Is it rational to be moral? How do rationality and morality fit together with being human? These questions are at the heart of David Schmidtz's exploration of the connections between rationality and morality. This inquiry leads into both metaethics and rational choice theory, as Schmidtz develops conceptions of what it is to be moral and what it is to be rational. He defends a fairly expansive conception of rational choice, considering how ends as well as means can be rationally chosen (...) and explaining the role of self-imposed constraints in a rational life plan. His moral theory is dualistic, ranging over social structure as well as personal conduct and building both individual and collective rationality into its rules of recognition for morals. To the "why be moral" question, Schmidtz responds that being moral is rational, but he does not assume we have reasons to be rational. Instead, Schmidtz argues that being moral is rational in a particular way and that beings like us in situations like ours have reasons to be rational in just that way. This approach allows him to identify decisive reasons to be moral; at the same time, it explains why immorality is as prevalent as it is. This book thus offers a set of interesting and realistic conclusions about how morality fits into the lives of humanly rational agents operating in an institutional context like our own. (shrink)

In this paper I review recent philosophical work in English on the nature of emotion. I begin with the well-known attacks of Bedford, Kenny and Pitcher on what I call the traditional (i.e., Cartesian) view of the nature of emotion. I then trace and discuss the successive alternative views that have been developed in the past thirty years. My aim is both to review the development of these alternative views and to indicate what particular problems have come to be considered (...) the central problems in this area. A comprehensive bibliography of recent work in English is appended. (shrink)

This article sets out the key findings from the seminar series ‘Transplantation and organ deficit in the UK: Pragmatic solutions to ethical controversy’ which ran from November 2006 to March 2008, and was sponsored by the Economic and Social Research Council. A broad range of issues were examined in the seminars, including religious and cultural attitudes affecting organ donation, the role of health-care professionals and what could be learned from the experiences of other countries, particularly in the European context. Core (...) participants in the series came from a range of academic and practitioner backgrounds and had different ethical perspectives on issues affecting organ donation and transplantation. Notwithstanding such diversity, the findings set out in the article reflect the fact that core participants were focused on developing a principled, yet pragmatic approach to dealing with the urgent problem of organ shortage in the UK. (shrink)

It is extraordinary, when one thinks about it, how little attention has been paid by theorists of the nature and justification of punishment to the idea that punishment is essentially a matter of self-defense. H. L. A. Hart, for example, in his famous “Prolegomenon to the Principles of Punishment,” is clearly committed to the view that, at bottom, there are just three directions in which a plausible theory of punishment can go: we can try to justify punishment on purely consequentialist (...) grounds, which for Hart, I think, would be to try to construct a purely utilitarian justification of punishment; we can try to justify punishment on purely retributive grounds; or we can try to justify punishment on grounds that are some sort of shrewd combination of consequentialist and retributive considerations. Entirely absent from Hart's discussion is any consideration of the possibility that punishment might be neither a matter of maximizing the good, nor of exacting retribution for a wrongful act, nor of some imaginative combination of these things, but, rather, of something altogether different from either of them: namely, the exercise of a fundamental right of self-protection. Similarly, but much more recently, R. A. Duff, despite the fact that he himself introduces and defends an extremely interesting fourth possibility, begins his discussion by writing as though, apart from his contribution, there are available to us essentially just the options previously sketched by Hart. Again, there is no mention here, any more than in Hart's or any number of other recent discussions, of the possibility that we might be able to justify the institution of punishment on grounds that are indeed forward-looking, to use Hart's famous term, but that are not at all consequentialist in any ordinary sense of the word. (shrink)

Much has changed in maternal-fetal medicine since the early 2000s, when the previous ethical frameworks for fetal therapy trials were established. We applaud Hendriks and colleagues for taking on t...

Primordial emotions are the subjective element of the instincts which are the genetically programmed behaviour patterns which contrive homeostasis. They include thirst, hunger for air, hunger for food, pain and hunger for specific minerals etc.There are two constituents of a primordial emotion—the specific sensation which when severe may be imperious, and the compelling intention for gratification by a consummatory act. They may dominate the stream of consciousness, and can have plenipotentiary power over behaviour.It is hypothesized that early in animal evolution (...) complex reflex mechanisms in the basal brain subserving homeostatic responses, in concert with elements of the reticular activating system subserving arousal, melded functionally with regions embodied in the progressive rostral development of the telencephalon. This included the emergent limbic and paralimbic areas, and the insula. This phylogenetically ancient organization subserved the origin of consciousness as the primordial emotion, which signalled that the organisms existence was immediately threatened. Neuroimaging confirms major activations in regions of the basal brain during primordial emotions in humans. The behaviour of decorticate humans and animals is discussed in relation to the possible existence of primitive awareness.Neuroimaging of the primordial emotions reveals that rapid gratification of intention by a consummatory act such as ingestion causes precipitate decline of both the initiating sensation and the intention. There is contemporaneous rapid disappearance of particular regions of brain activation which suggests they may be part of the jointly sufficient and severally necessary activations and deactivations which correlate with consciousness [Crick, F. & Koch, C. . A framework for consciousness. NatureNeuroscience,6, 119–126]. (shrink)

Imagine someone who deliberately provokes someone else into attacking him so that he can harm that person in defending himself against her attack and then claim “self-defense” when brought to court to defend himself for what he has done to her. Should he be allowed to use this defense, even though it’s clear that he has deliberately manipulated his attacker into attacking him precisely in order to be able to harm her with impunity (assuming he were allowed to use the (...) defense and thus escape legal penalties)? This question is the focal point in the paper that follows. I argue first that the case described above is indeed an instance of an “actio libera in causa,” albeit arguably one at the margins of this controversial class of cases. Then, using a view about the justification of self-defense that I have defended elsewhere, I show why I believe that, while the manipulator should not be deprived of the legal right to defend his self-defensive actions in such cases by claiming they were a legitimate matter of self-defense, there is good reason to enact laws that will allow him to be prosecuted, independently of his “self-defense” defense, for manipulating his attacker as he did, thus allowing him to harm her in self-defense and then defend his actions as purely a matter of “self-defense.”. (shrink)

Much of the discourse in the bioethics literature on what is often called “cesarean delivery on maternal request” has focused on balancing respect for patient autonomy with attention to the short- and long-term risks of this procedure to maternal and neonatal well-being. And while there has been some analysis of the social and economic costs inherent in performing cesareans, much of the clinical and ethical analysis has concluded that, given the degree of risk to the mother and neonate from a (...) primary or single repeat cesarean delivery, there is sufficient justification for pregnant women to request and obtain this procedure from obstetricians willing to meet such requests. However, these same analyses often caution that physicians should not offer these elective cesareans to all women, but only to those who initiate the request. This paper analyzes recommendations that do not promote universal access to these procedures and concludes that such a policy is ethically unjustifiable, as it treats women who do not inquire about such procedures differently. Depriving appropriate candidates—for example, healthy women who are good surgical candidates and desire only one or two children—of information about elective cesarean delivery is a form of undue influence on women's decision-making. (shrink)

Advocates for the professionalization of clinical bioethics argue that bioethics professionals play an important role in contemporary medicine and patient care, especially when addressing complex ethical questions that arise in the delivery of reproductive medicine. For bioethics consultants to serve effectively, they need adequate training in the medical and ethical issues that patients and clinicians will face, and they need skills to facilitate effective dialog among all parties. Because clinical ethics consultation is a “high‐stakes endeavor” that can acutely affect patient (...) care, efforts are under way to ensure that bioethics consultants have the competence to provide such guidance. Yet to date, no studies have examined whether the training of bioethics consultants meets the needs of health care professionals who are on the front lines of such issues. In fact, limited information is available on the reproductive health issues that bioethics training programs address or the degree to which these programs meet the needs of patients confronting reproductive health decisions and their clinicians. It is therefore important to answer this key question: What are the primary ethical issues encountered in reproductive medicine that currently affect patient care? Equally important, are bioethics training programs prepared to address those issues?To begin to answer these questions, we conducted parallel surveys of directors of graduate bioethics training programs and obstetrician‐gynecologists. The goal of this project is to lay the groundwork to establish a working partnership between bioethics educators and reproductive medicine practitioners to address the often troubling and frequently complex ethical issues in reproductive medicine. (shrink)

Decisions related to births in the “gray zone” of periviability are particularly challenging. Despite published management guidelines, clinicians and families struggle to negotiate care management plans. Stakeholders must reconcile conflicting values in the context of evolving circumstances with a high degree of uncertainty within a short time period. Even skilled clinicians may struggle to guide the patient in making value–laden decisions without imposing their own values. Exploring the experiences of one pregnant woman and her caregivers, this case study highlights how (...) bias may undermine caregivers’ ability to meet their obligation to enhance patient autonomy and the moral distress they may experience when a patient’s values do not align with their own. Management strategies to mitigate the potential impact of bias and related moral distress are identified. The authors then describe one management strategy used in this case, facilitated ethics consultation, which is focused on thoughtful consideration of the patient’s perspective. (shrink)

_Contexts of Justice,_ highly acclaimed when it was published in Germany, provides a significant new intervention into the important debate between communitarianism and liberalism. Rainer Forst argues for a theory of "contexts of justice" that leads beyond the narrow confines of this debate as it has been understood until now and posits the possibility of a new conception of social and political justice. This book brings refreshing clarity to a complex topic as it provides a synthesis of traditions and theories (...) that leads to a truly original approach. Forst makes a four-part distinction to decipher the debate between communitarianism and liberalism. These four parts concern the constitution of the self, the neutrality of law, the ethos of democracy, and the opposition between universalism and contextualism. He shows that a comprehensive theory of justice needs to take these different contexts adequately into account. He discusses recent debates about discursive democracy and feminist critiques of liberalism, and addresses such topics as multiculturalism and civil society. (shrink)

This paper reports findings from a study into national associations of accountants from the perspective of the model code of the International Federation of Accountants (IFAC), Code of Ethics for Professional Accountants. Using data collected from a survey document, the paper analyses the extent of the model code’s influence in an international process of harmonisation of ethical rules for accountants. Obstacles to the adoption of the model code are examined, as is the impact that government supervision of codes has had (...) on harmonisation efforts. Particular attention is paid to the relationship between professional independence and close family relationships and culture. Findings are also presented on other issues of code content, and the most appropriate body for interpreting national codes is identified. These items were included as matters of then current concern to the Ethics Committee of IFAC. (shrink)

This paper reports findings from a study into national associations of accountants from the perspective of the model code of the International Federation of Accountants (IFAC), Code of Ethics for Professional Accountants. Using data collected from a survey document, the paper analyses the extent of the model code’s influence in an international process of harmonisation of ethical rules for accountants. Obstacles to the adoption of the model code are examined, as is the impact that government supervision of codes has had (...) on harmonisation efforts. Particular attention is paid to the relationship between professional independence and close family relationships and culture. Findings are also presented on other issues of code content, and the most appropriate body for interpreting national codes is identified. These items were included as matters of then current concern to the Ethics Committee of IFAC. (shrink)

As the patient drew her last breaths, with her daughter at her bedside, and the curtain closed across the room, my resident, whom I will call Emma, talked me through what was happening. She explained that the patient's only hope for survival had been surgery, yet surgery would surely have killed her. Emma talked about the different ways different families approach withdrawing the level of care provided in the intensive care unit, allowing a loved one's death. She talked about how (...) hard it is to leave behind everything that happens in this job when she goes home. An intern arrived to make the declaration of death, and Emma encouraged me to go back into the patient's room for this. I placed my stethoscope on the patient's still chest, confirming what we already knew to be true. Death was palpable in that room, and my response was visceral. I did my best to leave the ICU calmly and then ran down five flights of stairs to the hospital chapel and sobbed. When I returned, Emma could see that I was shaken. “It's human,” she told me. In the afternoon, I felt the deep tiredness that I always feel after really crying. In that haze of emotion, I wasn't sure quite how to respond when Emma's next activity for us was to find a patient who needed an arterial blood gas. (shrink)