This paper examines the ethical aspects of organ transplant surgery in which a donor heart is transplanted from a first recipient, following determination of death by neurologic criteria, to a second recipient. Retransplantation in this sense differs from that in which one recipient undergoes repeat heart transplantation of a newly donated organ, and is thus referred to here as “reuse cardiac organ transplantation.” Medical, legal, and ethical analysis, with a main focus on ethical analysis. From the medical perspective, it is (...) critical to ensure the quality and safety of reused organs, but we lack sufficient empirical data pertaining to medical risk. From the legal perspective, a comparative examination of laws in the United States and Japan affirms no illegality, but legal scholars disagree on the appropriate analysis of the issues, including whether or not property rights apply to transplanted organs. Ethical arguments supporting the reuse of organs include the analogous nature of donation to gifts, the value of donations as inheritance property, and the public property theory as it pertains to organs. Meanwhile, ethical arguments such as those that address organ recycling and identity issues challenge organ reuse. We conclude that organ reuse is not only ethically permissible, but even ethically desirable. Furthermore, we suggest changes to be implemented in the informed consent process prior to organ transplantation. The organ transplant community worldwide should engage in wider and deeper discussions, in hopes that such efforts will lead to the timely preparation of guidelines to implement reuse cardiac organ transplantation as well as reuse transplantation of other organs such as kidney and liver. (shrink)

In organ transplantation, there is a lack of ethical discussion about the recipient’s right not to receive a transplant. Using the current situation of living organ transplantation and deceased organ transplantation in Japan as an example, we prospectively discussed to what extent the recipient’s right not to receive a transplant is ethically acceptable. In directed transplantation from a living donor, a recipient may refuse organ donation from a particular donor. It is preferable that a recipient’s request for organ donation from (...) a donor occurs as part of a transparent process. In nondirected transplantation from a deceased donor, refusal of transplantation from a particular type of donor appears potentially justifiable. There are both moral and pragmatic considerations. Certain refusals based solely on belief are morally unacceptable, and refusal to transplant a recipient based on the donor’s age jeopardizes the entire transplant system. When religious beliefs affect mental and physical health, individualized measures are required for transplant rejection. We also deductively developed a prospective argument based on the current status of donor–recipient communication in living organ transplantation in Japan and the 2010 amendment of the law allowing relatives to be given priority in organ transplantation from deceased donors. (shrink)

In this article, we perform a thought experiment about living donor kidney transplantation. If a living kidney donor becomes in need of renal replacement treatment due to dysfunction of the remaining kidney after donation, can the donor ask the recipient to give back the kidney that had been donated? We call this problem organ restitution and discussed it from the ethical viewpoint. Living organ transplantation is a kind of ‘designated donation’ and subsequently has a contract-like character. First, assuming a case (...) in which original donor wishes the return of the organ which had been transplanted into B, and the original recipient agrees, organ restitution will be permissible based on contract-like agreement. However, careful and detailed consideration is necessary to determine whether this leaves no room to question the authenticity of B’s consent. Second, if B offers to give back the organ to A, then B’s act is a supererogatory act, and is praiseworthy and meritorious. Such an offer is a matter of virtue, not obligation. Third, if A wishes B to return the organ, but B does not wish/allow this to happen, it is likely difficult to justify returning the organ to A by violating B’s right to bodily integrity. But B’s refusal to return the donated organ cannot be deemed praiseworthy, because B forgets the great kindness once received from A. Rather than calling this an obligation, we encourage B to consider such virtuous conduct. (shrink)

We explore the various ethical challenges that arise during the practical implementation of an emergency resource allocation protocol. We argue that to implement an allocation plan in a crisis, a hospital system must complete five tasks: (1) formulate a set of general principles for allocation, (2) apply those principles to the disease at hand to create a concrete protocol, (3) collect the data required to apply the protocol, (4) construct a system to implement triage decisions with those data, and (5) (...) create a system for managing the consequences of implementing the protocol, including the effects on those who must carry out the plan, the medical staff, and the general public. Here we illustrate the complexities of each task and provide tentative solutions, by describing the experiences of the Coronavirus Ethics Response Group, an interdisciplinary team formed to address the ethical issues in pandemic resource planning at the University of Rochester Medical Center. While the plan was never put into operation, the process of preparing for emergency implementation exposed ethical issues that require attention. (shrink)

BackgroundMoral distress (MD) is an emotional and psychological response to morally challenging dilemmas. Moral distress is experienced frequently by nurses in the intensive care unit (ICU) and can result in emotional anguish, work dissatisfaction, poor patient outcomes, and high levels of nurse turnover. Opportunities to discuss ethically challenging situations may lessen MD and its associated sequela.ObjectiveThe purpose of this project was to develop, implement, and evaluate the impact of nursing ethics huddles on participants’ MD, clinical ethics knowledge, work satisfaction, and (...) patient care among ICU nurses.Sample and SettingThe sample, 32 nurses from three ICU settings in an 800-bed tertiary academic medical center, participated in six nursing ethics huddles over a two-month period.MethodsAlvita K. Nathaniel’s Theory of Moral Reckoning guided development of the nursing ethics huddle process.1 The Moral Distress Thermometer was administered at three data points: baseline level of MD, and pre- and post-huddle to determine changes in the subjects’ level of MD.2 Focused content analysis was used to analyze qualitative responses from questionnaires about the subjects’ perception of the effect of the huddles on work satisfaction and patient care. Knowledge attainment was evaluated via open-ended short-answer questions.ResultsOverall, use of nurse-ethicist-led nursing ethics huddles was associated with improved quality of work life, patient care, and clinical ethics knowledge. The change in pre- and post-nursing ethics huddles MD scores was statistically significant (p < 0.0001). (shrink)

Qualitative and quantitative research on the impact of medical and health humanities teaching in baccalaureate education is sparse. This paper reviews recent studies of the impact of medical and health humanities coursework in pre-health professions education and describes a pilot study of baccalaureate students who completed semester-long medical humanities courses in the Division of Medical Humanities & Bioethics at the University of Rochester. The study format was an email survey. All participants were current or former baccalaureate students who had taken (...) one or more courses in literature and narrative in medicine, bioethics, history of medicine, and/or visual arts and healthcare during the past four years. The survey gathered numerical data in several areas: demographic information, career plans, self-reported influence of coursework on educational and career plans, and self-reported influence of coursework on intellectual skills and abilities. It also gathered narrative commentary that elaborated on students’ responses to the numerically-based questions. Notable findings from preliminary analysis of the data include higher scores of self-reported impact of the coursework on specific habits of mind and on preparedness for intended career rather than on gaining admission to future educational programs. Discussion of the results focuses on several potential future directions this type of study might take, including multi-center, longitudinal, and sequential approaches. (shrink)

BUSINESS ETHICS, 9th Edition is a comprehensive and practical guide that will help you with real life ethical issues that rise in the business world. It will assist you through the process of developing the critical thinking and analytical skills needed to successfully navigate the unique set of problems that emerge when ethics and commerce collide. This book focuses on key ethical concepts and emphasizes the real world importance of critical topics such as the nature of morality, major theories of (...) ethics and economic justice, and competing views of capitalism and corporate responsibility. It is thorough, flexible, and designed to bolster student involvement with the material for better comprehension and understanding. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

ABSTRACT This essay explores the question of what sorts of relations morality permits, requires, or forbids nations, businesses, and individuals to have with South Africa and South Africans. After reflecting on the immorality of apartheid and rebutting several defences of it, the essay turns its attention to several questions that bear on the assessment of foreign policy toward South Africa. The final sections discuss how individuals ought to respond to South African apartheid, focusing on collective boycotts and personal abstentions. The (...) essay critically assesses various proposed boycotts and weighs the significance of symbolic protests of apartheid. (shrink)

ABSTRACT Nuclear deterrence has struck many people as morally perplexing because it is a case in which it appears to be right to threaten, and in a sense intend, what it would be wrong to do. Section 1 explores the assumptions that are necessary to generate this moral paradox. Some moral theorists, however, have refused to embrace this paradox, contending instead that nuclear deterrence is immoral in principle precisely because it is wrong to threaten that which it would be immoral (...) to do. Section 2 rebuts this contention and seeks to reduce the apparent paradoxicality of nuclear deterrence to manageable proportions. This is not to maintain, though, that nuclear deterrence is morally permissible in the world in which we live; consequently, Section 3 surveys some of the factors relevant to a moral assessment of the legitimacy of the actual practice of nuclear deterrence. (shrink)

Nielsen Busch and Mjaaland (2023) argue that controlled donation after circulatory death does not violate the dead donor rule because the dead donor rule “merely requires that procurement of organs...

Combining engaging discussions and stimulating new case studies, BUSINESS ETHICS: A TEXTBOOK WITH CASES gives students a comprehensive survey of business ethics that will guide them toward becoming ethical professionals, even if they have never studied philosophy before. Rich with real-world examples, BUSINESS ETHICS: A TEXTBOOK WITH CASES invites students to critically analyze and apply a broad range of philosophical concepts and principles to today's most important issues in business and beyond. BUSINESS ETHICS: A TEXTBOOK WITH CASES is a concise (...) (without readings) and updated version of the eleventh edition of MORAL ISSUES IN BUSINESS. BUSINESS ETHICS: A TEXTBOOK WITH CASES is also available in an eBook format. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

"[This] book guides readers in thinking deeply about important moral issues that frequently arise in business situations and helps them develop the reasoning and analytical skills to resolve those issues. Combining insightful and accessible textbook chapters by the authors, cases that highlight the real-world importance of key ethical concepts, and reading selections from the most influential voices in contemporary ethical debates, this book provides a comprehensive, flexible, and pedagogically proven course of study exploring the intersections of commerce and ethics."--Book cover.

Aimed at undergraduates, _Contemporary Ethics_ presupposes little or no familiarity with ethics and is written in a clear and engaging style. It provides students with a sympathetic but critical guide to utilitarianism, explaining its different forms and exploring the debates it has spawned. The book leads students through a number of current issues in contemporary ethics that are connected to controversies over and within utilitarianism. At the same time, it uses utilitarianism to introduce students to ethics as a subject. In (...) these ways, the book is not only a guide to utilitarianism, but also an introduction to some standard problems of ethics and to several important topics in contemporary ethical theory. (shrink)

Eldon Soifer and Béla Szabados argue that hypocrisy poses a problem for consequentialism because the hypocrite, in pretending to live up to a norm he or she does not really accept, acts in ways that have good results. They argue, however, that consequentialists can meet this challenge and show the wrongness of hypocrisy by adopting a desirefulfilment version of their theory. This essay raises some doubts about Soifer and Szabados's proposal and argues that consequentialism has no difficulty coming to grips (...) with hypocrisy, whether or not one favours a desire-fulfilment account of the good. (shrink)

Originally delivered at a conference of Marxist philosophers in China, this article examines some links, and some tensions, between business ethics and the traditional concerns of Marxism. After discussing the emergence of business ethics as an academic discipline, it explores and attempts to answer two Marxist objections that might be brought against the enterprise of business ethics. The first is that business ethics is impossible because capitalism itself tends to produce greedy, overreaching, and unethical business behavior. The second is that (...) business ethics is irrelevant because focusing on the moral or immoral conduct of individual firms or businesspeople distracts one’s attention from the systemic vices of capitalism. I argue, to the contrary, that, far from being impossible, business requires and indeed presupposes ethics and that for those who share Marx’s hope for a better society, nothing could be more relevant than engaging the debate over corporate social responsibility. In line with this, the article concludes by sketching some considerations favoring corporations’ adopting a broader view of their social and moral responsibilities, one that encompasses more than the pursuit of profit. (shrink)

This in-depth examination of the major theories of economic justice focuses on the central question: What should the economic distribution of goods and services be based on?

This book offers a detailed utilitarian analysis of the ethical issues involved in war. Utilitarianism and the Ethics of War addresses the two basic ethical questions posed by war: when, if ever, are we morally justified in waging war, and if recourse to arms is warranted, how are we permitted to fight the wars we wage? In addition, it deals with the challenge that realism and relativism raise for the ethical discussion of war, and with the duties of military personnel (...) and the moral challenges they can face. In tackling these matters, the book covers a wide range of topics—from pacifism to armed humanitarian intervention, from the right of national defense to pre-emptive or preventive war, from civilian immunity to the tenets of just war theory and the moral underpinnings of the rules of war. But, what is distinctive about this book is that it provides a consistent and thorough-going utilitarian or consequentialist treatment of the fundamental normative issues that war occasions. Although it goes against the tide of recent work in the field, a utilitarian approach to the ethics of war illuminates old questions in new ways by showing how a concern for well-being and the consequences of our actions and policies shape the moral constraints to which states and other actors must adhere. This book will be of much interest to students of the ethics of war, just war theory, moral philosophy, war and conflict studies and IR. (shrink)

The adversary system and the practice of law -- The rule of law -- The moral force of law -- Statutes -- Precedents -- Constitutional interpretation -- Natural law and legal positivism: classical perspectives -- Formalism and legal realism -- Morality and the law -- International law -- Law and economics -- The justification of punishment -- The rights of defendants -- Sentencing -- Criminal responsibility -- Compensating for private harms: the law of torts -- Private ownership: the law of (...) property -- Private agreements: the law of contract -- Church and state -- Personal liberty and privacy -- Freedom of speech -- Equality. (shrink)

Despite the enormous impact that war and the threat of war have had on human well-being, utilitarians have had surprisingly little to say about when, if ever, we may fight wars. Discussion of this question has been dominated by realism, pacifism and just war theory. This article takes some preliminary steps toward remedying this situation. I begin by spelling out what I call the Utilitarian War Principle (UWP). After presenting some considerations in its favour and answering some possible objections to (...) it, I compare UWP with pacifism and with the principles of jus ad bellum found in the work of contemporary just war theorists. I argue that adherents of UWP should treat those principles as secondary moral principles, which, although subordinate to UWP, can and should guide its application and which, in turn, should be refined and revised with this goal in mind. (shrink)

This chapter contains section titled: Introduction Understanding Utilitarianism The Most Common Criticism of Utilitarianism A Deeper Objection: Utilitarianism Requires Immoral Conduct The Utilitarian Response Utilitarianism in Practice Some Final Criticisms of Utilitarianism.

Deontological moral theories may forbid a particular action in certain circumstances even though performing it would result in fewer actions of the forbidden type. This is the paradox of deontology, and the first two sections of the essay explicate this paradox and criticize some ways in which deontologists have responded to it. Thereafter, however, I come to the assistance of the deontologist. The third and fourth sections discuss the conditions that must be met before this paradox poses a genuine problem (...) and the likelihood of those conditions being satisfied. Then, with a nod to rule utilitarianism, I show that the deontologist has an important, albeit pragmatic line of rebuttal, which in conjunction with other considerations raised in the essay can assist nonconsequentialists to disarm the paradox of deontology. (shrink)

This essay situates Mill in relation to modern utilitarianism, comparing some of his ideas with current thinking and highlighting aspects of his thought that have influenced it. Scholarly controversy over whether Mill was an act‐ or rule‐utilitarian has had a lasting influence on modern utilitarianism, prodding theorists to identify and refine various possible forms of the theory. By contrast, Mill's defense of a qualitatively‐oriented hedonism and his famous ‘proof’ of the theory have had little impact. Nevertheless, utilitarians today share his (...) skepticism about moral intuition and his belief that any acceptable moral system must have a consequentialist structure. Mill strengthened the case for utilitarianism by answering various objections to it, objections that utilitarianism's detractors continue to advance. His rejoinders to these criticisms are among his most seminal contributions to utilitarian thinking because his arguments and insights, many utilitarians believe, point toward a sophisticated, largely indirect form of utilitarianism, one that is subtle, refined, and attractive. (shrink)

Marx found in the American anthropologist Lewis Henry Morgan's work a confirmation of and expansion upon his own materialist approach. Similarities he found included Morgan's division of mankind's early development into distinct stages, each the necessary forerunner of its successor; a theory of historical development; the importance of "productive forces"; and an awareness of the social contradictions of private property. Marx knew Morgan did not share his political sympathies, but he and Engels did not see or ignored evidence that Morgan (...) was not an historical materialist. Marx and Engels through their enthusiasm for Morgan brought their materialist conception of history into contact with the important question of the nature of kinship bonds, even if they did not resolve it themselves. (shrink)

Deontological moral theories may forbid a particular action in certain circumstances even though performing it would result in fewer actions of the forbidden type. This is the paradox of deontology, and the first two sections of the essay explicate this paradox and criticize some ways in which deontologists have responded to it. Thereafter, however, I come to the assistance of the deontologist. The third and fourth sections discuss the conditions that must be met before this paradox poses a genuine problem (...) and the likelihood of those conditions being satisfied. Then, with a nod to rule utilitarianism, I show that the deontologist has an important, albeit pragmatic line of rebuttal, which in conjunction with other considerations raised in the essay can assist nonconsequentialists to disarm the paradox of deontology. (shrink)

Chemotaxis in bacteria is an excellent model for signal transduction processes. In Agrobacterium tumefaciens, the causative agent of crown gall tumour on wounded plants, it is a vital part of the organism's biology. A chromosomally‐determined chemotaxis system causes the bacterium to be attracted into the rhizosphere by chemoattractants in plant exudates. By interfacing with this system, the multifunctional products of two Tiplasmid encoded genes, virA and virG, allow the sensing of specific wound phenolics such as acetosyringone. This attracts Ti‐plasmid harbouring (...) A. tumefaciens to wound sites, where the higher acetosyringone concentrations lead to virA and virG‐mediated induction of the vir‐genes. The products of the induced genes, act in concert to effect transfer of the T‐DNA to the plant cell. (shrink)