Accounts of the value of patient choice in contemporary medical ethics typically focus on the act of choosing. Being the one to choose, it is argued, can be valuable either because it enables one to bring about desired outcomes, or because it is a way of enacting one’s autonomy. This paper argues that all such accounts miss something important. In some circumstances, it is having the opportunity to choose, not the act of choosing, that is valuable. That is because in (...) many situations whether one has, or is denied, that opportunity conveys how one is seen. In particular, it conveys whether or not one is seen as an equal and competent member of society. Adequately recognising this fact has implications for what healthcare professionals should do, ones that require a move away from the current focus on autonomy. The paper draws out these implications by focusing on patients who may struggle to be recognised as competent and equal members of society, and whose autonomy may thus itself sometimes be in question. (shrink)

There is widespread agreement that it would be both morally and legally wrong to treat a competent patient, or to carry out research with a competent participant, without the voluntary consent of that patient or research participant. Furthermore, in medical ethics it is generally taken that that consent must be informed. The most widely given reason for this has been that informed consent is needed to respect the patient’s or research participant’s autonomy. In this article I set out to challenge (...) this claim by considering in detail each of the three most prominent ways in which ‘autonomy’ has been conceptualized in the medical ethics literature. I will argue that whilst these accounts support the claim that consent is needed if the treatment of competent patients, or research on competent individuals, is to respect their autonomy, they do not support the claim that informed consent is needed for this purpose. (shrink)

It is generally held that doctors and researchers have an obligation to obtain informed consent. Over time there has been a move in relation to this obligation from a requirement to disclose information to a requirement to ensure that that information is understood. Whilst this change has been resisted, in this article I argue that both sides on this matter are mistaken. When investigating what information is needed for consent to be informed we might be trying to determine what information (...) a person would need in order to consent at all, or we might be trying to determine what information a person needs in order to make an informed choice about whether or not to consent. I argue that the obligation to ensure understanding only applies to information generated by the first type of enquiry; but that much of the information generally thought necessary in order for consent to be informed is only required if our concern is with the second type of enquiry. For this reason it is neither the case that doctors and researchers should ensure all the information they provide is understood, nor is it the case that their only obligation is to disclose it. (shrink)

In a health service with limited resources we must make decisions about who to treat first. In this paper I develop a version of the restoration argument according to which those whose need for resources is a consequence of their voluntary choices should receive lower priority when it comes to health care. I then consider three possible problems for this argument based on those that have been raised against other theories of this type: that we don't know in a particular (...) case that the illness is self-inflicted, that it seems that all illness is self-inflicted in the sense used in my argument, and finally that this type of approach incorporates an unacceptable moralising element if it is to avoid giving those like fire-fighters a lower priority for treatment. I argue that the position outlined here has the resources to respond to each of these objections. (shrink)

Around the world, the population is ageing in ways that pose new challenges for healthcare providers. To date these have mostly been formulated in terms of challenges created by increasing costs, and the focus has been squarely on life-prolonging treatments. However, this focus ignores the ways in which many older people require life-enhancing treatments to counteract the effects of physical and mental decline. This paper argues that in doing so it misses important aspects of what justice requires when it comes (...) to older people. (shrink)

Ulysses contracts are a method by which one person binds himself by agreeing to be bound by others. In medicine such contracts have primarily been discussed as ways of treating people with episodic mental illnesses, where the features of the illness are such that they now judge that they will refuse treatment at the time it is needed. Enforcing Ulysses contracts in these circumstances would require medical professionals to override the express refusal of the patient at the time treatment is (...) required, something that is generally problematic both ethically and legally. In this paper I will argue that despite appearances Ulysses contracts can make it the case that treating a patient in such circumstances is an instance of treating him with his consent, although safeguards are needed to ensure that this is the case. Given the potential benefits to patients I further argue that modified Ulysses contracts should be made legally enforceable. (shrink)

People often have a strong intuitive sense that we ought to rescue those in serious need, even in cases where we could produce better outcomes by acting in other ways. It has become common in such cases to refer to this as the Rule of Rescue. Within the medical field this rule has predominantly been discussed in relation to decisions about whether to fund particular treatments. Whilst in this setting the arguments in favour of the Rule of Rescue have generally (...) been found to be unconvincing, there are some reasons for thinking that it may have more of a role to play at the clinical level. In this article we examine three lines that such reasoning might take. In each case we argue that the reasons given do not support the adoption of a Rule of Rescue in clinical practice. (shrink)

Within medical ethics it is widely agreed both that it would be morally wrong to give a competent patient medical treatment without his consent, and that for his agreement to treatment to constitute valid consent it needs to meet certain criteria. In illustrating why these requirements are needed it is common to use treatments that involve a healthcare professional doing something to the patient's body—for example, performing surgery, giving an injection, or taking a blood sample or swab (see, for example, (...) Manson 2007, 299;... (shrink)

It is relatively uncontroversial that some public health policies are paternalistic. Furthermore, that they are paternalistic is often taken to show that they are morally wrong. In this article I challenge this position. The article starts by arguing that given standard definitions of paternalism it is unclear why such policies count as paternalistic. Whilst it might appear that they impose restrictions on what individuals can, or cannot, do for their own good, this is not the case. The reason for this (...) is that whilst public health policies focus on achieving benefits at a population or group level, the imposition is made at the level of the individual. If we are to retain the idea that such policies are paternalistic we must characterize them in such a way that both the benefit and imposition are at the same level: either that of the individual or that of the group. I argue that in many cases moving to the group level is the only plausible option. However, if we move to the group level, the features that make a policy paternalistic will not, unlike in those cases where paternalism is targeted at an individual, make the policy morally wrong. (shrink)

Psychological altruism (being motivated by the needs of others) has a tendency to produce behaviour that is costly in evolutionary terms. How, then, could the capacity for psychological altruism evolve? One suggestion is that it is the result of sexual selection. There are, however, two problems that face such an account: first, it is not clear that the resulting behaviour would be altruistic in the relevant sense, and second, it does not seem to fit with key features of our actual (...) helping behaviour. I will argue that both of these problems can be avoided if we adopt a modular account of desire formation. (shrink)

Healthcare ethics has to date had very little to say about the treatment of chronic illness. That is problematic. Chronic illness differs from other illnesses in that: 1. in most cases it cannot be cured; 2. patients can live with it for many years; and 3. its day to day management is typically carried out, not by healthcare professionals, but by the patient and/or members of their family. These features problematise key distinctions that underlie much existing work in healthcare ethics (...) — including those between beneficence and autonomy, between treatment and prevention, and between the recipient and provider of treatment. They also raise ethical questions that have not to date been addressed in any detail — including what healthcare professionals should do when patients are managing their illness poorly, or when changes occur that affect their patients. For these reasons chronic illness provides a lens through which to challenge the adequacy of existing approaches to healthcare ethics, exposing the gaps and false assumptions built into them. In doing so it also provides the materials to build a more philosophically adequate account of healthcare professionals’ moral obligations than exists to date. Providing such an account is the aim of this monograph. (shrink)

Researchers working on drug addiction may, for a variety of reasons, want to carry out research which involves giving addicts their drug of choice. In carrying out this research consent needs to be obtained from those addicts recruited to participate in it. Concerns have been raised about whether or not such addicts are able to give this consent. Despite their differences, however, both sides in this debate appear to be agreed that the way to resolve this issue is to determine (...) whether or not addicts have irresistible cravings for drugs – if they do, then they cannot consent to this type of research; if they do not, then they can. This I will argue is a mistake. Determining whether or not addicts can say 'No' to offers of drugs will not help us to make much progress here. Instead we need to look at the various ways in which different types of research may undermine an addict's competence to give consent. What we will find is that the details of the research make a big difference here and that, as such, we need to steer a course between, on the one hand, painting all addicts as being unable to consent to research which involves providing them with drugs, and, on the other, maintaining that there are no problems in obtaining consent from addicts to take part in such research. (shrink)

We are living through a demographic transition from a world in which there were lots of young people and very few older adults to one in which the numbers in these age groups are becoming more evenly balanced. One reason for this is that more of us are living into our seventies, eighties, nineties, and beyond. That is the good news. Unfortunately, the chance of developing chronic illnesses (including diabetes, arthritis, and dementia) is typically higher for people in these older (...) age groups than for those who are younger. Because we do not know how to cure these illnesses, many of us will spend at least some of this extra time with one or more chronic illness. While we are more likely than in the past to live into older age, we are likely to be living with illness when we get there. That raises a challenge: how should we respond to this change? (shrink)

Worldwide populations are aging with economic development as a result of public health initiatives and advances in therapeutic discoveries. Since 1850, life expectancy has advanced by 1 year for every four. Accompanying this change is the rapid development of anti‐aging science. There are three schools of thought in the field of aging science. One perspective is the life course approach, which considers that aging is a good and natural process to be embraced as a necessary and positive aspect of life, (...) where the aim is to improve the quality of existing lifespan and “compress” morbidity. Another view is that aging is undesirable, and that rejuvenation and indeed immortality are possible since the biological basis of aging is understood, and therefore, strategies are possible for engineering negligible senescence. Finally, a hybrid approach is that life span can be extended by anti‐aging medicines but with uncertain effects on health. While these advances offer much promise, the ethical perspectives are seldom discussed in cross‐disciplinary settings. This article discusses some of the key ethical issues arising from recent advances in biogerontology. (shrink)

Lycambes, the most famous of Archilochus' whipping boys, is everywhere upstaged in the surviving iambic texts and testimonia. This paper seeks to reconstruct something of Lycambes' voice and its role in the Archilochean tradition. I begin with a reconsideration of Archilochus' “first epode” and argue that Lycambes is styled as an older public rival to Archilochus who questions the role of the poet's iambos. The preliminary results of this section are then strengthened by drawing upon two relevant episodes in the (...) later ancient reception of Archilochean poetics: the sniping between Aristophanes and his older rival Cratinus and the Mnesiepes Inscription's tale of the uproar surrounding Archilochus' first performance. Lycambes emerges from this study as a character constructed to question the value and status of the iambist within the social space of contemporary Paros. As such, his criticisms afford Archilochus the opportunity to trumpet his claim to the very cultural capital that Lycambes strives to deny him. More than just a private enemy, Lycambes raises aesthetic and ethical debates that can still be heard throughout the iambographic tradition. (shrink)

Plato Tom Angier -- Aristotle Timothy Chappell -- Stoics Jacob Klein -- Aquinas Vivian Boland O.P -- Hume Peter Millican -- Kant Ralph Walker -- Hegel Kenneth Westphal -- Marx Sean Sayers -- Mill Krister Bykvist -- Nietzsche Ken Gemes and Christoph Schuringa -- Macintyre David Solomon.

We dedicate this book to John Thibaut. He was mentor and personal friend to one of us, and his work had a profound intellectual influence on both of us. We were both strongly influenced by Thibaut's insightful articulation of the importance to psychology of the concept of pro cedural justice and by his empirical work with Laurens Walker in reactions to legal institu demonstrating the role of procedural justice tions. The great importance we accord the Thibaut and Walker (...) work is evident throughout this volume. If anyone person can be said to have created an entire field of inquiry, John Thibaut created the psychological study of procedural justice. (To honor Thibaut thus in no sense reduces our recognition of the contributions of his co-worker, Laurens Walker, in the creation of the field. We are as certain that Walker would endorse our statement as we are that Thibaut, with characteristic modesty, would demur from it. ) Even to praise Thibaut in this fashion falls short of recognizing all of his contributions to procedural justice. Not only did he initiate the psy chological study of the topic, he also built much of the intellectual foun dation upon which the study of procedural justice rests. Thibaut's work with Harold Kelley (1959; Kelley & Thibaut, 1978) created a social psy chological theory of interdependence that, among many other applica tions, serves as the basis for one of the major models of the psychology of procedural justice. (shrink)

An introduction to Gila Walker’s translation of Michel Mourlet’s “On a Misunderstood Art (1959).”.

In this new study the authors examine a range of theories about the state of nature in seventeenth- and eighteenth-century England, considering the contribution they made to the period's discourse on sovereignty and their impact on literary activity. Texts examined include Leviathan, Oceana, Paradise Lost, Discourses Concerning Government, Two Treatises on Government, Don Sebastian, Oronooko, The New Atalantis, Robinson Crusoe, Dissertation upon Parties, David Simple, and Tom Jones. The state of nature is identified as an important organizing principle for narratives (...) in the century running from the Civil War through to the second Jacobite Rebellion, and as a way of situating the author within either a reactionary or a radical political tradition. The Discourse of Sovereignty provides an exciting new perspective on the intellectual history of this fascinating period. (shrink)

This book review essay discusses Principles of Animal Research Ethics (2020), by Tom L. Beauchamp and David DeGrazia.

Over the course of its first seven editions, Principles of Biomedical Ethics has proved to be, globally, the most widely used, authored work in biomedical ethics. It is unique in being a book in bioethics used in numerous disciplines for purposes of instruction in bioethics. Its framework of moral principles is authoritative for many professional associations and biomedical institutions-for instruction in both clinical ethics and research ethics. It has been widely used in several disciplines for purposes of teaching in the (...) classroom, during conferences, etc. (shrink)

More than twenty years after its original publication, The Case for Animal Rights is an acknowledged classic of moral philosophy, and its author is recognized as the intellectual leader of the animal rights movement. In a new and fully considered preface, Regan responds to his critics and defends the book's revolutionary position.

In this paper, we develop an analysis of the structure and content of loneliness. We argue that this is an emotion of absence-an affective state in which certain social goods are regarded as out of reach for the subject of experience. By surveying the range of social goods that appear to be missing from the lonely person's perspective, we see what it is that can make this emotional condition so subjectively awful for those who undergo it, including the profound sense (...) of being unable to realise oneself, in collaboration with others. (shrink)

This accessible overview of classical and modern moral theory with short readings provides comprehensive coverage of ethics and unique coverage of rights, justice, liberty and law. Real-life cases introduce each chapter. While the book's content is theoretical rather than applied ethics, Beauchamp consistently applies the theories to practical moral problems. Aristotle, Hume, Kant, and Mill are at the book;s core and they are placed in the context of moral philosophical controversies of the last 30 years. In this edition one-third of (...) the reading selections are new and all the selections in chapter 8 on rights are new. Chapter 7 on Hume has been heavily reshaped. Chapter 1 has been reduced to get students past introductory material and into the philosophers. (shrink)

Fifteen original essays open up a novel area of inquiry: the distinctively ethical dimensions of women's experiences of and in aging. Contributors distinguished in the fields of feminist ethics and the ethics of aging explore assumptions, experiences, practices, and public policies that affect women's well-being and dignity in later life. The book brings to the study of women's aging a reflective dimension missing from the empirical work that has predominated to date. Ethical studies of aging have so far failed to (...) emphasize gender. And feminist ethics has neglected older women, even when emphasizing other dimensions of 'difference.' Finally work on aging in all fields has focused on the elderly, while this volume sees aging as an extended process of negotiating personal and social change. (shrink)

"The well-known moral and political doctrines of Leviathan have tended to overshadow Hobbes's speculations in other fields. In this book doctrines familiar from the treatises on 'Policy', as well as less familiar empirical and metaphysical theories, are given balanced consideration against the background of his philosophy of science."--Bookjacket.

Externalist theories hold that a comprehensive understanding of mental disorder cannot be achieved unless we attend to factors that lie outside of the head: neural explanations alone will not fully capture the complex dependencies that exist between an individual’s psychiatric condition and her social, cultural, and material environment. Here, we firstly offer a taxonomy of ways in which the externalist viewpoint can be understood, and unpack its commitments concerning the nature and physical realization of mental disorder. Secondly, we apply a (...) strongly externalist approach to the case of Autistic Spectrum Disorder, and argue that this condition can be illuminated by appeal to the hypothesis of extended cognition. We conclude by briefly considering the significance this strongly externalist approach may have for psychiatric practice and pedagogy. (shrink)

From Platonism to phenomenology -- Kant's epistemological shift to phenomenology -- Hegel's phenomenology as epistemology -- Husserl's phenomenological epistemology -- Heidegger's phenomenological ontology -- Kant, Merleau-Ponty's descriptive phenomenology, and the primacy of perception -- On overcoming the epistemological problem through phenomenology.

The criticism that voluntary codes of conduct are ineffective can be met by giving greater centrality to human rights in such codes. Provided the human rights obligations of multinational corporations are interpreted as moral obligations specifically tailored to the situation of multinational corporations, this could serve to bring powerful moral force to bear on MNCs and could provide a legitimating basis for NGO monitoring and persuasion. Approached in this way the human rights obligations of MNCs can be taken to include (...) support for political as well as economic rights. This will go some way towards filling the regulatory gap created by the difficulty of controlling the activities of corporations operating globally. However, such a proposal will require a measure of ‘meta-regulation’ whereby the operations of MNCs are legally required to be sufficiently transparent to create the conditions for effective external moral scrutiny. (shrink)

In Working Virtue: Virtue Ethics and Contemporary Moral Problems, leading figures in the fields of virtue ethics and ethics come together to present the first ...

_Philosophy and the Maternal Body_ gives a new voice to the mother and the maternal body which have often been viewed as silent within philosophy. Michelle Boulous Walker clearly shows how some male theorists have appropriated maternity, and suggests new ways of articulating the maternal body and women's experience of pregnancy and motherhood.

The paper examines a single, apparently simple argument for the existence of incompatibilities between the virtues as traits of character. This argument appeals not to empirical truths about human psychology or human nature but to the possibility of conflict between the exercise of different virtues in action. There are, for example, situations in which we can exercise the virtue of truthfulness only at the expense of not exercising the virtue of tact, as when we are asked a question to which (...) the straightforward answer will pain our questioner. The person who in these situations would give a straightforward answer possesses the virtue of truthfulness to a higher degree than the person who would respond more evasively, whereas the latter person possesses the virtue of tact to a higher degree than the former. But since the two responses are mutually exclusive, it follows that the degree to which we possess the virtue of truthfulness must, at least in some measure, correlate inversely with the degree to which we possess the virtue of tact. And similarly for many other pairs of virtues. My paper focusses on the two cardinal assumptions of this argument, viz., (i) that sometimes the exercise of one virtue can conflict with the exercise of another, and (ii) that the degree to which a person possesses a virtue correlates directly with the extent of its exercise, and defends both assumptions against a variety of objections which allege that, in different ways, they are insensitive to the complexity of the virtues. (shrink)

This is a reprinted excerpt from Sorell and Hendry, Business Ethics (Butterworth Heinemann, 1994).

In Plato’s Symposium, the mysterious Apollodorus recounts to an unnamed comrade, and to us, Aristodemus’ story of just what happened at Agathon’s drinking party. Since Apollodorus did not attend the party, however, it is unclear what relevance he could have to our understanding of Socrates’ speech, or to the Alcibiadean “satyr and silenic drama” (222d) that follows. The strangeness of Apollodorus is accentuated by his recession into the background after only two Stephanus pages. What difference—if any—does Apollodorus make to the (...) Symposium? Does his inclusion call the dramatic and philosophical unity of the work into question? I argue that despite initial appearances, Plato has important philosophical reasons for including Apollodorus as a character. Far from being an odd appendage to an otherwise complete narrative, the figure of Apollodorus is useful for our understanding of Socrates’s conception of eros later in the work. (shrink)

This chapter is divided into three parts. In the first, I ask whether there is a human right to be spared extreme poverty. The answer is ‘Not necessarily’ if a human right is a legal right, and I argue that ‘human right’ either means a right in international law and associated policy, or else the term has an unacceptably wide sense. In the second section I consider microcredit as a poverty-alleviating mechanism, distinguishing between extreme and relative poverty in developing countries. (...) I argue that credit may not be a good way of alleviating extreme poverty, and that methods of collecting debt used by microcredit providers may have moral drawbacks. In the third section I consider the fit between the class of agents currently involved in offering financial services to the poor, and the class of agents recognized as duty-bearers by human rights law and policy. Unless states become highly involved in microcredit, it is not clear that microfinance providers are or can be human rights duty bearers. (shrink)

For forty years, successive editions of Ethical Theory and Business have helped to define the field of business ethics. The 10th edition reflects the current, multidisciplinary nature of the field by explicitly embracing a variety of perspectives on business ethics, including philosophy, management, and legal studies. Chapters integrate theoretical readings, case studies, and summaries of key legal cases to guide students to a rich understanding of business ethics, corporate responsibility, and sustainability. The 10th edition has been entirely updated, ensuring that (...) students are exposed to key ethical questions in the current business environment. New chapters cover the ethics of IT, ethical markets, and ethical management and leadership. Coverage includes climate change, sustainability, international business ethics, sexual harassment, diversity, and LGBTQ discrimination. New case studies draw students directly into recent business ethics controversies, such as sexual harassment at Fox News, consumer fraud at Wells Fargo, and business practices at Uber. (shrink)