This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

But as Harvard ethicist Arthur J. Dyck shows in this powerful work, there are solid moral and practical bases for the existing laws against assisted suicide in ...

Examines ethics as a discipline from which knowledge may be derived, which offers guidance for practical understanding and moral decision making, and which underlies methods of effecting such moral decisions.

Contemporary moral philosophy tends to equate what is moral with what is obligatory. Hence, there is a tendency to exclude all virtues from what is moral because they are dispositions other than the one morally good disposition to fulfill obligations out of a sense of obligation. This has the effect of excluding much of what we admire about persons from moral philosophy and from the moral life. This essay argues that there are at least two virtues, both forms of love, (...) moral perceptivity and moral tenacity, which are moral and obligatory. The author explores some of the relationships of these two moral virtues to the traditional theological virtues of faith, hope, and love, and to heroism and saintliness. (shrink)

In Joseph Butler, we have an account of human beings as moral beings that is, as this essay demonstrates, being supported by the recently emerging findings of the neurosciences. This applies particularly to Butler's portrayal of our empathic emotions. Butler discovered their moral significance for motivating and guiding moral decisions and actions before the neurosciences did. Butler has, in essence, added a sixth sense to our five senses: this is the moral sense by means of which we perceive what we (...) ought or ought not do. The moral sense yields relatively reliable moral perceptions when we love our neighbors as ourselves, and when our love for ourselves is genuine. Accurate moral perceptions will be thwarted by self-deceit—that is, by a self-partiality devoid of neighbor love, a condition that thwarts genuine self-love. This essay explores the parallels between Butler's understanding of self-deceit and Robert J. Lifton's understanding of "doubling.". (shrink)

This book focuses on justice and its demands in the way of providing people with medical care. Building on recent insights on the nature of moral perceptions and motivations from the neurosciences, it makes a case for the traditional medical ethic and examines its financial feasibility. The book starts out by giving an account of the concept of justice and tracing it back to the practices and tenets of Hippocrates and his followers, while taking into account findings from the neurosciences. (...) Next, it considers whether the claim that it is just to limit medical care for everyone to some basic minimum is justifiable. The book then addresses finances and expenditures of the US health care system and shows that the growth of expenditures and the percentage of the gross national product spent on health care make for an unsustainable trajectory. In light of the question what should be changed, the book suggests that overdiagnosis and medicalizing normal behavior lead to harmful, costly and unnecessary interventions and are the result of unethical behavior on the part of the pharmaceutical industry and extensive ethical failures of the FDA. The book ends with suggestions about what can be done to put the U.S. health care system on the path to sustainability, better medical care, and compliance with the demands of justice. (shrink)

Part I of this essay described "Ought" and "Value" as forms of moral requiredness. Now in Part II, a description of the ideal conditions for veridical perceptions of moral requiredness are specified. This is done in the form of an ideal observer type of analysis. This analysis is defended against those who oppose naturalism by assuming a bifurcation between 'ought' and 'is' and those who accuse naturalism of a "naturalistic fallacy." It is argued that theistic versions of the ideal observer (...) form of analysis exist in the Christian tradition in logically acceptable and plausible formulations. Specific illustrations are provided. (shrink)

This is the first of two essays concerned to specify in what sense "ought" and "value" are genuine characteristics of reality serving as data that help us empirically verify the truth and falsity of our moral judgments. This, the first, essay discusses the significance of the ought/is question for moral philosophy and theological ethics, giving reasons for the inadequacy of current views on the relation between "ought" and "is." Building on the perceptual theories of Gestalt psychologists yields a phenomenological description (...) of the nature of "ought" and "value" as unique experiences of gap-induced demands or requiredness. These moral experiences of requiredness are delineated in such a way that they are distinguishable from aesthetic, logical, and causal forms of requiredness. (shrink)

Just below the surface of public life in the United States, a biblically based theory of rights vies with a theory that first appeared in the work of Bentham and Mill, and the latter is gaining increasing dominance. The resolution of this conflict has implications for a host of legal matters and public policy decisions, including life and death issues like physician-assisted suicide. Though the ascendancy of the Millian tradition reflects widespread skepticism concerning the possibility of developing a basis for (...) a common morality or defending a conception of natural inalienable rights, the author argues that a plausible account of common human morality can be developed from attention to the relationships that are requisite for sustaining the communities that are the condition of moral agency. (shrink)

Medical professionals are a community of highly educated individuals with a commitment to a core set of ideals and principles. This community provides both technical and ethical socialization. The ideal physician is confident, empathic, forthright, respectful, and thorough. These ideals allow us to define broadly "the excellence" of being a physician. At the core of these ideals is the ability to be empathic. Empathy exhibits itself in attributes of an individual's moral character and also in actions that actualize and support (...) communal life. Empathy, however, can be diminished or even lost and must be nurtured on an ongoing basis. The development of ethical physicians is strongly linked to experiences in the training period. Moral traits are situation-sensitive psychological and behavioral dispositions. The clinical environment of medical training programs can be so intense as to lead to conditions that may actually deprofessionalize trainees. Creating a clinical environment that is ethically nurturing and sustaining is an indispensable component of practicing medicine. (shrink)

During the past four decades, the Netherlands played a leading role in the debate about euthanasia and assisted suicide. Despite the claim that other countries would soon follow the Dutch legalization of euthanasia, only Belgium and the American state of Oregon did. In many countries, intense discussions took place. This article discusses some major contributions to the discussion about euthanasia and assisted suicide as written by Nigel Biggar, Arthur J. Dyck, Neil M. Gorsuch, and John Keown. They share (...) a concern that legalization will undermine a society's respect for the inviolability and sanctity of life. Moreover, the Report of the House of Lords Select Committee on the Assisted Dying for the Terminally Ill Bill is analyzed. All studies use ethical, theological, philosophical, and legal sources. All these documents include references to experiences from the Netherlands. In addition, two recent Dutch documents are analyzed which advocate further liberalization of the Dutch euthanasia practice, so as to include infants and elderly people "suffering from life". (shrink)

There is a growing consensus in Britain on the importance of character, and on the belief that the virtues that contribute to good character are part of the solution to many of the challenges facing modern society. Parents, teachers and schools understand the need to teach basic moral virtues to pupils, such as honesty, self-control, fairness, and respect, while fostering behaviour associated with such virtues today. However, until recently, the materials required to help deliver this ambition have been missing in (...) Britain. The Knightly Virtues Programme, devised by the Jubilee Centre for Character and Virtues, aims to help solve this challenge. The programme, designed for 9 to 11 year olds, draws on selected classic stories to help teach moral character in schools. This approach has proved to be popular with children and teachers, with more than 5,000 pupils from one hundred schools having participated in the programme so far. Fifty-five of these schools and 3,272 pupils were directly involved in different stages of the research. Based at the University of Birmingham, the Jubilee Centre houses leading academics dedicated to researching the various ways in which good character, which underpins the building blocks of society, can be developed. Recent research from the Centre has shown that the qualities that make up character can be learnt and taught, and suggests that we need a new emphasis on their importance in schools and in professional education. This report from the Centre into the use of classic literature within schools sets out the ways in which the Knightly Virtues Programme is able to develop the virtue literacy of school pupils, and the extent to which an understanding and awareness of good moral character can make positive changes to behaviour. The impact of the programme has been tested using several rigorous research methods, detailed in this report alongside their findings, which provide substantial empirical evidence for the effectiveness of using stories to develop virtue literacy. (shrink)

Institutions receiving federal funding for research from the U.S.Public Health Service need to have policies and procedures to both prevent research misconduct and to adjudicate it when it occurs. The person who is designated to handle research misconduct is typically referred to as the research integrity officer (RIO). In this interview study we report on 79 RIOs who describe how they would handle allegations of research misconduct. Their responses were compared to two expert RIOs. The responses to the allegations in (...) the scenarios demonstrated that RIOs are not uniformly well prepared to handle activities associated with reported allegations of research misconduct. We recommend greater preparation through directed training, use of check lists of possible behaviors necessary to consider when situations arise, being involved in a network of RIOs so one can discuss options, and the possible need to certify RIOs. (shrink)

This paper is a response to William Hasker’s “bring about” argument (1999, reiterated in 2011) against the Molinist theory of divine providence. Hasker’s argument rests on his claim that God’s middle knowledge must be regarded as part of the world’s past history; the primary Molinist response has been to resist this claim. This paper argues that even if this claim about middle knowledge is granted, the intended reductio does not go through. In particular, Hasker’s claim about middle knowledge is shown (...) to undermine his proof of the “power entailment principle.” The paper closes with a critical examination of ideas about free will and the past history of the world that might be supposed to support Hasker’s conviction that Molinism is incompatible with a libertarian view of free will. (shrink)

The aim of the My Character project was to develop a better understanding of how interventions designed to develop character might enhance moral formation and futuremindedness in young people. Futuremindedness can be defined as an individual’s capacity to set goals and make plans to achieve them. Establishing goals requires considerable moral reflection, and the achievement of worthwhile aims requires character traits such as courage and the capacity to delay gratification. The research team developed two new educational interventions – a website (...) and a hard-copy journal – with the specific aim of developing future-mindedness. After development, the website and journal were piloted over a one-year period by over 1,000 11–14 year olds in six schools across England. Various research methods, including group interviews and case studies, were implemented to assess impact. In addition, a pilot RCT was conducted to assess the feasibility of using experimental methods to measure character. The main findings from the research are that: - Students benefit from opportunities in school to think about future-mindedness; this can be successfully taught through character education. - Harnessing new technology, such as the Internet, offers exciting opportunities for character education. - It is beneficial to investigate the impact of new character education resources in order to bring greater clarity about ‘what works’. The most useful approach is a mixed methods one that allows for triangulation of evidence. - It is possible to run RCTs and other experimental research in schools to assess developmental projects of this kind, but applying the method in schools and creating suitable outcome measures present challenges for researchers. - A positive indicator of the success is that five out of the six pilot schools have embedded My Character into their curriculum. In addition, many new schools, both in Britain and internationally, have started to use the website and / or journal. This report describes the research, analyses the impact of My Character and concludes with recommendations for policy makers, practitioners and researchers embarking on similar projects. These recommendations include: i) advocating that schools create space in the curriculum to teach future-mindedness through character education; ii) enhancing traditional character education teaching methods with opportunities brought by Internet technologies; iii) evaluating character education interventions using triangulated evidence drawn from a mixture of research methods. (shrink)

The death story of Jesus of Nazareth has traditionally been understood as a matter of historical fact. The various versions of the story would seem to confirm a documented death scene. Nevertheless, critical appraisals of this material have raised numerous questions regarding the passion story. This article considers how the very structure of the story is a vital clue to the way in which the death of Jesus was invented. The Jewish tale of the suffering and vindication of the innocent (...) one provides the memory locus for discovering meaning in the fate of Jesus. We find that the basic fact of the death tale of Jesus is that it was a fiction, authorising further elaborations for those who understood the craft of memory. (shrink)

In several of the 100?plus drawings that Haarlem artist Maerten van Heemskerck made while he was in Rome in the 1530s, he depicts the sculpture collections he visited in the Vatican, on the Capitoline and in the cortili and gardens of numerous Roman palaces. This is some of the earliest Northern ?collection imagery?, and the collection environment commands as much of his pictorial attention as the sculptures themselves. The central argument of the essay is that van Heemskerck?s novel images related (...) to period conceptions of the uses and functions of memory, and suggests that his drawings had an important afterlife in the Flemish pictures of collections genre of the early seventeenth century. (shrink)

How one thinks about the relationship between individual autonomy (sometimes referred to as individual willpower or human agency) and technology can influence the way legal thinkers develop policy at the intersection of law and technology. Perspectives that fall toward the `machines control us' end of the spectrum may support more interventionist legal policies while those who identify more closely with the `we are in charge of machines' position may refuse to interfere with technological developments. The concept of soft determinism charts (...) a middle-ground between these two positions and could assist in the formulation of a general theory of the relationship between law and technology. Soft determinism maintains that technological developments are embedded in social, political, economic and other processes, and serve to guide and, potentially, configure future actions and relationships with these technologies, their users, and their subjects: while past technology develops shape the present, individuals and groups can still exert control over these technological developments. (shrink)