The ethical theories employed in health care today assume, in the main, a modern Western philosophical framework. Yet the diversity of cultural and religious assumptions regarding human nature, health and illness, life and death, and the status of the individual suggest that a cross-cultural study of health care ethics is needed. A Cross-Cultural Dialogue on Health Care Ethics provides this study. It shows that ethical questions can be resolved by examining the ethical principles present in each culture, critically assessing each (...) value, and identifying common values found within all traditions, It encourages the development of global awareness and sensitivity to and respect for the diversity of peoples and their values and will advance understanding as well as help to foster a greater balance and a fuller truth in consideration of the human condition and what makes for health and wholeness. (shrink)

Recently, moral deliberation within care institutions is gaining more attention in medical ethics. Ongoing dialogues about ethical issues are considered as a vehicle for quality improvement of health care practices. The rise of ethical conversation methods can be understood against the broader development within medical ethics in which interaction and dialogue are seen as alternatives for both theoretical or individual reflection on ethical questions. In other disciplines, intersubjectivity is also seen as a way to handle practical problems, and methodologies have (...) emerged to deal with dynamic processes of practice improvement. An example is responsive evaluation. In this article we investigate the relationship between moral deliberation and responsive evaluation, describe their common basis in dialogical ethics and pragmatic hermeneutics, and explore the relevance of both for improving the quality of care. The synergy between the approaches is illustrated by a case example in which both play a distinct and complementary role. It concerns the implementation of quality criteria for coercion in Dutch psychiatry. (shrink)

This paper challenges the traditional assumption that descriptive and prescriptive sciences are essentially distinct by presenting a study on the implicit normativity of the production and presentation of biomedical scientific facts within evidence-based medicine. This interdisciplinary study serves as an illustration of the potential worth of the concept of implicit normativity for bioethics in general and for integrated empirical ethics research in particular. It demonstrates how both the production and presentation of scientific information in an evidence-based decision-support contain implicit presuppositions (...) and values, which pre-structure the moral environment of the clinical process of decision-making. As a consequence, the evidence-based decision support did not only support the clinical decision-making process; it also transformed it in a morally significant way. This phenomenon undermines the assumption within much of the literature on patient autonomy that information disclosure is a conditional requirement before patient autonomy even starts; patient autonomy is already influenced during the production and presentation of information. These results imply an increased responsibility of those who produce and present evidence-based facts(i.e. scientists in general and physicians in particular). The insights of this study not only involve a different focus on both theory and practice of patient autonomy and informed consent, but they also call for a broader scope of morality than does traditional empirical research in bioethics. The concept of implicit normativity within integrated empirical ethics research calls for a strong cooperation between bioethicists and descriptive scientists, i.e., a cooperation that goes beyond the discipline-specific epistemic values and that takes place during all phases of the research process. (shrink)

Within this thesis, I argue for an interpretive approach to bioethics in pediatric intensive care. I begin by outlining the dominant bioethical doctrine that defines standards for ethical care in critically ill children. I critique this doctrine as legalistic and acultural. Drawing largely on the ideas of Charles Taylor, I call for a reconception of bioethics and propose an interpretive framework that is centred on culture and context. Finally, I illustrate this interpretive approach through a comparative study of two cases (...) in pediatric intensive care: the narratives of Marc and Larry. (shrink)

Practical ethics can greatly benefit from the work in cognitive science. Cognitive science boasts substantial research and data on how people think, reason, and process information, as well as on the nature of the mind. I argue that cognitive science research and data are invaluable to investigating how people conduct themselves as they plod through practical moral problems. I discuss three reasons why practical ethics should be interested in cognitive science: cognitive science : helps us to better understand how people (...) reason and offers theories about underlying mental processes; offers substantive discussion on normative accounts of reason and rationality; and provides insight into the nature of the human mind which may ground morality qua a human enterprise. (shrink)

The aim of this paper is to offer some philosophical remarks concerning the concept of moral application in applied ethics. In doing so, I argue in favour of a philosophical approach towards applied ethics as a unitary form of moral experience. In fact every form of applied ethics, no matter how specific, moves from a problem of application and tries to fill a gap between moral theory and practice. This essential unity of applied ethics as a moral phenomenon is of (...) great philosophical interest, since it belongs to the core problem from which moral thinking itself originates. For this reason, what applied ethics may reveal to a philosophical inquiry could provide valuable insight into the nature of moral experience itself. This is why it is important to reflect on what applied ethics is and whether the way in which application is usually framed be ts the properties of moral experience or not. In the first section I submit some preliminary remarks concerning the theoretical requirements to any philosophical approach to applied ethics. In the second section I present how application is commonly understood in the applied ethics debate by discussing the deductive and the procedural models of application. Both models, however, draw upon a technological conception of application which fails to t the structure of moral experience. Finally, I brie y sketch out the main features and the future tasks of what seems to me to be the most promising approach to the issue, i.e., the hermeneutic concept of application. (shrink)

MA Thesis. Biomedical ethics does not lend itself to easy categorisation as either a 'theoretical' or a 'practical' enterprise because inquiry into the quandaries of morality requires both situational and 'translocal' perspectives. These types of investigation bring into question the legitimacy of the theory/practice divide that has dominated intellectual thought since antiquity. This division hinders the development of bioethics by fostering internal dispute within the discipline regarding appropriate methodology and the practice of clinical ethics. In this thesis, I argue that (...) much of these disciplinary disjunctions are due to an undue labeling of bioethics as either 'applied ethics' or 'practical ethics', and a failure to recognise the intricate way in which theory and practice inform each other and are integral and interrelated parts of moral deliberation. I argue for an integration of the theory and practice of bioethics. (shrink)

Is restructuring an underhanded way to make the rich richer and the poor poorer? Or is it necessary, although bitter, medicine for an ailing economy? In The Ethics of the New Economy: Restructuring and Beyond, professionals from the fields of philosophy, ethics, management, as well as those representing the groups affected by restructuring, tackle thorny ethical issues. Referring to concrete case studies, these timely essays discuss a variety of topics, including justified and unjustified restructuring; employers’ obligations during the restructuring process; (...) equity issues; the rise of part-time employment; the effects of restructuring on communities; the internal risks faced by restructuring corporations; deprofessionalization in health care; the consequences of restructuring in the developing world; philanthropy and cause-related marketing; corporate “judo” and restructuring; and responsible and irresponsible restructuring. (shrink)