The target article (Sofaer and Eyal 2010) resonates with a long-simmering theme in the ethics of human subjects research, namely, that too much scrutiny and oversight of research impedes the dramat...

When is it morally acceptable to expose others to risk? Most moral philosophers have had very little to say in answer to that question, but here is a moral philosopher who puts it at the centre of his investigations.

The purpose of the research is to explicate the Buddhist principles of ethical analysis of premeditated murder as an immoral act. The author solves this problem through the method of case study of exegetical treatises of outstanding Buddhist thinkers Vasubandhu (4th-5th centuries) and Yašomitra (8th century). It is shown that the ethical analysis of premeditated murder is based on a religious anthropological concept (the Buddhist doctrine of human action producing karmic retribution). Sinful intent is interpreted as (...) an immoral mental urge that generated a verbal intention to take the life of a certain person or a certain animal. According to the canonical point of view, there are three mental roots of immoral acts - greed, hatred, ignorance. The ethnical analysis of sinful intent is aimed at determining the connection of intent with any of these three mental phenomena. In accordance with this principle, Buddhist thinkers have identified three types of premeditated murder. All of them produce a “black” (unfavorable) karmic fruit, i.e. an unfortunate form of rebirth, exacerbating physical suffering. Great attention is paid by the author to the problem of the karmic responsibility of individuals ordering murders and the executors of such orders. In the considered sources, the verbal order to kill and its physical execution are interpreted as equally immoral actions that produce collective karmic responsibility. The author of the research examines in detail a special class of premeditated murder, fraught with inevitable infernal retribution. This class includes murders of benefactors (mother, father, arhat) and Buddhist ascetics practicing asceticism. These malicious sins were interpreted as an insurmountable obstacle to achieving a soteriological goal, even in the distant transcendental future. It is shown that Buddhist exegetes have developed principles for diagnosing these sins and characterized the immoral personal characteristics of sinners (disrespect towards parents, Buddhist preachers and religious ascetics, heretical denial of spiritual values, shamelessness, arrogance, ignorant self-will, misanthropy). (shrink)

There’s no doubt that medical ethics should be ‘grounded’, in the sense that it aims to make a practical, normative contribution to significant ethical issues in medicine. There are a number of ways in which ethics can do that, two of which feature in this issue of the Journal of Medical Ethics. One way is by responding to significant new policy or legal developments that will have an impact on clinical practice. This issue discusses two legal developments that matter (...) to patients and healthcare professionals: the sanctions applied to Dr Bawa-Garba and the Supreme Court’s ruling on the withdrawal of artificial nutrition and hydration. A second way of grounding ethical analysis in the reality and complexity of ethical issues is by using empirical methods. There are two papers in this issue from Canada that illustrate how the subtleties of complex ethical issues can be teased out via qualitative methods. Medical tourism is an important and rapidly developing phenomenon that raises a set of interesting and tricky ethical issues.1 It has been discussed in the Journal of Medical Ethics before and its implications for end of life, dentistry and other health interventions have been explored.2 3 Reproductive tourism occurs in many countries and the complications it can create for issues such as the citizenship of resulting children have been discussed at some length in the JME.4 5 Reproductive tourism is a good example of an area where it is particularly important for ethical analysis to be grounded in the facts and reality of a situation and an empirical approach to ethics is therefore a good option for this topic. In this issue, Couture et …. (shrink)

Health care systems throughout the developed world face ‘crises’ of quality, financing and sustainability. These pressures have led governments to look for more efficient and equitable ways to allocate public resources. Prioritisation of health care services for public funding has been one of the strategies used by decision makers to reconcile growing health care demands with limited resources. Priority setting at the macro level has yet to demonstrate real successes. This paper describes international approaches to explicit prioritisation at the macro-governmental (...) level in the six experiences most published in the English literature; analyzes the ways in which values, principles and other normative concepts were presented in these international priority setting experiences; and identifies key elements of a more robust framework for ethical analysis which could promote meaningful and effective health priority setting. (shrink)

Originally applied on domestic and lab animals, assisted reproduction technologies (ARTs) have also found application in conservation breeding programs, where they can make the genetic management of populations more efficient, and increase the number of individuals per generation. However, their application in wildlife conservation opens up new ethical scenarios that have not yet been fully explored. This study presents a frame for the ethical analysis of the application of ART procedures in conservation based on the Ethical (...) Matrix (EM), and discusses a specific case study—ovum pick-up (OPU) procedures performed in the current conservation efforts for the northern white rhinoceros (Ceratotherium simum cottoni)—providing a template for the assessment of ART procedures in projects involving other endangered species. (shrink)

COVID-19 vaccination of children has begun in various high-income countries with regulatory approval and general public support, but largely without careful ethical consideration. This trend is expected to extend to other COVID-19 vaccines and lower ages as clinical trials progress. This paper provides an ethical analysis of COVID-19 vaccination of healthy children. Specifically, we argue that it is currently unclear whether routine COVID-19 vaccination of healthy children is ethically justified in most contexts, given the minimal direct benefit (...) that COVID-19 vaccination provides to children, the potential for rare risks to outweigh these benefits and undermine vaccine confidence, and substantial evidence that COVID-19 vaccination confers adequate protection to risk groups, such as older adults, without the need to vaccinate healthy children. We conclude that child COVID-19 vaccination in wealthy communities before adults in poor communities worldwide is ethically unacceptable and consider how policy deliberations might evolve in light of future developments. (shrink)

Health care institutions have paid increasing attention to preventing nosocomial transmission of influenza through vaccination of health care personnel. While multifaceted voluntary interventions have increased vaccination rates, proponents of mandatory programs contend the rates remain unacceptably low. Conventional bioethical analyses of mandatory programs are inadequate; they fail to account for the obligations of nonprofessional personnel or to justify the weights assigned to different ethical principles. Using an ethics framework for public health permits a fuller analysis. The framework's focus (...) on fairness accentuates the potential differences between the risk of transmitting infection and employment status, and the need to equitably evaluate exemptions. The framework's emphasis on balancing benefits and burdens highlights the need to justify a specific goal and questions the need to exclude all nonmedical exemptions. While mandatory vaccination programs are justifiable, greater attention should be paid to their implementation. (shrink)

Health care institutions have paid increasing attention to preventing nosocomial transmission of influenza through vaccination of health care personnel. While multifaceted voluntary interventions have increased vaccination rates, proponents of mandatory programs contend the rates remain unacceptably low. Conventional bioethical analyses of mandatory programs are inadequate; they fail to account for the obligations of nonprofessional personnel or to justify the weights assigned to different ethical principles. Using an ethics framework for public health permits a fuller analysis. The framework's focus (...) on fairness accentuates the potential differences between the risk of transmitting infection and employment status, and the need to equitably evaluate exemptions. The framework's emphasis on balancing benefits and burdens highlights the need to justify a specific goal and questions the need to exclude all nonmedical exemptions. While mandatory vaccination programs are justifiable, greater attention should be paid to their implementation. (shrink)

Ethical analyses of the relations between managers and subordinates have traditionally focused on the employment contract. The inequality and requisite mutual trust between managers and subordinates makes the sub-disciplines of professional ethics and feminist ethics more applicable than the contractarian perspective. When professional ethics is applied to hierarchic relationships, specific obligations emerge for managers and subordinates alike. The application of feminist ethics results in the identification of an entirely different, though not contradictory, set of obligations. In toto, the (...) class='Hi'>analysis improves on the conventional wisdom governing hierarchic relationships while at the same time remaining consistent with our moral intuitions. (shrink)

We appreciate Meynen’s examination of ethical implications of using neurotechnologies to decode neural data and make inferences about cognitive processes. Here, we address three issues that we beli...

This ethical analysis compares two mid-size Asian-based multinational corporations (Japanese and Taiwanese) that have established extensive operations in China. We describe and analyze ethically relevant dimensions of each corporation's culture and practices, including their corporate cultures and the ethical issues they face. We argue that these companies add value to China's social and economic transformation in several important ways, including their development of human capital – the enhanced skill sets, work experiences, and values acquired by their workers. (...) We conclude by highlighting three ethical challenges that seem most critical for these two firms: (a) creating mutual benefit for the corporation and the host country; (b) localization and management of the cultural gap between expats and local workers; and (c) dealing effectively with the power and roles of a large, pervasive government in a non-democratic society. The experiences of these two international firms can provide insights into how international firms might construct effective management strategies for doing business in countries such as China. (shrink)

Ethical analysis may result in recommendations for legal reform. This article discusses the problem of how academic researchers can go from ethical normative judgments to recommendations for law reform. It develops a methodological framework for what may be called ‘ethical transplants’: transplanting ethical normative judgments into legislation. It is an inventory of the issues that need to be addressed, but not a substantive normative theory. It may be especially helpful for Ph.D. students and beginning researchers (...) working in interdisciplinary projects combining ethical and legal analysis.I distinguish three stages in the process from ethics to law: translation, transformation, and incorporation. The latter stage can be divided into three clusters of issues, these being legal, empirical, and normative ones. Most of the philosophical literature on the legal enforcement of morals focuses on the normative issues. My aim is to broaden the perspective in two ways. First, I show that this is only one relevant issue and that we should address legal and empirical issues and the processes of translation and transformation as well. Second, I argue that we should pay more attention to pluralism and variation. (shrink)

The general public and environmental policy makers often perceive management actions of environmental managers as “science,” when such actions are, in fact, value judgments about when to intervene in natural processes. The choice of action requires ethical as well as scientific analysis because managers must choose a normative outcome to direct their intervention. I examine a management case study involving prescribed burning of sagebrush (Artemisia tridentata) communities in south-central Montana (USA) to illustrate how to teach students to ethically (...) evaluate a management action by precisely identifying: 1) the proposed management action, 2) the deficiency of the system to be remedied by the action, 3) the stakeholders affected by the action, and 4) the category and type of values affirmed in the management action. Through such analysis, students are taught to recognize implicit and explicit value judgments associated with management actions, identify stakeholders to whom managers have legitimate ethical obligations, and practice a general method of ethical analysis applicable to many forms of environmental management. (shrink)

The institutional review board is the social-oversight mechanism charged with protecting research subjects. Performing this task competently requires that the IRB scrutinize informed-consent procedures, the balance of risks and potential benefits, and subject-selection procedures in research protocols. Unfortunately, it may be said that IRBs are spending too much time editing informed-consent forms and too little time analyzing the risks and potential benefits posed by research. This time mismanagement is clearly reflected in the research ethics literature. A review of articles published (...) between 1979 and 1990 in IRB: A Review of Human Subjects Research, for example, reveals a large number of articles on informed consent and confidentiality and considerably fewer on the assessment of risks and potential harms, study design, and subject-selection procedures. (shrink)

Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as ‘keepsake’ ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and (...) professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed. (shrink)

Bangladesh, a Muslim-majority country, has a national organ donation law that was passed in 1999 and revised in 2018. The law allows living-related and brain-dead donor organ transplantation. There are no legal barriers to these two types of organ donations, but there is no legislation providing necessary costs and incentive measures associated with successful organ transplants. However, many governments across the globe provide different types of incentives for motivating living donors and families of deceased donors. This study assesses the merits (...) and demerits of incentive measures already in use around the world and proposes ethical measures that can promote organ donation in Bangladesh. The primary focus of this paper is to present an ethical analysis of the comparison of incentive measures on organ donation between Bangladesh and the Islamic Republic of Iran as two Muslim countries that operate organ donation for transplantation practices according to Islamic principles. In this paper, I mainly argue that providing a fixed bare minimum financial incentive measure to distantly related living donors and families of deceased donors will encourage Bangladeshis to donate organs in a manner that is ethically justifiable, morally permissible, and socio-economically appropriate. The government of Bangladesh should revise the existing biomedical law to include a provision related to incentive measures and set a strict policy to properly regulate these measures as key stewardship that can ethically promote organ donation for transplantation. (shrink)

The institutional review board is the social-oversight mechanism charged with protecting research subjects. Performing this task competently requires that the IRB scrutinize informed-consent procedures, the balance of risks and potential benefits, and subject-selection procedures in research protocols. Unfortunately, it may be said that IRBs are spending too much time editing informed-consent forms and too little time analyzing the risks and potential benefits posed by research. This time mismanagement is clearly reflected in the research ethics literature. A review of articles published (...) between 1979 and 1990 in IRB: A Review of Human Subjects Research, for example, reveals a large number of articles on informed consent and confidentiality and considerably fewer on the assessment of risks and potential harms, study design, and subject-selection procedures. (shrink)

The general public and environmental policy makers often perceive management actions of environmental managers as science, when such actions are, in fact, value judgments about when to intervene in natural processes. The choice of action requires ethical as well as scientific analysis because managers must choose a normative outcome to direct their intervention. I examine a management case study involving prescribed burning of sagebrush (Artemisia tridentata) communities in south-central Montana (USA) to illustrate how to teach students to ethically (...) evaluate a management action by precisely identifying: 1) the proposed management action, 2) the deficiency of the system to be remedied by the action, 3) the stakeholders affected by the action, and 4) the category and type of values affirmed in the management action. Through such analysis, students are taught to recognize implicit and explicit value judgments associated with management actions, identify stakeholders to whom managers have legitimate ethical obligations, and practice a general method of ethical analysis applicable to many forms of environmental management. (shrink)

Current ethical analysis tends to evaluate synthetic biology at an overview level. Synthetic biology, however, is an umbrella term that covers a variety of areas of research. These areas contain, in turn, a hierarchy of different research fields. This abstraction hierarchy—the term is borrowed from engineering—permits synthetic biologists to specialise to a very high degree. Though synthetic biology per se may create profound ethical challenges, much of the day-to-day research does not. Yet seemingly innocuous research could lead (...) to ethically problematic results. For example, Dolly the sheep resulted from a long series of research steps, none of which presented any ethical problems. The atomic bomb was developed as a result of Einstein’s uncontentions theoretical research that proved the equivalence of matter and energy. Therefore it would seem wise for ethicists to evaluate synbio research across its subfields and through its abstraction hierarchies, comparing and inter-relating the various areas of research. In addition, it would be useful if journals that publish synbio papers require an ethical statement from authors, as standard practice, so as to encourage scientists to constantly engage with ethical issues in their work. Also, this would allow an ethical snapshot of the state of the research at any given time to exist, allowing for accurate evaluation by scientists and ethicists, regulators and policymakers. (shrink)

Our understanding of emotional labor, while conceptually and empirically substantial, is normatively impoverished: very little has been said or written expressly about its ethical dimensions or ramifications. Emotional labor refers to efforts undertaken by employees to make their private feelings and/or public emotion displays consistent with job and organizational requirements. We formally define emotional labor, briefly summarize research in organizational behavior and social psychology on the causes and consequences of emotional labor, and present a normative analysis of its (...) moral limits focused on conditional rights and duties of employers and employees. Our focus is on three points of conflict involving rights and duties as they apply to the performance of emotional labor: when employees’ and organizations’ rights conflict, when employees’ rights conflict with their duties, and when organizations’ rights conflict with their duties. We discuss implications for future inquiry as well as managerial practice. (shrink)

In the field of health technology assessment, there are several approaches that can be used for ethical analysis. However, there is a scarcity of literature that critically evaluates and compares the strength and weaknesses of these approaches when they are applied in practice. In this paper, we analyse the applicability of some selected approaches for addressing ethical issues in HTA in the field of complex health interventions. Complex health interventions have been the focus of methodological attention in (...) HTA. However, the potential methodological challenges for ethical analysis are as yet unknown.Six of the most frequently described and applied ethical approaches in HTA were critically assessed against a set of five characteristics of complex health interventions: multiple and changing perspectives, indeterminate phenomena, uncertain causality, unpredictable outcomes, and ethical complexity. The assessments are based on literature and the authors’ experiences of developing, applying and assessing the approaches.The Interactive, participatory HTA approach is by its nature and flexibility, applicable across most complexity characteristics. Wide Reflective Equilibrium is also flexible and its openness to different perspectives makes it better suited for complex health interventions than more rigid conventional approaches, such as Principlism and Casuistry. Approaches developed for HTA purposes are fairly applicable for complex health interventions, which one could expect because they include various ethical perspectives, such as the HTA Core Model® and the Socratic approach.This study shows how the applicability for addressing ethical issues in HTA of complex health interventions differs between the selected ethical approaches. Knowledge about these differences may be helpful when choosing and applying an approach for ethical analyses in HTA. We believe that the study contributes to increasing awareness and interest of the ethical aspects of complex health interventions in general. (shrink)

Pragmatic comparative effectiveness randomized controlled trials evaluate the effectiveness of one interventions under real-world clinical conditions. The results of ceRCTs are often directly generalizable to everyday clinical practice, providing information critical to decision-making by patients, clinicians, and healthcare policymakers. The PRECIS-2 framework identifies nine domains that serve to score a trial on a continuum between very explanatory to very pragmatic. According to the framework, pragmatic trials may have one or more of the following features: there are fewer eligibility criteria for (...) participants, in an... (shrink)

Community-researcher partnerships constitute one of the most important recent developments in biomedical ethics. The partnerships protect vulnerable communities within which research is conducted and help ensure that the communities benefit from the research. At the same time, they embody deep, core values about the social nature of persons and the value of community that significantly modify the radical individualism too often associated with the prevailing concepts of autonomy and respect for persons. This article examines the burgeoning literature on community-researcher partnerships (...) to identify the main ways of thinking ethically about the obligations of investigators and the roles and rights of communities in scientific research. The paper helps to uncover the deep commonalities and differences that mark the current debate in this emerging arena of research ethics, a debate over the social nature of persons that is beginning to influence the understanding of other bioethical issues. (shrink)

This paper examines several issues regarding deception in advertising. Some generally accepted definitions are considered and found to be inadequate. An alternative definition is proposed for legal/regulatory purposes and is related to a suggested definition of the term deception as it is used in everyday language. Based upon these definitions, suggestions are offered for detecting and regulating deception in advertising. This paper additionally considers the grounds for the generally held but largely unquestioned assumption that deceptive advertising is unethical. It is (...) argued that deceptive advertising can be shown to be morally objectionable, on the weak assumption that it is prima facie wrong to harm others. Finally, the implications of this analysis with respect to current regulation of deceptive advertising by the FTC are considered. (shrink)

This paper analyses the ethical considerations using the stakeholder theory on two specific domains of the newly implemented ‘Ayushman Bharat-Pradhan Mantri Jan Arogya Yojna ’ scheme by the Government of India. The paper recommends a solidarity-based approach over an entitlement based one that focuses on out-of-pocket expenses for the most vulnerable and a stewardship role from the private sector to ensure equity, accountability, and sustainability of PM-JAY scheme.

Nonpharmaceutical interventions to minimize the transmission of the severe acute respiratory syndrome coronavirus 2 are necessary because we currently lack a vaccine or specific treatments. Healthcare facilities have adopted visitor restrictions and masking requirements. These interventions should be evaluated as public health measures, focusing on their efficacy, the availability of less-restrictive alternatives, and the minimization of the burdens and their balance with the benefits. These interventions, as well as exceptions, can be justified by the same analysis. For example, visitor (...) restrictions are sound, as are exceptions for women in labor, adults with disabilities, minor children, and individuals who are dying. In implementing these policies, specific rules are preferable to general principles because they are more efficient and reduce possible bias. There should, however, be appeal mechanisms and retrospective review processes. Evaluating requests for medical exemptions to masking requirements is particularly difficult, given the prevalence of nonmedical objections, false claims of medical exemptions, and a lack of objective medical criteria. Requiring written statements by licensed healthcare providers that undergo subsequent substantive review may therefore be justified. (shrink)

Research in the intensive care unit (ICU) is commonly thought to pose 'serious risk' to study participants. This perception may be at the root of a variety of impediments to the conduct of clinical trials in the ICU setting. Component analysis offers a promising approach to the ethical analysis of ICU research. Because clinical trials commonly involve a mixture of study interventions, therapeutic and nontherapeutic procedures must be analyzed separately. Therapeutic procedures must meet the requirement of clinical (...) equipoise. Risks associated with nontherapeutic procedures must be minimized consistent with sound scientific design, and be deemed reasonable in relation to the knowledge to be gained. When research involves a vulnerable population, such as adults incapable of providing informed consent, nontherapeutic risks are limited to a minor increase over minimal risk. Understood in this way, the incremental risk posed by participation in ICU research may be minimal. This realization has important implications for review by institutional review boards of such research and for the informed consent process. (shrink)

Among the most significant findings of SUPPORT was that 50% of ICU patients suffered from moderate to severe pain during the last days of life. At the time of its publication late in 1995, SUPPORT was merely the latest in a long series of articles in the medical literature documenting the widespread and significant undertreatment of pain, beginning with a 1973 study of hospital inpatients. Much has been written about the phenomenon of undertreated pain and inadequate care of patients at (...) the end of life, and many positive suggestions for reform of clinical education and clinical practice have been iterated and reiterated in the two decades separating the studies. Proposals for modifying clinician behaviors in this aspect of patient care have tended to focus on particular barriers to effective pain management and palliative care. (shrink)

Japan's politieal, cultural, and geographic isolation, its symbiotic government-business arrangement, and its practice of practical, resources-oriented politics, trade, and diplomacy have led it to be the only major global economic power to strictIy comply with the Arab boycott. A brief history and description of the boycott are presented here, along with an overview of the responses of major economic trading nations. Three issues are addressed: Japan's global conscience, the framework appropriate to analyze the ethics of global economic boycotts, and the (...) Japanese government's excuse of leaving boycott decisions to business considering the historic relationship between the two. The logical conclusion of this analysis is that Japan as a nation must abandon its insularity and take a greater ethical responsibility in line with its economic power. From this comes the responsibility of the govenment to guide the business sector towards a corporate conscienee, one that is grounded in global awareness. (shrink)

Even though the 3Rs are widely accepted as ethical standards when evaluating research projects using animals as experimental subjects, the ethical status of the 3Rs still remains to be clarified. The 3Rs were not derived from any ethical theory, but they represented an attempt to increase humanity to animal experimentation and at the same time to improve validity of scientific data . The aim of the present article was to provide an ethical analysis of the (...) 3Rs through Engelhardt's bioethics theory . The analysis revealed the 3Rs fitted to some extent Engelhardt ethical values. But the analysis also revealed some internal contradictions between the 3Rs and Engelhardt's ethical vaules. Although the 3Rs are still valuable tools in animal ethical evaluation, the present analysis suggests that some ethical issues still remain to be clarified. (shrink)

Background Healthcare systems are increasingly struggling with resource constraints, given demographic changes, technological development, and citizen expectations. The aim of this article is to normatively analyze different suggestions regarding how publicly financed plastic surgery should be delineated in order to identify a well-considered, normative rationale. The scope of the article is to discuss general principles and not define specific conditions or domains of plastic surgery that should be treated within the publicly financed system. Methods This analysis uses a reflective (...) equilibrium approach, according to which considered normative judgements in one area should be logically and argumentatively coherent with considered normative judgements and background theories at large within a system. Results and conclusions In exploring functional versus non-function conditions, we argue that it is difficult to find a principled reason for an absolute priority of functional conditions over non-functional conditions. Nevertheless, functional conditions are relatively easier to establish objectively, and surgical intervention has a clear causal effect on treating a functional condition. Considering non-functional conditions that require plastic surgery [i.e., those related to appearance or symptomatic conditions ], we argue that the patient needs to experience some degree of suffering, which must be ‘validated’ in some form by the healthcare system. This validation is required for both functional and non-functional conditions. Functional conditions are validated by distinguishing between statistically normal and abnormal functioning. Similarly, for non-functional conditions, statistical normality represents a potential method for distinguishing between what should and should not be publicly funded. However, we acknowledge that such a concept requires further development. (shrink)

Scant consideration has been given to the ethical implications of the policy of closing down psychiatric hospitals in favour of community care. The recent adherents of this policy in government have been enthusiastic in encouraging its implementation. This paper has three sections: a brief resumé of the history and principles of community care for the mentally ill; a discussion on the merits and de-merits of psychiatric care in the hospital and in the community; and an outline of some preliminary (...) categories for ethical analysis. (shrink)

Since the outbreak of the global financial crisis in 2008, the exchange rate between China and USA has drawn a lot of attention. Because of the balance of payments surplus, China has accumulated a large amount of foreign exchange reserves, and there is much pressure on the Renminbi (RMB) to appreciate. The appreciation of RMB has raised a series of intertwining economic and ethical concerns in China. This paper is an inter-disciplinary study to illustrate the inter-relationship between economics and (...) ethics. We analyze the major economic factors affecting the trend of exchange rate of RMB and the effects of its appreciation. We then discuss the ethical implications of the appreciation and conclude with some policy suggestions to address the economic and the ethical concerns. (shrink)

Recent technological developments have considerably transformed the supply, storage, and transportation processes of cadavers, creating new and previously unforeseen ethical challenges regarding cadaver usage. In this study, we analyzed two aspects of the cadaver processing system—cadaver supply and its use in research. Thereafter, we highlighted the major ethical concerns underlying these stages and correlated our search results with the ethical principles outlined in the Declaration of Helsinki (DoH), or Helsinki Declaration. To ensure the reliability and continuity of (...) medical progress, human—especially cadaver—research depends on the ethical priorities as outlined in the DoH: respect for autonomy, privacy/confidentiality, risks/burdens/benefits, and the protection of vulnerable groups. According to our ethics analysis, which also corresponds with the ethics guidelines of the Consensus Panel on Research with the Recently Dead, the most ignored values were respect for autonomy and privacy/confidentiality issues. Based on these ethical concerns, we provide recommendations to address these challenges in anatomy research. (shrink)

In this article, we provide an ethical analysis of the first porcine cardiac xenotransplant, performed in Maryland, USA in early 2022. David Bennett was offered the experimental procedure after he was deemed ineligible for human heart transplantation and mechanical circulatory support, based on a history of non-compliance. It was reported that Mr Bennett’s previous instances of non-compliance were for medically non-life-threatening conditions years earlier, where the risks of non-compliance were not as high. We argue that, in Mr Bennett’s (...) case, a history of non-compliance in a different context, should not necessarily rule him ineligible for a potentially life-saving treatment now. Furthermore, using previous non-compliance to exclude individuals from donor organs may have the unintended effect of placing the burden of testing xenotransplantation on those who are already disadvantaged. We then argue that it is not enough to rely on patient consent to ethically justify xenotransplantation research. Taking a broad ethical perspective is crucial when mapping a clinical pathway for xenotransplantation. (shrink)

The paper addresses the issue of how indemocratic societies a procedure might be formulatedto facilitate ethical judgements on modernbiotechnologies used in food production. A frameworkfor rational ethical analysis, the Ethical Matrix, isproposed. The Matrix adapts the principles describedby Beauchamp and Childress for application to medicalissues, to interest groups (e.g., producers,consumers, and the biotic environment) affected bythese technologies. The use of the Matrix isillustrated by applying it to an example of a ``novelfood,'' viz., a form of genetically (...) modified maize. (shrink)

In the dialogues earlier than the Republic, Plato indicates in many ways his lack of confidence that any method of ethical analysis will lead to a discovery of the truth. The doubts which he expresses or implies have not always been given the attention which they deserve, and there has often been a reluctance to accept them as an expression of Plato's genuine conviction. There is, admittedly, some justification for this reluctance. Plato does not always seem to be (...) consistent. In his attitude towards the results attainable by the use of a method of joint inquiry, he is sometimes extremely optimistic, at other times sceptical; and it seems a not unreasonable explanation of his scepticism to ascribe it to his desire to preserve a consistent portrait of the ‘ignorant’ Socrates. Thus the hesitation and reserve with which Plato immediately qualifies his dogmatic presentation of the theory of νμνησις in the Meno is explicable as a concession to dramatic realism. His reference to the method discussed in the Phaedo as a δετερος πλος may be dismissed as ‘ironical’, as ‘the habitual playful selfdepreciation of Socrates’. The purpose of this paper is to suggest that the development of Plato's views on method in the dialogues as far as the Republic can be traced more consistently if we accept Plato's doubts, as well as his optimism, about ethical analysis, as the expression of his genuine conviction. (shrink)

Despite the importance of the Moist-Confucian debate to students of both Chinese thought and comparative religious ethics, it remains in need of a careful analysis using contemporary ethical theory. In presenting such an analysis, this essay aims to accomplish three things: (1) to show how Confucius and Mo-tzu were divided over the priority-of-the-right issue, the latter being a utilitarian in his working ethics despite his oft-noted interest in divine command theory; (2) to describe how their followers worked (...) out a meta-ethical basis for their respective positions on this issue (Mencius, in particular, opposing the psychological and "definist" approach of the Moists with an "intuitionist" one that would have a deep influence upon later Confucian orthodoxy); (3) to demonstrate the tendency, perhaps grounded in the structure of human thought, toward conflict between two basic ways of doing normative ethics: the deontological and the teleological. (shrink)

This paper addresses three questions central to the ethical analysis of risks and potential benefits in human subjects research: 1. How was the ethical analysis of risk understood by the members of the U.S. National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (National Commission)? 2. What conceptual framework should guide the ethical analysis of risk? 3. What changes to U.S. regulations would the implementation of such a framework require?

Research shows that a culture of consumerism and materialism has a dramatic and negative impact on children's physical and psychological health. Psychologists have a duty to act to reverse this trend. Information on why and how to act is the key. This article explores the use of psychology to improve the effectiveness of advertising to youth and details the harm suffered by children as a result of some of this advertising. A discussion of ethical considerations related to specific guiding (...) principles and ethical standards of the 2002 American Psychological Association (APA) Ethics Code frames why action is imperative. Actions for psychologists to take in applying the 2002 APA Ethics Code are suggested herein. (shrink)

The transplant community has faced unprecedented challenges balancing risks of performing living donor transplants during the COVID-19 pandemic with harms of temporarily suspending these procedures. Decisions regarding postponement of living donation stem from its designation as an elective procedure, this despite that the Centers for Medicare and Medicaid Services categorise transplant procedures as tier 3b (high medical urgency—do not postpone). In times of severe resource constraints, health systems may be operating under crisis or contingency standards of care. In this manuscript, (...) the United Network for Organ Sharing Ethics Workgroup explores prioritisation of living donation where health systems operate under contingency standards of care and provide a framework with recommendations to the transplant community on how to approach living donation in these circumstances.To guide the transplant community in future decisions, this analysis suggests that: (1) living donor transplants represent an important option for individuals with end-stage liver and kidney disease and should not be suspended uniformly under contingency standards, (2) exposure risk to SARS-CoV-2 should be balanced with other risks, such as exposure risks at dialysis centres. Because many of these risks are not quantifiable, donors and recipients should be included in discussions on what constitutes acceptable risk, (3) transplant hospitals should strive to maintain a critical transplant workforce and avoid diverting expertise, which could negatively impact patient preparedness for transplant, (4) transplant hospitals should consider implementing protocols to ensure early detection of SARS-CoV-2 infections and discuss these measures with donors and recipients in a process of shared decision-making. (shrink)

I analyze Ojibway objections to genomics and genetics research on wild rice. Although key academic and industry participants in this research have dismissed their objections out of hand, my analysis supports the conclusion that the objections merit serious consideration, even by those who do not share the Ojibway’s religious beliefs.

This paper ethically analyses arising out the proposed changes to the Mental Health Act for England and Wales. It looks in particular at thea shift in philosophy that the author claims has occurred with the proposals away from rights-focused principles to more utilitarian or outcome-focused principles. It gives examples of these changes and explores itstheir consequences.

We examine the issues concerning the legality and ethicality of the Second Amendment right to bear arms balanced by the employer's duty to provide a safe workplace for its employees. Two court rulings highlight this balancing act: McDonald et al. v. City of Chicago et al. and District of Columbia v. Heller. “Stand Your Ground” and “Castle Doctrine” laws in the recent Trayvon Martin shooting on February 26, 2012 are also applicable. Various ethical frameworks examine the firearms debate by (...) viewing the Second Amendment from three perspectives. These include a pro‐gun perspective drawing upon libertarianism and fundamental rights; a moderate gun perspective drawing upon consequentialism and stakeholder theory; and finally, an anti‐gun perspective drawing upon a Public Health Ethics and peace ethics approach. We explore the issue of gun control from a business perspective as employers face ethical decisions in responding to legislation that allows guns in the workplace and/or in employer parking lots while still being responsible to provide a safe workplace for their employees. We make recommendations regarding how companies should manage by proactively avoiding legal challenges to employees' rights to own and carry guns into the workplace. This includes emphasis on enhanced security, Human Resource policies and monitoring rapidly changing laws. (shrink)