterrence, humanitarian intervention, and provability a priori of the success of Tit-for-Tat. First, and despite strong assertions to the contrary, it is far from clear that preventive war is absolutely prohibited in traditional Just War Theory, (...) and it is also dubious that it is in all cases ?clearly illegal?. Second, the morality of both preemptive and preventive wars is shown to turn on epistemological considerations: on what degree and kind of justification the primary metaphysical facts of threat can be reasonably believed. Third, an argument is made that whatever epistemic threshold is held to be necessary, some preventive wars will exceed it, and that this is more likely with advancing technologies of information acquisition. Finally, the common argument that allowing all nations to follow policies of preventive war would result in more wars than barring such policies is shown to be mistaken by simulations in game theory. Suggestions are made about the derivation of traditional Just War criteria from more basic moral principles, and about their subtle failures as jointly necessary conditions for the morality of war. (shrink)

Preventive use of force may be defined as the initiation of military action in anticipation of harmful actions that are neither presently occurring nor imminent. This essay explores the permissibility of preventive war from a cosmopolitan normative perspective, one that recognizes the basic human rights of all persons, not just citizens of a particular country or countries. It argues that preventive war can only be justified if it is undertaken within an appropriate rule-governed, institutional framework that is designed to help (...) protect vulnerable countries against unjustified interventions while also avoiding unacceptable risks of the costs of inaction. The key to ensuring the fairness of rules governing the preventive use of force is accountability.This essay proposes a scheme that would make those promoting and those rejecting the preventive use of force more accountable. The proposal contains the following crucial features:States proposing preventive war are required to enter into a contract with a diverse body of states as a condition for authorization of their actions;Prior to taking preventive action, states must make an evidence-based case to the UN Security Council, and agree in advance to submit themselves to an evaluation by an impartial body after the preventive action occurred;Both proponents of action and those opposing it will be held accountable ex post for the accuracy of their prior statements and the proportionality of their actions;Sanctions will be imposed against intervening states or states that opposed preventive action, respectively, depending on the findings of the ex post evaluation.If preventive action were blocked in the Security Council, states seeking to engage in preventive action could then present their case in a different body–a coalition of democratic states–with its own ex post and ex ante accountability procedures. (shrink)

This chapter sets the scene for the subsequent philosophical discussions by surveying a number of biological interventions that have been used, or might in the future be used, for the purposes of crime prevention. These interventions are pharmaceutical interventions intended to suppress libido, treat substance abuse or attention deficit-hyperactivity disorder (ADHD), or modulate serotonin activity; nutritional interventions; and electrical and magnetic brain stimulation. Where applicable, we briefly comment on the historical use of these interventions, and in each case we discuss (...) the evidence that they are effective, or might become so with further refinement. The chapter concludes with a comment on some potentially significant differences between the varieties of intervention that we canvass. (shrink)

Does A cause B simply if A prevents what would have prevented B? Such a case is known as double prevention: where we have the prevention of a prevention. One theory of causation is that A causes B when B counterfactually depends on A and, as there is such a dependence, proponents of the view must rule that double prevention is causation.<br><br>However, if double prevention is causation, it means that causation can be an extrinsic matter, that the cause and effect (...) need not be connected by a continuous chain of events, that there can be causation by absence, and that there can be causation at a distance. All of these implications jar with strong intuitions we have about the nature of causation. There is, on the other hand, a theory of causation based on an ontology of real dispositions, where causation involves the passing around of powers. This theory in contrast entails that double prevention is not causation and, on this issue, it can claim a victory over the counterfactual dependence account. (shrink)

The brain requires sustained interaction with a rich physical and social environment to stay healthy. Individuals without access to such enabling environments and who instead live and grow in disabling environments tend to have greater risk of developing dementia. But research and policymaking as regards dementia risk reduction have so far focused almost exclusively on the role of how individuals’ health behaviors change their risk profile. This exclusive focus on “lifestyle” is both ethically problematic and therapeutically inadequate. I highlight a (...) growing literature on three different kinds of deprivation, an independent and overlooked risk factor for dementia that invites upstream action against inequalities. Future prevention guidelines should include explicit mention of deprivation as a risk factor and be developed around the need to make society fairer. Meanwhile, interventions and discourse based on lifestyle modification should respect the principle of “no ought without support.”. (shrink)

School violence is a burning issue these days. This book provides an in-depth analysis of violence prevention programs and an assessment of their effectiveness, using data from observations, individual interviews, and focus groups, as well as published data from the schools. It is distinguished by its focus on the cultural and structural context of school violence and violence prevention efforts. Where most other researchers use quantitative measures, such as surveys, to assess the effectiveness of violence prevention programs, the authors of (...) this book use qualitative research and ethnography to study the environment where such programs take place. Thus, this work--one of only a few ethnographic studies of violence prevention programs in schools--links previous quantitative research on the topic and critical ethnography. _Preventing Violence in Schools: A Challenge to American Democracy_: *includes voices of school students, accused of practicing violence, who have been participants in violence prevention programs; *analyzes a citywide peer mediation program ; *examines the kinds of violence recognized in schools and the ways schools themselves may perpetuate violence; and *describes a violence prevention program for students at an alternative school. _Preventing Violence in Schools: A Challenge to American Democracy_ is highly relevant for students in courses on urban education, foundations of education, education and social policy, youth and the law, and qualitative research, and for teachers, administrators, and other professionals, such as school psychologists and guidance counselors, at the middle and high school levels. (shrink)

Since at least the advent of Jack Kevorkian’s “suicide machine” the major argument against adopting physician-assisted suicide laws has been that they will lead us down a slippery slope to state-sa...

A large part of the contemporary phenomenology of medicine has been devoted to accounts of health and illness, arguing that they contribute to the improvement of health care. Less focus has been paid to the issue of prevention of disease and the associated difficulty of adhering to health-promoting behaviours, which is arguably of equal importance. This article offers a phenomenological account of this disease prevention, focusing on how we—as embodied beings—engage with health-promoting behaviours. It specifically considers how we engage with (...) oral hygiene regimens to prevent periodontitis and why we are not good at it. The article suggests that poor adherence to health-promoting behaviours can be explained with reference to the concept of the absent body, because prevention of disease is generally concerned with pre-symptomatic illness experience. The final section contains a discussion of some strategies for the improvement of disease prevention based on this viewpoint. (shrink)

ABSTRACTThis article argues that there is a just cause for war to prevent the future hazards of anthropogenic climate change even if, because of what is known as the Non-Identity Problem, that caus...

This paper explores the question of whether the United Nations should engage in preventive military actions. Correlatively, it asks whether UN preventive military actions could satisfy just war principles. Rather than from the standpoint of the individual nation state, the ethics of preventive war is discussed from the standpoint of the UN. For the sake of brevity, only the legitimate authority, just cause, last resort, and proportionality principles are considered. Since there has been disagreement about the specific content of these (...) principles, a third question also is explored: How should they be formulated? Moreover, these questions are addressed in the context of a particular issue: the goals of the non-proliferation and the abolition of weapons of mass destruction. (shrink)

A US Department of Health and Human Services Final Rule, Protecting Statutory Conscience Rights in Health Care, and a proposed bill in the British House of Lords, the Conscientious Objection Bill, may well warrant a concern that—to borrow a phrase Daniel Callahan applied to self-determination—conscientious objection in health care has “run amok.” Insofar as there are no significant constraints or limitations on accommodation, both rules endorse an approach that is aptly designated “conscience absolutism.” There are two common strategies to counter (...) conscience absolutism and prevent conscientious objection in medicine from running amok. One, non-toleration, is to decline to accommodate physicians who refuse to provide legal, professionally accepted, clinically appropriate medical services within the scope of their clinical competence. The other, compromise or reasonable accommodation, is to impose constraints on accommodation. Several arguments for non-toleration are critically analyzed, and I argue that none warrants its acceptance. I maintain that non-toleration is an excessively blunt instrument to prevent conscientious objection in medicine from running amok. Instead, I defend a more nuanced contextual approach that includes constraints on accommodation. (shrink)

The risk of stroke for a child with SCD is many times greater than that of a healthy child without SCD or heart disease. There is a technique that allows the identification of the children with SCD who have high risk even within this relatively high-risk group. And there is a highly effective preventive treatment. While this would on the surface appear to be a straightforward medical decision, it is not. One must weigh the benefits of preventing permanent brain damage (...) against the risks of infection from transfused blood, iron overload, which is the result of the frequent transfusions, and rare transfusion reactions. (shrink)

Sickle cell anemia is a disease characterized by abnormal hemoglobin structure. There is a mutation in the beta-globin gene that changes the sixth amino acid from glutamic acid to valine causing the mutated hemoglobin to polymerize reversibly when deoxygenated to form a gelatinous network of fibrous polymers that stiffen and distort the red blood cell membrane. This leads to episodes of microvascular vasoocclusion and premature RBC destruction leading to hemolytic anemia. For reasons that are unclear, some children develop a large (...) artery vasculopathy involving the intracranial arteries supplying the brain.The risk of stroke for a child with SCD is many times greater than that of a healthy child without SCD or heart disease. There is a technique that allows the identification of the children with SCD who have high risk even within this relatively high-risk group. And there is a highly effective preventive treatment. (shrink)

Academic misconduct is widespread in all cultures, and factors that influence it have been investigated for many years. An act of reporting peers’ misconduct not only identifies and prevents misconduct, but also encourages a student to think and act morally and raises awareness about academic integrity. The aim of this study was to determine factors that prevent students from reporting academic misconduct. A questionnaire to assess views on reporting the academic misconduct of a colleague was developed and sent to all (...) students enrolled at the University of Rijeka, Croatia. Results indicate that a tendency to protect fellow student and to comply with other opinions is the most influential factor that prevents students from reporting peers’ misbehavior. Furthermore, scientific discipline, gender, and age are all significant factors in students’ intention to report peer misconduct. Understanding the factors that influence students’ willingness to report academic misconduct enables faculties, administrators and students to strengthen the ethical culture in the academic community. (shrink)

Epigenetic markers could potentially be used for risk assessment in risk-stratified population-based cancer screening programmes. Whereas current screening programmes generally aim to detect existing cancer, epigenetic markers could be used to provide risk estimates for not-yet-existing cancers. Epigenetic risk-predictive tests may thus allow for new opportunities for risk assessment for developing cancer in the future. Since epigenetic changes are presumed to be modifiable, preventive measures, such as lifestyle modification, could be used to reduce the risk of cancer. Moreover, epigenetic markers (...) might be used to monitor the response to risk-reducing interventions. In this article, we address ethical concerns related to personal responsibility raised by epigenetic risk-predictive tests in cancer population screening. Will individuals increasingly be held responsible for their health, that is, will they be held accountable for bad health outcomes? Will they be blamed or subject to moral sanctions? We will illustrate these ethical concerns by means of a Europe-wide research programme that develops an epigenetic risk-predictive test for female cancers. Subsequently, we investigate when we can hold someone responsible for her actions. We argue that the standard conception of personal responsibility does not provide an appropriate framework to address these concerns. A different, prospective account of responsibility meets part of our concerns, that is, concerns about inequality of opportunities, but does not meet all our concerns about personal responsibility. We argue that even if someone is responsible on grounds of a negative and/or prospective account of responsibility, there may be moral and practical reasons to abstain from moral sanctions. (shrink)

Dans le cadre d’une éthique préventive, nous serons amenés à valider toute la pertinence que requiert la compréhension des logiques de la non-perception d’un risque de contamination du sida par voie sexuelle dans la population guadeloupéenne. En passant par l’analyse des limites sous-jacentes à la séparation de deux populations, celle infectée et celle non infectée, nous pourrons avancer que la non-perception de ce risque relève d’une construction culturelle et sociale où toute confusion, qu’elle soit sexuelle, corporelle, spatiale, participe à la (...) fois d’un sentiment d’invulnérabilité et d’un sentiment de peur. C’est en tenant compte de cette réalité que les différentes instances décisionnelles devraient agir afin d’enrayer une épidémie déjà bien implantée en Guadeloupe. (shrink)

When the state aims to prevent responsible and dangerous actors from harming its citizens, it must choose between criminal law and other preventive techniques. The state, however, appears to be caught in a Catch-22: using the criminal law raises concerns about whether early inchoate conduct is properly the target of punishment, whereas using the civil law raises concerns that the state is circumventing the procedural protections available to criminal defendants. Andrew Ashworth has levied the most serious charge against civil preventive (...) regimes, arguing that they evade the presumption of innocence. After sketching out a substantive justification for a civil, preventive regime, I ask what Ashworth’s challenge consists in. It seems that there is broad disagreement over the meaning and requirements of the presumption of innocence. I thus survey the myriad possibilities and extract two claims that have potential bearing on preventive regimes. One claim is that of substantive priority—the criminal law comes first when assessing blame. This is the claim at the root of objections to pretrial detention based on consideration of the crime charged. The second strand of argument is one of procedural symmetry. This is the concern that with respect to citizen/state relations, certain procedures are required, including, for example, proof beyond a reasonable doubt as to the offense or defense. Having extracted these claims, I then assess their applicability with respect to the preventive regime defended. I first conclude that the criminal law must share blame and censure with other fora, and thus, the criminal law only has substantive priority when criminal proceedings have been instituted. I then survey whether procedural symmetry is required, specifically assessing whether the preventive regime I defend requires proof beyond a reasonable doubt. My tentative conclusion is that proof beyond a reasonable doubt is warranted. (shrink)

This article examines preventive constraints on suspected terrorists that can lead to restrictions on liberty similar to imprisonment and disrespect the target’s autonomy. In particular, it focuses on two examples: travel bans and asset freezes. It seeks to develop guidelines for setting appropriate limits on their future use. Preventive constraints do not generate legal protections as constraints in response to conduct do. In addition, these constraints are often seen as a permissible alternative to imprisonment. Still, preventive de facto detentions, or (...) what I term “exprisonments”, imperil the free and autonomous life of the targeted person. With the recognition that such constraints can infringe on one’s ability to lead a free and autonomous life, this article argues that some of these constraints require similar protections as their counterparts that put persons under lock and key. (shrink)

It is commonly held that there are both cases in which there is a strong moral reason not to cause the existence of a disabled person and cases in which, although it would be permissible to cause a disabled person to exist, it would be better not to. Yet many disabled people are affronted by the idea that it is sometimes better to prevent people like themselves from existing, precisely because these people would be disabled. One of their grounds for (...) concern, which will be my particular focus in this paper, is that claiming that there are reasons to prevent the existence of disabled people may be expressive of a demeaning and hurtful view of the status of existing disabled people, a view that may encourage discriminatory attitudes towards and treatment of the disabled. I will contend that there can indeed be moral and prudential reasons for preventing the existence of a disabled person. But I will argue that it is less obvious than many people assume what, if anything, the recognition of these reasons expresses about disabled people. And I will contend that, even if the recognition of these reasons does express a perception of disabled people that is potentially hurtful, this effect could be offset by the social expression of a contrary view that I will claim is in fact compatible with and equally valid as the potentially hurtful view. Whether it may be morally objectionable to cause a disabled person to exist depends, in part, on whether the person’s life would be worth living. If it is ever objectionable to cause a disabled person to exist, the objections are surely strongest when the person’s life would be “worth not living” – that is, would have aspects or features that would be bad for the person and that would decisively outweigh those, if any, that would be good. Such cases are, however, quite rare. Indeed, some people question whether there are any disabilities so severe as to cause life to be worth not living. It can be argued that disability involves only the absence of certain abilities and that mere deficits.... (shrink)

Prior research has consistently established the pragmatic nature of literature regarding occupational injuries and accidental happenings faced by nursing professionals. However, current realities require a subjective approach to identify preventative measures that could influence occupational health and safety in healthcare sectors. A qualitative design followed a descriptive approach to assess unbiased opinions towards occupational obstructions that lead to accidental happenings. This study used the social capital framework in particular as a support resource to eliminate its detrimental effects on nurse's capacity (...) to serve their patients. The findings extended the fundamental understanding of social capital from social ties to workplace and personal ties as potential mechanisms of support. Healthcare organizations need to redefine their control policies to provide the ultimate support to their care agents. A social capital model offers nursing practitioners and nursing managers an approach for building evidence‐based policies with implications for nurse's safety, education and training. (shrink)

Background and aim Healthcare professionals are regularly exposed to moral challenges in patient care potentially compromising quality of care and safety of patients. Preventive clinical ethics support aims to identify and address moral problems in patient care at an early stage of their development. This study investigates the occurrence, risk factors, early indicators, decision parameters, consequences and preventive measures of moral problems. Method Semi-structured expert interviews were conducted with 20 interprofessional healthcare professionals from 2 university hospitals in Basel, Switzerland. A (...) Likert scale questionnaire was completed by the interviewees and analysed using descriptive and inferential statistics. Results Healthcare professionals are frequently exposed to a variety of moral problems, such as end-of-life decisions, resource allocation and assessing the patient's will or decisional capacity. Thirty-four different risk factors for moral problems are identified, e.g. patient vulnerability, divergent values or world views, inadequate resources or poor ethical climate. Twenty-one early indicators are recognised such as disagreement between healthcare professionals, patients and relatives, emotional disturbances, gut feeling or conflict of conscience. A variety of preventive measures are suggested and presented in a preventive clinical ethics support process model. The most helpful measures are early ethical conversations with colleagues, early team-internal ethical case discussions and an ethics-trained contact person on the ward. Ethics training, kerbside consultations, proactive ethics consultations, ethics screening and rounds are also considered helpful. Conclusions Clinical ethics support services should not only offer reactive and complex, but also proactive and low-threshold support for healthcare professionals, patients and relatives. (shrink)

Healthcare institutions have been making increasing efforts to standardize consultation methodology and to accredit both bioethics training programs and the consultants accordingly. The focus has traditionally been on the ethics consultation as the relevant unit of ethics intervention. Outcome measures are studied in relation to consultations, and the hidden assumption is that consultations are the preferred or best way to address day-to-day ethical dilemmas. Reflecting on the data from an internal quality improvement survey and the literature, we argue that having (...) general ethics education as a key function of ethics services may be more important in meeting the contemporaneous needs of acute care settings. An expanded and varied ethics education, with attention to the time constraints of healthcare workers’ schedules, was a key recommendation brought forward by survey respondents. Promoting ethical reflection and creating a culture of ethics may serve to prevent ethical dilemmas or mitigate their effects. (shrink)

In this article we address torture in military and police organizations as a public health and human rights challenge that needs to be addressed through multiple levels of intervention. While most mental health approaches focus on treating the harmful effects of such violence on individuals and communities, the goal of the project described here was to develop a primary prevention strategy at the institutional level to prevent torture from occurring in the first place. Such an approach requires understanding and altering (...) the conditions that cause and sustain “atrocity producing situations”. Given the persistence of torture across the world and its profound health consequences, this is an increasingly important issue in global health and human rights. (shrink)

Ethics dumping is the practice of undertaking research in a low- or middle-income setting which would not be permitted, or would be severely restricted, in a high-income setting. Whilst Kenya operates a sophisticated research governance system, resource constraints and the relatively low number of accredited research ethics committees limit the capacity for ensuring ethical compliance. As a result, Kenya has been experiencing cases of ethics dumping. This article presents 11 challenges in the context of preventing ethics dumping in Kenya, namely (...) variations in governance standards, resistance to double ethics review, resource constraints, unresolved issues in the management of biological samples, unresolved issues in the management of primary data, unsuitable informed consent procedures, cultural insensitivity, differing standards of care, reluctance to provide feedback to research communities, power differentials which facilitate the exploitation of local researchers and lack of local relevance and/or affordability of the resultant products. A reflective approach for researchers, built around the values of fairness, respect, care and honesty, is presented as a means of taking shared responsibility for preventing ethics dumping. (shrink)

Preventing War and Promoting Peace: A Guide for Health Professionals is an interdisciplinary study of how pervasive militarism creates a propensity for war through the influence of academia, economic policy, the defense industry, and the news media. Comprising contributions by academics and practitioners from the fields of public health, medicine, nursing, law, sociology, psychology, political science, and peace and conflict studies, as well as representatives from organizations active in war prevention, the book emphasizes the underlying preventable causes of war, particularly (...) militarism, and focuses on the methods health professionals can use to prevent war. Preventing War and Promoting Peace provides hard-hitting facts about the devastating health effects of war and a broad perspective on war and health, presenting a new paradigm for the proactive engagement of health professions in the prevention of war and the promotion of peace. (shrink)

Allen Buchanan and Robert O. Keohane reply to Steven Lee's critique of their previous essay on the preventive use of military force.

Liao and Carbonell discuss the role of (supposed) racial differences and racism in two medical devices: pulse oximeters and spirometers. They show that what might seem like cases of mere bias, are...

The precautionary principle brings a special challenge to the practice of evidence-based public health decision-making, suggesting changes in the interpretative methods of public health used to identify causes of disease. In this paper, precautionary changes to these methods are examined: including discounting contrary evidence, reducing the number of causal criteria, weakening the rules of evidence assigned to the criteria, and altering thresholds for statistical significance. All such changes reflect the precautionary goal of earlier primary preventive intervention, i.e. acting on insufficient (...) evidence, the least amount, or minimum level, of evidence for causation. Evaluating the impact of these changes will be difficult without a careful study of how well the current methods of causal inference work, their theoretical foundations, and the ethical implications of their applications. That research program will be most productive if it is jointly developed by public health professionals trained in the ethics and philosophy and by bioethicists and philosophers trained in the theories, methods, and practice of public health. (shrink)

Some causal situations appear similar but causally different. Preemptive prevention offers such an example. However, it is difficult to capture the causal difference. In fact, it resists analysis. I discuss Collins’ s account of causal difference, and argue that it is not adequate. I also argue that the causal difference is not analyzable in terms of either dependence or production. I then examine some non-reductive account of causal difference, and claim that the sense of causal difference has yet to be (...) specified. Preemptive prevention shows that the concept of causation, whether it is reducible to something else or not, still requires some further scrutiny. (shrink)

What is to be â € œprotectedâ € is US power and the interests it represents, not the world, which vigorously opposed the conception. Within a few months, studies revealed that fear of the United States had reached remarkable heights, along with distrust of the political leadership. An international Gallup poll in December, barely noted in the US, found virtually no support for Washingtonâ €™ s announced plans for a war in Iraq carried out â € œunilaterally by America and (...) its alliesâ €: in effect, the US - UK â € œcoalition. â €. (shrink)

The adoption and reporting of CSR policies have important ethical and managerial implications that need scrutiny. This study answers the call of CSR scholars for further studies in controversial sectors by focusing on the voluntary reporting practices of companies that market products or services that generate addiction among consumers. It contributes to the debate on organizational legitimacy and corporate reporting by empirically analyzing whether and how corporations in the tobacco, alcohol and gambling industries disclose their CSR actions and what reactions (...) such disclosures generate in stakeholders. Drawing on legitimacy theory and organizational façades, we apply a consequent mixed-methods design (initiation approach) built on (i) a content analysis of reports prepared by a large set of companies listed on the European, British, US, Canadian, Australian and New Zealand stock exchanges and (ii) an experiment on how different actions taken by the companies (preventive vs. remedial) elicit different perceptions of company hypocrisy and action effectiveness. While previous analyses have focused on “sin” or “harm” industries, this is one of the first to assess how companies account for “addiction”, which is more difficult for them to report and legitimate due to long-term negative consequences. This study contributes to the literature on the instrumental use of CSR reporting by empirically investigating how addiction companies shape their organizational façades and manage organizational legitimacy through disclosure. Moreover, the experimental evidence advances the knowledge of how cognitive mechanisms influence stakeholders in terms of legitimacy assessment and the perceived hypocrisy/effectiveness of CSR disclosure. (shrink)