The Oregon Basic Health Services Act of 1989 seeks to establish universal access to basic medical care for all currently uninsured Oregon residents. To control the increasing cost of medical care, the Oregon plan will restrict funding according to a priority list of medical interventions. The basic level of medical care provided to residents with incomes below the federal poverty line will vary according to the funds made available by the Oregon legislature. A rationing plan such as Oregon's which potentially (...) excludes medically necessary procedures from the basic level of health care may be just, for the right to publically-sponsored medical care is restricted by opposing rights of private property. However, the moral acceptability of the Oregon plan cannot be determined in the absence of knowing the level of resources to be provided. Finally, Oregon to date has failed to include the individuals being rationed in discussions as to how the scarce resources are to be distributed. (shrink)

This essay is composed of five stories written by practicing physicians about their patients. Each clinical story describes a challenging ethical condition–potential abuse of medical power, gravely ill and probably over-treated newborns, iatrogenic narcotic addiction, deceived dying people. Rather than singling out one ethical conflict to resolve or adjudicate, the authors attempt, through literary methods, to grasp the singular experiences of their patients and to act according to the deep structures of their patients' lives. Examining these five stories with simple (...) literary tools–attention to narrative frames, time, plot, and desire–reveals the mechanisms through which acts of writing and reading contribute to clinical clarity and ethical actions. (shrink)

Video news releases (VNRs) have been criticized when they are used within a newscast without source disclosure because they violate ethical codes related to transparency and consumers' “right to be informed” by whom they are being persuaded. In an experiment, we show how increased persuasion knowledge about VNRs is positively related to beliefs in news commercialization, beliefs in VNR inappropriateness without disclosure, and support for disclosure of VNR material. We suggest that increased knowledge about VNRs without source disclosure measures might (...) harm messages that are not employing the tactic (“false positives”) and lead to a general distrust of all media. (shrink)

Objective To assess parental permission for a neonate's research participation using the MacArthur competence assessment tool for clinical research (MacCAT-CR), specifically testing the components of understanding, appreciation, reasoning and choice. Study Design Quantitative interviews using study-specific MacCAT-CR tools. Hypothesis Parents of critically ill newborns would produce comparable MacCAT-CR scores to healthy adult controls despite the emotional stress of an infant with critical heart disease or the urgency of surgery. Parents of infants diagnosed prenatally would have higher MacCAT-CR scores than parents (...) of infants diagnosed postnatally. There would be no difference in MacCAT-CR scores between parents with respect to gender or whether they did or did not permit research participation. Participants Parents of neonates undergoing cardiac surgery who had made decisions about research participation before their neonate's surgery. Methods The MacCAT-CR. Results 35 parents (18 mothers; 17 fathers) of 24 neonates completed 55 interviews for one or more of three studies. Total scores: magnetic resonance imaging (mean 36.6, SD 7.71), genetics (mean 38.8, SD 3.44), heart rate variability (mean 37.7, SD 3.30). Parents generally scored higher than published subject populations and were comparable to published control populations with some exceptions. Conclusions The MacCAT-CR can be used to assess parental permission for neonatal research participation. Despite the stress of a critically ill neonate requiring surgery, parents were able to understand study-specific information and make informed decisions to permit their neonate's participation. (shrink)

Academic dishonesty, including cheating and plagiarism, is on the rise in colleges, particularly among engineering students. While students decide to engage in these behaviors for many different reasons, academic integrity training can help improve their understanding of ethical decision making. The two studies outlined in this paper assess the effectiveness of an online module in increasing academic integrity among first semester engineering students. Study 1 tested the effectiveness of an academic honesty tutorial by using a between groups design with a (...) Time 1- and Time 2-test. An academic honesty quiz assessed participants’ knowledge at both time points. Study 2, which incorporated an improved version of the module and quiz, utilized a between groups design with three assessment time points. The additional Time 3-test allowed researchers to test for retention of information. Results were analyzed using ANCOVA and t tests. In Study 1, the experimental group exhibited significant improvement on the plagiarism items, but not the total score. However, at Time 2 there was no significant difference between groups after controlling for Time 1 scores. In Study 2, between- and within-group analyses suggest there was a significant improvement in total scores, but not plagiarism scores, after exposure to the tutorial. Overall, the academic integrity module impacted participants as evidenced by changes in total score and on specific plagiarism items. Although future implementation of the tutorial and quiz would benefit from modifications to reduce ceiling effects and improve assessment of knowledge, the results suggest such tutorial may be one valuable element in a systems approach to improving the academic integrity of engineering students. (shrink)

Recruiting research participants based on genetic information generated about them in a prior study is a potentially powerful way to study the functional significance of human genetic variation, but it also presents ethical challenges. To inform policy development on this issue, we conducted a survey of U.S. institutional review board chairs concerning the acceptability of recontacting genetic research participants about additional research and their views on the disclosure of individual genetic results as part of recruitment. Our findings suggest there is (...) unlikely to be a “one-size-fits-all” solution, but rather several ethically acceptable approaches to genotype-driven recruitment, depending on context. Disclosures made during the consent process for the original study and the clinical validity of the results are key considerations. Researchers must be prepared to communicate and answer questions in clear lay language about what is known and not known regarding the role of genetics in their proposed area of research. (shrink)

The vegetation eaten by animals on large areas of several continents is deficient in phosphate and deleterious effects on physiology, particularly reproduction, ensue. Records on bone chewing behaviour by both pastoral andwild game animals extend over two centuries. In laboratory investigation of this apt behaviour it has been shown that the appetite for bones is innate and specific and cued predominantly by olfactory stimuli. It is suppressed by rapidly increasing the plasma phosphate concentration to normal but not influenced by increasing (...) the phosphate concentration in cerebrospinal fluid. The central organization of this genetically programmed behaviour appears to differ from systems subserving thirst and sodium appetite. (shrink)

I define ethical intuitionism as the view that it is appropriate to appeal to inferentially unsupported moral beliefs in the course of moral reasoning. I mention four common objections to this view, including the view that all such appeals to intuition make ethical theory politically and noetically conservative. I defend intuitionism from versions of this criticism expressed by R.B. Brandt, R.M. Hare and Richard Miller.

We agree with van der Pijl et al that the question of how to ensure consent is obtained for procedures which occur during labour and childbirth is vitally important, and worthy of greater attention.1 However, we argue that the modified opt-out approach to consent outlined in their paper may not do enough to protect the choice and agency of birthing people. Moreover, while their approach reflects a pragmatic attempt to facilitate legal clarity and certainty in this context, this is not (...) necessarily responsive to the messy realities of decision-making during labour (and beyond). We outline some of our concerns with their proposals and demonstrate how these illuminate some broader, longstanding tensions around consent and medical law. The authors place significant focus on the particularities of labour, outlining six ways in which maternity care is ‘unlike the usual healthcare setting’ (van der Pijl M et al,1p4). We support the need for attentiveness to these particularities and the problematic nature of consent in this context. Recent scholarly attention on the possible ‘political, ethical and theoretical implications and meanings of birthing embodiment’ (Chadwick R,2p2) has invited more nuanced conversation about consent, agency and decision-making during labour. However, while recognising the embodied particularities of labour, we must also avoid essentialising the differences of labouring bodies and thereby reinforcing exclusionary norms of consent. This points to a long-standing tension in feminist theory between the universal and the particular; between recognising and responding to the powerlessness of individuals without …. (shrink)

I define ethical intuitionism as the view that it is appropriate to appeal to inferentially unsupported moral beliefs in the course of moral reasoning. I mention four common objections to this view, including the view that all such appeals to intuitionism collapse into “subjectivism”, i.e., that they make truth in ethical theory depend on what people believe. I defend intuitionism from versions of this criticism expressed by R.M. Hare and Peter Singer.

Roughly thirty years ago, R. M. Hare told an Anglo-French philosophy conference about a young Swiss student who came to stay with his family in Oxford. It seems that the student was doing very nicely, until, in a burst of misguided hospitality, the Hares provided him with one of their few French books, Camus's L'Etranger. Reading Camus had the effect of changing the student from an affable, altogether attractive young man into a chain-smoking recluse for whom “rien, rien n'avait d'importance”.

This paper is an attempt to bring some order to a classic debate over the mind/body problem. I formulate the dualist, identity, and eliminativist positions and then examine the disagreement between eliminativists and their critics. I show how the apparent impasse between eliminativists and non-eliminativists can be helpfully interpreted in the light of the higher-order debate over methodological versus substantive commitments in philosophy. I argue that non-eliminativist positions can be defended using Roderick Chisholm's defense of what he calls "particularism" in (...) the problem of the criterion. (shrink)

Walter Sinnott-Armstrong's recent defense of moral skepticism raises the debate to a new level, but I argue that it is unsatisfactory because of problems with its assumption of global skepticism, with its use of the Skeptical Hypothesis Argument, and with its use of the idea of contrast classes and the correlative distinction between "everyday" justification and "philosophical" justification. I draw on Chisholm's treatment of the Problem of the Criterion to show that my claim that I know that, e.g., baby-torture is (...) wrong, is no more question-begging than Sinnott-Armstrong's denial that I know this. (shrink)

What do Ross’s The Right and the Good; Chisholm’s Theory of Knowledge; Kripke’s Naming and Necessity; and Audi’s The Architecture of Reason have in common? They all advance important philosophical positions, but not so much via analytic arguments as via formal schemas, distinctions, examples, and analogies. They use such formal schemas, etc, to describe the world so as to make some aspect of it manifest. That is, they simply try to ‘tell it like it is’. This ‘method of descriptive manifestation’ (...) is less commonly recognized than it should be given its divergence from the self-image of analytic philosophy. (shrink)

Signs of mankind's solidarity, by J. R. Nelson.--Mankind, Israel and the nations in the Hebraic heritage, by M. Greenberg.--Christian insights from biblical sources, by C. Maurer.--Muhammad and all men, by D. Rahbar.--The impact of New World discovery upon European thought of man, by E. J. Burrus.--The effects of colonialism upon the Asian understanding of man, by J. G. Arapura.--Religious pluralism and the quest for human community, by S. J. Samartha.--From Confucian gentleman to the new Chinese 'political' man, by D. (...) A. Robinson.--The scientific revolution and the unity of man, by B. Towers.--Language and communication, by E. A. Nida.--Man and the son of man, by J. Moltmann.--The potentiality of conciliarity: communion, conscience, council, by W. B. Blakemore.--Oneness must mean wholeness, by J. R. Nelson. (shrink)