This article analogizes the state, in its role as tax collector, to that of an investor, or to be more precise, that of a residual claimant on the earnings of all of the people and firms subject to the taxing power of the state. The relationship between modern democracy and its citizens would be strengthened if this analogy were more widely acknowledged because it recognizes citizen-taxpayers as contracting partners with the state. Unlike other libertarian conceptions of the state's taxing authority, (...) the framework developed here does not jeopardize the state's ability to collect the revenues it needs to provide for the protections of its citizens. The state-as-investor framework developed in this Article leads to a number of tax policy improvements. The framework suggests limits on the government's ability to change people's tax status after they have already embarked on careers and made the sunken, non-diversifiable investments in human capital that such career training requires. The framework advanced here also suggests that people should be able to make a once-in-a lifetime payment in lieu of taxes to the state in order to discharge their tax liability. This approach articulated here also seems superior to the utopian suggestion offered by Ayn Rand that taxation be voluntary, as well as to the unrealistic suggestion made by Nozick that income taxes are violative of man's natural rights. (shrink)
The release of the Final Report of the Lyons Inquiry into Local Government in England, entitled Place-shaping: A shared ambition for the future of local government (Lyons Inquiry into Local Government) was a significant milestone in the debate on local government reform. Place-shaping is a sophisticated piece of rhetoric and policy making and can be seen to have relevance far beyond its own jurisdiction. This paper traces its theoretical antecedents alongside developments in the debate on (...) local government in England. Despite its broad appeal, we argue that problems familiar to local government such as rent-seeking and cost shifting will be heightened rather than resolved with any take-up of the place-shaping agenda. (shrink)
Too much contemporary bioethical discourse is weak on science, lazily citing and adopting science fiction scenarios rather than science facts in the framing of analyses and policies. We challenge bioethicists to take more seriously the role of providing informed insight into and oversight over contemporary science and its implications and applications. Bioethicists must work harder to understand the fast-changing truths and limits of basic science, and they must incorporate only appropriate and authentic science into their discourse, just as they did (...) in the past when addressing the quandaries of clinical medicine. The field of bioethics is not so old and entrenched that its future is assured. Bioethicists must make themselves useful to society in order to deserve and retain the public's trust. They can best do this by ensuring that decision making and public policy are grounded in facts, not fictions and fantasies. (shrink)
In few other areas of bioethical inquiry exists as close a connection between bioethical professional advice and policy development as is the case with HIV and AIDS. Historically, the reasons for this have much to do with one of the groups initially affected most severely by HIV and AIDS, namely well-educated middle-class gay men in developed countries. This particular group of people, highly sophisticated and used to political activism in its pursuit of civil rights-related objectives, engaged the medical profession (...) as well as regulatory agencies such as the US Food and Drug Administration, and legislators (more so in the USA than in other countries) in a number of bioethically interesting policy areas. Many of the controversies of the times were framed as civil rights and/or ethical disputes. The initial areas of concern and inquiry focused on: informed consent to HIV testing and trial participation, the confidentiality of HIV test results, access to trials as a means of access to experimental drugs, the length of time it took to get an experimental drug to the market approval stage, and end-of-life decision-making. This line-up of issues explains why AIDS has become such an interesting topic for bioethicists. Bioethicists concerned about the traditional breadand- butter themes of medical ethics themes of the doctor - patient relationship (e.g., Daniels, 1991; Boyd, 1992), as well as bioethicists more concerned about policy and regulatory issues in the drug research and approval process (e.g., Edgar & Rothman, 1990; Salisbury & Schechter, 1990), found research topics worthy of vigorous pursuit. No surprise, then, that HIV/AIDS led to a probably unprecedented number of books and articles in professional journals (Manuel et al., 1990). HIV/AIDS has become a permanent fixture in all major mainstream bioethics textbooks (e.g., Kuhse & Singer, 1998; Arras & Steinbock, 1999). Reference series in medicine, ethics and law provide for dedicated volumes on AIDS.1 Even specialist bioethics textbooks, for instance those directed at dentistry students, carry chapters on HIV/AIDS (Ozar & Sokol, 2002). 128 Udo Schuklenk AIDS, designated by the medical profession a pandemic lives up to its classification. It did not stop at the borders of developed countries. As one would expect of a primarily sexually transmitted illness in the age of globalisation, it spread rapidly across the globe. Indeed, in many countries it has become one of the main causes of death, as in sub- Saharan Africa (Shisana & Simbayi, 2002). Dramatic increases in the number of AIDS cases are predicted for many Eastern European countries as well as for the two most populous nations on earth, India and China. Some of the HIV/AIDS-related bioethical and policy issues of concern to developed countries remain the same for developing countries. However, in ethically important ways they are dwarfed by concerns over drug prices, intellectual property rights, and affordable access to essential AIDS drugs for the impoverished masses of infected people in such countries. Of increasing importance have become ethical issues pertaining to the ever-growing research industry associated with clinical trials undertaken in developing countries. Indeed, major funding initiatives both in the USA and UK have brought clinical research in developing countries into focus. Some have questioned whether this attention is appropriate, considering other bioethical problems of arguably greater importance to developing countries (Chadwick & Schuklenk, 2003). Standards of clinical care in a study, and after a trial has concluded, as well as community benefits and access to the trial regime after the trial's conclusion remain contentious issues. It is worth noting that more often than not it was an AIDS-related trial or policy decision that led to a great deal of bioethical analysis, yet the issues discussed almost always have ramifications far beyond AIDS. For instance, decisions about the question of what (if any) standards of care failures in preventive trials (of HIV vaccines or microbicides) ought to receive have important implications for non-AIDS prevention trials. (shrink)
News media accounts of issues in bioethics gain significance to the extent that the media influence public policy and inform personal decision making. The increasingly frequent appearance of bioethics in the news thus imposes responsibilities on journalists and their sources. These responsibilities are identified and discussed, as is (i) the concept of "newsworthiness" as applied to bioethics, (ii) the variable quality of bioethics reportage and (iii) journalists' reliance on ethicists to pass judgment. Because of the (...) potential social and other benefits of high quality reporting on ethical issues, it is argued that journalists and their bioethics sources should explore and accommodate more productive relationships. An optimal journalism-ethics relationship will be one characterized by "para-ethics," in which journalistic constraints are noted but also in which issues and arguments are presented without oversimplification and credible disagreement is given appropriate attention. (shrink)
This paper is an analysis of the relationship of social ethics and bioethics in Roman Catholic theology. The argument of the paper is that the character of both Catholic moral theology and ecclesiology shape the broadly defined interest of the church in bioethics. The paper examines the common elements of social ethics and bioethics in Catholic teaching, describes how ecclesiology shapes Catholic public policy and uses the examples of abortion and health care to illustrate the relationship (...) of Catholic social thought and bioethics. In developing the relationship of these two dimensions of Catholic moral argument the article highlights how the appeal to natural law categories differs in social ethics and bioethics and how the two topics are received differently in the theological community. It also seeks to illustrate how the premises of Catholic social ethics remain central to public positions taken on bioethics. Keywords: ecclesiology, moral theology, natural law, social ethics CiteULike Connotea Del.icio.us What's this? (shrink)
Policy making is not only about the cut and thrust of politics. It is also a bureaucratic activity. Long before laws are drafted, policy commitments made, or groups consulted on government proposals, officials will have been working away to shape the policy into a form in which it can be presented to ministers and the outside world. Policy bureaucracies - parts of government organizations with specific responsibility for maintaining and developing policy - have (...) to be mobilized before most significant policy initiatives are launched. -/- This book describes the range of work policy officials do. The 140 civil servants interviewed for this study included officials who helped originate policies which were subsequently taken over as manifesto commitments by the Labour Party; officials who helped devise the formula by which billions of pounds are allocated to local government in grants; and also officials who recommended to the Secretary of State that a controversial publisher be allowed to take over a national newspaper. The background and career paths of middle-ranking officials show them to be a diverse group who do not tend to develop long-term subject specialisms. The instructions to which these officials work - whether coming from ministers or senior officials - are often very broad and leave much to personal interpretation. -/- Policy Bureaucracy goes on to examine how ministers and senior officials affect the work of middle ranking officials and the cues policy bureaucrats use to develop policy. The analytical approach adopted in the book is derived from Alvin Gouldner's Patterns of Industrial Bureaucracy and his elaboration of Max Weber's notion that hierarchy and expertise place a fundamental tension at the heart of modern bureaucracies. In the UK this tension is handled by combining 'invited authority' with 'improvised expertise'. The book also explores other models of handling this tension in political systems in Europe and the USA. (shrink)
: This paper discusses the role of ethical considerations in the formulation of public policies aimed at shaping the scientific agenda. Specifically, new and controversial public policy issues will confront us in the twenty-first century as the result of developments on the frontiers of biomedical science. Some of the anxieties in the ethical arena generated by the rapid pace of these developments are likely to result in efforts to place constraints on the shape of the scientific agenda and the (...) application of new knowledge. Our moral propositions, therefore, will be tested and re-tested in their application to evolving social, cultural, and historical circumstances and the ever-changing technological context. (shrink)
This paper analyses whether the aggregation of individual happiness scores to a National Happiness Index can still be trusted once governments have proclaimed their main objective to be the pursuit—or even maximization—of this National Happiness Index. The answer to this investigation is clear-cut: as soon as the National Happiness Index has become a policy goal, it can no longer be trusted to reflect people’s true happiness. Rather, the Index will be systematically distorted due to the incentive for citizens to (...) answer strategically and the incentive for government to manipulate the Index in its favour. Such a distortion would arise even if the measurement of subjective well-being correctly reflected actual happiness before the intervention of government. Governments in a democracy should establish the conditions enabling individuals to become happy. The valuable and important results of happiness research should be introduced into the political process. Each person should be free to pursue happiness according to his or her preferences. This process is supported by obedience to the rule of law, human rights and free media, as well as by extended political participation rights, decentralized public decision-making, an open and effective education system fostering upward mobility and the possibility to find suitable employment. (shrink)
Critically examining what most people take for granted is central to philosophical inquiry. Philosophers who accept positions on policy making commissions, tasks forces, or committees cannot, however, play the same uncompromisingly critical role in this capacity as they do in the classroom or in their personal research or writing. Still, philosophers have much to contribute to such bodies, and they can do so without compromising their integrity or betraying themselves as philosophers. Keywords: compromise, critical reflection, embryo research, integrity, organ (...) transplantation, policy development, Warnock Committee CiteULike Connotea Del.icio.us What's this? (shrink)
Juridical councils that render rulings on bioethical issues for Muslims living in non-Muslim lands may have limited familiarity with the foundational concept of wilāyah (authority and governance) and its implications for their authority and functioning. This paper delineates a Sunni Māturīdi perspective on the concept of wilāyah, describes how levels of wilāyah correlate to levels of responsibility and enforceability, and describes the implications of wilāyah when applied to Islamic bioethical decision making. Muslim health practitioners and patients living in the absence (...) of political wilāyah may be tempted to apply pragmatic and context-focused approaches to address bioethical dilemmas without a full appreciation of significant implications in the afterlife. Academic wilāyah requires believers to seek authentication of uncertain actions through scholarly opinions. Fulfilling this academic obligation naturally leads to additional mutually beneficial discussions between Islamic scholars, healthcare professionals, and patients. Furthermore, an understanding derived from a Māturīdi perspective provides a framework for Islamic scholars and Muslim health care professionals to generate original contributions to mainstream bioethics and public policy discussions. (shrink)
Focusing on the work of one bioethics commission, the New York State Task Force on Life and the Law, this article explores the role played by moral consensus in public ethics. Task Force members, who were appointed to represent diverse interests in New York State, identified a culturally strong value of individual autonomy as the ethical basis for their work on life-sustaining treatment. This moral consensus permitted the members to unite across their differences and develop public policy recommendations (...) that substantially reformed a highly troubling New York law. However, the principle of autonomy insufficiently guides decisions by caring family members for incompetent adults in cases where little is known of patient preference. A different, more innovative moral vision is required – one that grants a more robust moral authority to the family. While government efforts that rely on moral consensus developed in a broadbased and well-reasoned manner can serve us well, in some cases the consensus will provide inadequate moral guidance. Government bioethical efforts must guard against the limits of moral vision in light of their disproportionate societal power. Keywords: autonomy, consensus, family decisionmaking, governmentbioethics, incompetent patients, life-sustaining treatment, surrogate decisionmaking CiteULike Connotea Del.icio.us What's this? (shrink)
Part 1. Introduction -- Introduction: Navigating the Perfect Moral Storm in Light of a Thirty-Five Year Debate -- Thirty-Five Year Climate Change Policy Debate -- Part 2. Priority Ethical Issues -- Ethical Problems with Cost Arguments -- Ethics and Scientific Uncertainty Arguments -- Atmospheric Targets -- Allocating National Emissions Targets -- Climate Change Damages and Adaptation Costs -- Obligations of Sub-national Governments, Organizations, Businesses, and Individuals -- Independent Responsibility to Act -- Part 3. The Crucial Role of Ethics in (...) Climate Change Policy Making -- Why Has Ethics Failed to Achieve Traction? -- Conclusion: Navigating the Perfect Moral Storm. (shrink)
American healthcare -- Bioterror and bioart -- State of emergency -- Licensed to torture -- Hunger strikes -- War -- Cancer -- Drug dealing -- Toxic tinkering -- Abortion -- Culture of death -- Patient safety -- Global health -- Statue of security -- Pandemic fear -- Bioidentifiers -- Genetic genocide.
A principal challenge facing the progressive bioethics project is the crafting of a consistent message on biopolitical issues that divide progressives. -/- The regulation of enhancement technologies is one of the issues central to this emerging biopolitics, pitting progressive defenders of enhancement, “technoprogressives,” against progressive critics. This essay [PDF] will argue that technoprogressive biopolitics express the consistent application of the core progressive values of the Enlightenment: the right of individuals to control their own bodies, brains and reproduction according to (...) their own conscience, under democratic states that work for the public good. -/- Insofar as left bioconservatives want to ensure the safety of therapies and their equitable distribution, these concerns can be addressed by thorough and independent regulation and a universal health care system, and a progressive bioethics of enhancement can unite both enthusiasts and skeptics. Insofar as bioconservative concerns are motivated by deeper hostility to the Enlightenment project however, by assertion of pre-modern reverence for human uniqueness for instance, then a common program is unlikely. -/- imageAfter briefly reviewing the political history and contemporary landscape of biopolitical debates about enhancement, the essay outlines three meta-policy contexts that will impact future biopolicy: the pressure to establish a universal, cost-effective health insurance system, the aging of industrial societies, and globalization. Technoprogressive appeals are outlined that can appeal to key constituencies, and build a majority coalition in support of progressive change. Finally, some guiding principles for a technoprogressive approach to biopolicy are offered. (shrink)
Globalization has increased the economic power of the multinational corporation (MNC), engendering calls for greater corporate social responsibility (CSR) from these companies. However, the current mechanisms of global governance are inadequate to codify and enforce recognized CSR standards. One method by which companies can impact positively on global governance is through the mechanism of Global Public Policy Networks (GPPN). These networks build on the individual strength of MNCs, domestic governments, and non-governmental organizations to create expected standards of behaviour in (...) such areas as labour rights, environmental standards, and working conditions. This article models GPPN in the issue area of CSR. The potential benefits of GPPN include better overall coordination among industry and government in establishing what social expectations the modern MNC will be expected to fill. (shrink)
Since the mid-1980s, internal corporate investigations have become commonplace in the U. S., with an upsurge occurring as a result of the corporate scandals of 2001-02 involving Adelphi Communications Corporation, Enron, Merck & Company, Riggs Bank, and other companies accused of financial malfeasance. After an introduction, this article first presents the U. S. public policy framework (as implemented through the U. S. Sentencing Commission, the U. S. Department of Justice, and the Securities and Exchange Commission) encouraging the use of (...) corporate internal investigations and self-reporting of these results to federal authorities; second, evaluates this framework, identifying the public policy issues inhibiting companies from using corporate internal investigations and self-reporting significant results; third, proposes a policy incentive regime which attempts to ameliorate these outstanding issues; and fourth, offer policy recommendations and suggestions for further research on this topic, including increasing the maximum deduction in the Organizational Sentencing Guidelines Culpability Score available to a firm for development of an Effective Compliance and Ethics Program (from 3 to 5 points), and self-reporting the results of an internal investigation (from 5 to 7 points); evaluating the effectiveness of these enhancements in legal incentives over a period of 5-7 years after implementation; instituting a formal federal government effort to educate the American business community on the corporate reputation (and financial) benefits of an effective compliance program; and protecting attorney-client privilege and work product protection, through legislative action, to encourage company executives and directors to utilize independent, outside attorneys to conduct fair, comprehensive, and impartial internal investigations. (shrink)
In response to political pressures arising from controversial science policy decisions, the United Kingdom (UK) government conducted a review of its biotechnology governance framework in 1999, identifying best practices of open government and creating strategic bodies to adopt them. Drawing from empirical data on the context and nature of the open government framework, this paper argues that the framework may be interpreted as elasticizing objectivity. Value-neutral scientific objectivity is essentially 'stretched' into a pluralist objectivity that purports (...) to represent a spectrum of interests without privileging any, allowing the policy culture to retain its legitimating objectivity and authority. Governance implications of this analysis are discussed. (shrink)
The article examines the role played by policy advice institutions in the governance of ethically controversial new and emerging science and technology in Europe. The empirical analysis, which aims to help close a gap in the literature, focuses on the evolution, role and functioning of national ethics advisory bodies (EABs) in Europe. EABs are expert bodies whose remit is to issue recommendations regarding ethical aspects of new and emerging science and technology. Negative experiences with the impacts of science and (...) technology in the past have resulted in calls for increased transparency and broader participation and pluralism in expert advice and policy decision-making. Do national EABs function as inclusive, anticipatory “hybrid forums”? Or do they resemble more “classical” expert-oriented bodies, inspired by technocratic or decisionist approaches? As part of the empirical analysis of the role and functioning of institutional ethical advisory structures in 32 European countries, an extensive analysis of EAB websites and the content of publicly available documents on such institutions has been carried out, supplemented by an online survey of representatives of the EABs. One major finding of the empirical analysis is the very uneven distribution of “hybrid forum” features of EABs across Europe. (shrink)
This volume investigates human genetic biobanking and its regulation in various Asian countries and areas, including Japan, Mainland China, Taiwan, Hong Kong, ...
IRBs in action -- Everyone's an expert? Warrants for expertise -- Local precedents -- Documents and deliberations: an anticipatory perspective -- Setting IRBs in motion in Cold War America -- An ethics of place -- The many forms of consent -- Deflecting responsibility -- Conclusion: the making of ethical research.
The book challenges the values of much of contemporary bioethics and health care policy by confronting their failure to secure the moral norms they seek to apply.
The continuous rise in the profile of the environment in politics reflects growing concern that we may be facing a large-scale ecological crisis. The new edition of this highly acclaimed textbook surveys the politics of the environment, providing a comprehensive and comparative introduction to its three components: ideas, activism and policy. Part I explores environmental philosophy and green political thought; Part II considers parties and environmental movements; and Part III analyses policy-making and environmental issues at international, national and (...) local levels. This second edition has been thoroughly updated with new and revised discussions of many topics including the ecological state, ecological citizenship, ecological modernisation and the Greens in government and also includes an additional chapter on 'Globalisation, Trade and the Environment'. As well as considering a wide variety of examples from around the world, this textbook features a glossary, guides to further study, chapter summaries and critical questions throughout. (shrink)
Stem cell research. Drug company influence. Abortion. Contraception. Long-term and end-of-life care. Human participants research. Informed consent. The list of ethical issues in science, medicine, and public health is long and continually growing. These complex issues pose a daunting task for professionals in the expanding field of bioethics. But what of the practice of bioethics itself? What issues do ethicists and bioethicists confront in their efforts to facilitate sound moral reasoning and judgment in a variety of venues? Are (...) those immersed in the field capable of making the right decisions? How and why do they face moral challenge -- and even compromise -- as ethicists? What values should guide them? In The Ethics of Bioethics, Lisa A. Eckenwiler and Felicia G. Cohn tackle these questions head on, bringing together notable medical ethicists and people outside the discipline to discuss common criticisms, the field's inherent tensions, and efforts to assign values and assess success. Through twenty-five lively essays examining the field's history and trends, shortcomings and strengths, and the political and policy interplay within the bioethical realm, this comprehensive book begins a much-needed critical and constructive discussion of the moral landscape of bioethics. (shrink)
Medicine and health care generate many bioethical problems and dilemmas that are of great academic, professional and public interest. This comprehensive resource is designed as a succinct yet authoritative text and reference for clinicians, bioethicists, and advanced students seeking a better understanding of ethics problems in the clinical setting. Each chapter illustrates an ethical problem that might be encountered in everyday practice; defines the concepts at issue; examines their implications from the perspectives of ethics, law and policy; and then (...) provides a practical resolution. There are 10 key sections presenting the most vital topics and clinically relevant areas of modern bioethics. International, interdisciplinary authorship and cross-cultural orientation ensure suitability for a worldwide audience. This book will assist all clinicians in making well-reasoned and defensible decisions by developing their awareness of ethical considerations and teaching the analytical skills to deal with them effectively. (shrink)
The aim of this article is to further our understanding of the “GM is unnatural” view, and of the critical response to it. While many people have been reported to hold the view that GM is unnatural, many policy-makers and their advisors have suggested that the view must be ignored or rejected, and that there are scientific reasons for doing so. Three “typical” examples of ways in which the “GM is unnatural” view has been treated by UK policy-makers (...) and their advisors are explored. These are the Government’s position (DEFRA Report), the account of the Nuffield Council on Bioethics, and the position of Nigel Halford, a scientist with an advisory role to the Government. I show that their accounts fail to mount a convincing critique. Then, I draw on an empirical research project held during 2003–2004 at the University of Newcastle-upon-Tyne in the north east of England. Scientists met with non-scientists in a range of facilitated one-to-one conversations (“exchanges”) on various environmental issues, one of which was on GM. Our findings show that some scientists who rejected the “GM is unnatural” view struggled to do so consistently. Their struggle is interpreted in terms of a conflict between a so-called “scientific” worldview, and a different worldview that underlies the concerns of those who held the “GM is unnatural” view. This worldview is explored further by an examination of their concerns. What distinguishes this worldview from the “scientific” worldview is that the instrumentalization of the nonhuman world is questioned to a larger extent. I conclude that, because the underlying concerns of those who held the “GM is unnatural” view were not with GM as such, yet with a worldview that was considered to be problematic, and of which many GM applications were held to be expressions, policy-makers and their advisors should reflect on the critical worldview of those who claim that GM is unnatural if they want to engage seriously with their concerns. (shrink)
This collection of papers explores one of the central debates in the field of bioethics in the new century. It evaluates the controversy between the claim that there is a common morality accepted by all and the opposing view that there are different moral visions and moral rationalities, within which complex bioethical issues demand a solution. Contributions within this volume offer different approaches and perspectives on the pursuit of global ethics in the new century. They are organized under five (...) major themes. The first theme explores the different plausible understandings of the foundations of bioethics and contemporary reflections on the nature and role of moral theory. The second theme analyses the impact of moral loss and moral diversity on the character of bioethics and the search for alternative perspectives in post-traditional and post-modern societies. The third theme examines a number of theoretical issues raised by concrete examples of bioethnological applications, which bear importantly on contemporary debates between the possibility and impossibility of global bioethics. The fourth theme discusses examples of moral conflicts and dilemmas in everyday health care practice regarding the permissible treatment of humans by humans under different ethical perspectives and cultural traditions. The fifth theme explores alternative suggestions for opening up new modes of self-understanding and new strategies for bioethical exploration in the new century. The volume is an important work of reference for philosophers, moral theologians, ethicists, counsellors, doctors, nurses, sociologists, journalists, health care professionals, public policy makers and everyone who is interested in the profound ethical issues arising from modern technological advancements which are not only transforming our lives but are also demanding urgent ethical decision-making and `pragmatic' solutions from a cross-cultural perspective. (shrink)
In this book, developed by a group of collaborating scholars in bioethics from different European countries, an overview is given of the most salient themes in present-day bioethics. The themes are discussed in order to enable the reader to have an in-depth overview of the state of the art in bioethics. Introductory chapters will guide the reader through the relevant dimensions of a particular area, while subsequent case discussions will help the reader to apply the ethical theories (...) to specific clinical problems and health policy queries. The book focuses on perspectives typical for the European context. This highlights not only particular bioethical themes such as social justice, choices in health care, and health policy (e.g., in post-communist countries), it also emphasizes specific approaches in ethical theory, in relation to Continental philosophies such as phenomenology and hermeneutics. Because of its articulation of what is typical for the European health care setting as well as for bioethical debate, this book is unique in comparison to existing textbooks in bioethics. The book is an introductory textbook acquainting the reader with the major issues in present-day health care as well as the various theoretical and practical approaches to clarify these issues. (shrink)
(2012). Ethics of Science for Policy in the Environmental Governance of Biotechnology: MON810 Maize in Europe. Ethics, Policy & Environment: Vol. 15, No. 3, pp. 321-340. doi: 10.1080/21550085.2012.730245.
Bioethics promises a considered, unprejudicial approach to areas of medical decision-making. It does this, in theory, from the perspective of moral philosophy. But the promise of fairly considered, insightful commentary fails when word choices used in ethical arguments are prejudicial, foreclosing rather than opening an area of moral discourse. The problem is illustrated through an analysis of the language of The Royal Society Expert Panel Report: End of Life Decision Making advocating medical termination.
How can one be both a philosophical ethicist and a democrat? In this article I conclude that it can be difficult to reconcile the two roles. One involves understanding, and reconciling, the conflicting views of citizens, and the other requires the pursuit of truth through reason. Nevertheless, an important function of philosophy and ethics is to inform and improve policy. If done effectively, we could expect better, and more just, laws and policies, thereby benefiting many lives. So applying philosophical (...) thinking to policy is an important job. However, it comes with substantial difficulties, not least in reconciling, or choosing between, competing philosophical theories. Despite the importance of the task, and the apparent obstacles, there is relatively little literature on how to apply ethics to real-world policy-making. Democracies need ethicists who can engage in democratic debate and bridge the gap between philosophy and public policy. I offer some tactics here. (shrink)
A collection celebrating some of the best essays from the Blackwell journals, Bioethics and Developing World Bioethics. Contributors include Helga Kuhse, Michael Selgelid and Baroness Mary Warnock, former Chair of the British Government’s Committee of Inquiry into Human Fertilization and Embryology’s. Traces some of the most important concerns of the 1980s, such as the ethics of euthanasia, reproductive technologies, the allocation of scarce medical resources, surrogate motherhood, through to a range of new issues debated today, particularly in (...) the field of genetics. Includes contributions that are still as hotly debated today as they were 20 years ago and serves as a salutary reminder that free and open discussion is vital to the health of the discipline itself. Includes eight sections comprising some of the journals' best publications in methodological issues, the health care professional-patient relationship, public health ethics, research ethics, genetics, as well as beginning- and end-of-life issues. Will serve the academic bioethicists as well as students of bioethics as an excellent source book. (shrink)
When the journal Minerva was founded in 1962, science and higher educational issues were high on the agenda, lending impetus to the interdisciplinary field of “Science Studies” qua “Science Policy Studies.” As government expenditures for promoting various branches of science increased dramatically on both sides of the East-West Cold War divide, some common issues regarding research management also emerged and with it an interest in closer academic interaction in the areas of history and policy of science. Through (...) a close reading of many early issues of Minerva but also of its later competitor journal Science Studies (now called Social Studies of Science) the paper traces the initial optimism of an academically based Science Studies dialogue across the Cold War divide and the creation in 1971 of the International Commission for Science Policy Studies as a bridging forum, one that Minerva strangely chose to ignore. In this light, attention is drawn to aspects of the often forgotten history of Science Studies in the former Soviet Union and the Eastern European block. Reviewed also are several early discussions that are still relevant today: e.g., regarding differing concepts of Big Science, science and democracy, autonomy in higher education and what conditions are necessary to sustain academic freedom and scientific integrity (some of Edward Shils’ primary concerns). Finally, it is noted how the question of quantitative methods to measure scientific productivity lay at the heart of a “Science of Science” movement of the 1960s has re-emerged in a new form integral to the notion of a “Science of Science Policy.”. (shrink)
This paper argues that some of the misunderstandings surrounding the meaning and function of the concept of human dignity in bioethics arise from a lack of distinction between two different roles that this notion plays: one as an overarching policy principle, and the other as a moral standard of patient care. While the former is a very general concept which fulfils a foundational and a guiding role of the normative framework governing biomedical issues, the latter reflects a much (...) more concrete and context-specific understanding of the patient as a “person”. The importance of dignity as a policy principle will be described by appealing to the distinction between principles and rules as developed by some legal philosophers. The value of dignity as a standard of patient care will be illustrated with the help of concrete examples and by drawing on the taxonomies of dignity proposed by Jonathan Mann and other scholars. The overall scope of the article is to highlight this double and complementary role of human dignity in bioethics. (shrink)
Bioethics represents a dramatic revision of the centuries-old professional ethics that governed the behavior of physicians and their relationships with patients. This venerable ethics code was challenged in the years after World War II by the remarkable advances in the biomedical sciences and medicine that raised questions about the definition of death, the use of life-support systems, organ transplantation, and reproductive interventions. In response, philosophers and theologians, lawyers and social scientists joined together with physicians and scientists to rethink and (...) revise the old standards. Governments established commissions to recommend policies. Courts heard arguments and legislatures passed laws. This book is the first broad history of the growing field of bioethics. Covering the period 1947-1987, it examines the origin and evolution of the debates over human experimentation, genetic engineering, organ transplantation, termination of life-sustaining treatment, and new reproductive technologies. It assesses the contributions of philosophy, theology, law and the social sciences to the expanding discourse of bioethics. Written by one of the field's founders, The Birth of Bioethics is based on extensive archival research into sources that are difficult to obtain and on interviews with many of the leading figures in the moral debates in medicine. A very readable and comprehensive account of the evolution of bioethics, this book stresses the history of ideas but does not neglect the social and cultural context and the people involved. It will serve the information needs of philosophers, ethicists, social historians, and everyone interested in the origins of some of today's most hotly debated issues. (shrink)
Background Public satisfaction with policy process influences the legitimacy and acceptance of policies, and conditions the future political process, especially when contending ethical value judgments are involved. On the other hand, public involvement is required if effective policy is to be developed and accepted. Methods Using the data from a large-scale national opinion survey, this study evaluates public appraisal of past government efforts to legalize organ transplant from brain-dead bodies in Japan, and examines the public's intent to (...) participate in future policy. Results A relatively large percentage of people became aware of the issue when government actions were initiated, and many increasingly formed their own opinions on the policy in question. However, a significant number (43.3%) remained unaware of any legislative efforts, and only 26.3% of those who were aware provided positive appraisals of the policymaking process. Furthermore, a majority of respondents (61.8%) indicated unwillingness to participate in future policy discussions of bioethical issues. Multivariate analysis revealed the following factors are associated with positive appraisals of policy development: greater age; earlier opinion formation; and familiarity with donor cards. Factors associated with likelihood of future participation in policy discussion include younger age, earlier attention to the issue, and knowledge of past government efforts. Those unwilling to participate cited as their reasons that experts are more knowledgeable and that the issues are too complex. Conclusions Results of an opinion survey in Japan were presented, and a set of factors statistically associated with them were discussed. Further efforts to improve policy making process on bioethical issues are desirable. (shrink)
: The President's Council on Bioethics has tried to make a distinctive contribution to the methodology of such public bodies in developing what it has styled a "richer bioethics." The Council's procedure contrasts with more modest methods of public bioethical deliberation employed by the United Kingdom's Warnock Committee. The practices of both bodies are held up against a backdrop of concerns about moral and political alienation, prompted by the limitations of moral reasoning and by moral dissent from state (...)policy under even the most democratic of governments. Although the President's Council's rhetoric is often scrupulously conciliatory, recurring features of its argumentative practice are regrettably divisive. They order these things better in Britain. (shrink)
As corporate social responsibility involves a voluntary business endeavour to address social and environmental issues beyond legal compliance, governments cannot fall back on hierarchical command-and-control policies to support it. As such, it is complementary with the increasing popularity of public policies known as New Governance policies, where the government is engaged in a horizontal inter-organizational network of societal actors and where public policy is both formed and executed by the interacting and voluntary efforts from a multitude of stakeholders. (...) However, such policies are known to generate substantive uncertainty about the content of CSR and its related issues, strategic uncertainty regarding the behavior of the actors involved and institutional uncertainty related to the interaction process involved in the institutional change. We explore New Governance policy instruments to address these uncertainties in the context CSR and discuss the experiences with these methods in the European Union. (shrink)
This paper discusses the viability of a virtue-based approach to bioethics. Virtue ethics is clearly appropriate to addressing issues of professional character and conduct. But another major remit of bioethics is to evaluate the ethics of biomedical procedures in order to recommend regulatory policy. How appropriate is the virtue ethics approach to fulfilling this remit? The first part of this paper characterizes the methodology problem in bioethics in terms of diversity, and shows that virtue ethics does (...) not simply restate this problem in its own terms. However, fatal objections to the way the virtue ethics approach is typically taken in bioethics literature are presented in the second section of the paper. In the third part, a virtue-based approach to bioethics that avoids the shortcomings of the typical one is introduced and shown to be prima facie plausible. The upshot is an inviting new direction for research into bioethics' methodology. (shrink)
In this article we distinguish between philosophical bioethics (PB), descriptive policy orientated bioethics (DPOB) and normative policy oriented bioethics (NPOB). We argue that finding an appropriate methodology for combining empirical data and moral theory depends on what the aims of the research endeavour are, and that, for the most part, this combination is only required for NPOB. After briefly discussing the debate around the is/ought problem, and suggesting that both sides of this debate are misunderstanding (...) one another (i.e. one side treats it as a conceptual problem, whilst the other treats it as an empirical claim), we outline and defend a methodological approach to NPOB based on work we have carried out on a project exploring the normative foundations of paternal rights and responsibilities. We suggest that given the prominent role already played by moral intuition in moral theory, one appropriate way to integrate empirical data and philosophical bioethics is to utilize empirically gathered lay intuition as the foundation for ethical reasoning in NPOB. The method we propose involves a modification of a long-established tradition on non-intervention in qualitative data gathering, combined with a form of reflective equilibrium where the demands of theory and data are given equal weight and a pragmatic compromise reached. (shrink)
The report of the President's Council on Bioethics, Human Cloning and Human Dignity, addresses the central ethical, political, and policy issue in human embryonic stem cell research: the moral status of extracorporeal human embryos. The Council members were in sharp disagreement on this issue and essentially failed to adequately engage and respectfully acknowledge each others' deepest moral concerns, despite their stated commitment to do so. This essay provides a detailed critique of the two extreme views on the Council (...) (i.e., embryos have full moral status or they have none at all) and then gives theoretical grounding for our judgment about the intermediate moral status of embryos. It also supplies an account of how to address profound moral disagreements in the public arena, especially by way of constructing a middle ground that deliberately pays sincere respect to the views of those with whom it has deep disagreements. (shrink)
The Social Issues in Management Division has had a long history of research into various aspects of governmental influences on business. Recent years, however, have seen stakeholder theory sort of sweep the field, and under a stakeholder theory of capitalism, governments will matter less then they have in the past as stakeholder principles are implemented throughout the corporate world. This article will examine the nature of this claim by discussing problems with the implementation of stakeholder theory and examining the role (...) of public policy in our society. (shrink)
This essay addresses a moral and cultural challenge facing health care in the People’s Republic of China: the need to create an understanding of medical professionalism that recognizes the new economic realities of China and that can maintain the integrity of the medical profession. It examines the rich Confucian resources for bioethics and health care policy by focusing on the Confucian tradition’s account of how virtue and human flourishing are compatible with the pursuit of profit. It offers the (...) Confucian account of the division of labor and the financial inequalities this produces with special attention to China’s socialist project of creating the profession of barefoot doctors as egalitarian peasant physicians and why this project failed. It then further develops the Confucian acknowledgement of the unequal value of different services and products and how this conflicts with the current system of payment to physicians which has led to the corruption of medical professionalism through illegal supplementary payments. It further gives an account the oblique intentionality of Confucian moral psychology that shows how virtuous persons can pursue benevolent actions while both foreseeing profit and avoiding defining their character by greed. This account of Confucian virtue offers the basis for a medical professionalism that can function morally within a robustly profit-oriented market economy. The paper concludes with a summary of the characteristics of Confucian medical professionalism and of how it places the profit motive within its account of virtue ethics. (shrink)
There is a widespread feeling that health is special; the rules that are usually used in other policy areas are not applied in health policy. Health economists, for example, tend to be reluctant to offer economists’ usual prescription of competition and consumer choice, even though they have largely failed to justify this reluctance by showing that health economics involves special features such as public goods, externalities, adverse selection, poor consumer information, or unusually severe consequences. Similarly, while some philosophers (...) argue for bioethical conclusions based on very general ethical intuitions,1 many others rely on moral intuitions that are specific to health and medicine to draw conclusions that are meant to apply mainly in health and medicine. For example, many authors appear to start from the strong moral intuition that it typically seems wrong to deny poor people access to health care, and then seek moral principles that can both account for such intuitions and justify the claim that people have some sort of right to health care.2 In metaethics, opinions on moral intuitions range from an extreme intuitionism, which accepts all case-specific moral intuitions at face value as reliable moral guides, to an extreme foundationalism, which rejects such intuitions as evidence regarding correct general moral principles. Between these extremes, opinions vary on how severe the errors in our moral intuitions are. The practice of bioethics seems to favor the extreme intuitionist end of this spectrum, and thus implicitly expects mild errors.3 In contrast, this essay will suggest that common practice in bioethics has seriously underestimated the errors in our moral intuitions. In this essay, I consider the evolutionary origin of our moral intuitions, but avoid the extreme positions of moral skepticism and “whatever evolved must be good,” both of which are commonly associated with evolution-. (shrink)
Medicalization has been a process articulated primarily by social scientists, historians, and cultural critics. Comparatively little is written about the role of bioethics in appraising medicalization as a social process. The authors consider what medicalization means, its definition, functions, and criteria for assessment. A series of brief case sketches illustrate how bioethics can contribute to the analysis and public policy discussion of medicalization.
Contemporary food supply chains are generating externalities with high economic and social costs, notably in public health terms through the rise in diet-related non-communicable disease. The UK State is developing policy strategies to tackle these public health problems alongside intergovernmental responses. However, the governance of food supply chains is conducted by, and across, both private and public spheres and within a multilevel framework. The realities of contemporary food governance are that private interests are key drivers of food supply chains (...) and have institutionalized a great deal of standards-setting and quality, notably from their locations in the downstream and midstream sectors. The UK State is designing some downstream and some midstream interventions to ameliorate the public health impacts of current food consumption patterns in England. The UK State has not addressed upstream interventions towards public health diet at the primary food production and processing stages, although traditionally it has shaped agricultural policy. Within the realities of contemporary multilevel governance, the UK State must act within the contexts set by the international regimes of the Common Agricultural Policy and the World Trade Organization agreements, notably on agriculture. The potential for further upstream agricultural policy reform is considered as part of a wider policy approach to address the public health externalities issuing from contemporary food supply chains within this multilevel governance context. (shrink)
Bioethics is a hybrid discipline. As a theoretical enterprise it stands for untrammeled inquiry and argument. Yet it aims to influence medical practice and policy. In this article we explore tensions between these two dimensions of bioethics and examine the merits and perils of a “Socratic” approach to bioethics that challenges “the conventional wisdom.”.
Many commentators today lament the politicization of bioethics, but some suggest distinguishing among different kinds of politicization. This essay pursues that idea with reference to three traditions of political thought: liberalism, communitarianism, and republicanism. After briefly discussing the concept of politicization itself, the essay examines how each of these political traditions manifests itself in recent bioethics scholarship, focusing on the implications of each tradition for the design of governmentbioethics councils. The liberal emphasis on the irreducible (...) plurality of values and interests in modern societies, and the communitarian concern with the social dimensions of biotechnology, offer important insights for bioethics councils. The essay finds the most promise in the republican tradition, however, which emphasizes institutional mechanisms that allow bioethics councils to enrich but not dominate public deliberation, while ensuring that government decisions on bioethical issues are publicly accountable and contestable. (shrink)
Although images are pervasive in public policy debates in bioethics, few who work in the field attend carefully to the way that images function rhetorically. If the use of images is discussed at all, it is usually to dismiss appeals to images as a form of manipulation. Yet it is possible to speak meaningfully of visual arguments. Examining the appeal to images of the embryo and fetus in debates about abortion and stem cell research, I suggest that bioethicists (...) would be well served by attending much more carefully to how images function in public policy debates. (shrink)
Even if there is a common morality, many would argue that it provides little guidance in resolving moral disputes, because universally accepted norms are both general in content and few in number. However, if we supplement common morality with commonly accepted factual beliefs and culture-specific norms and utilize coherentist reasoning, we can limit the range of acceptable answers to disputed issues. Moreover, in the arena of public policy, where one must take into account both legal and moral norms, the (...) constraints on acceptable answers will narrow the extent of reasonable disagreement even further. A consideration of the debate over legalization of assisted dying supports this claim. (shrink)
Since the 1980s, Islamic scholars and medical experts have used the tools of Islamic law to formulate ethico-legal opinions on brain death. These assessments have varied in their determinations and remain controversial. Some juridical councils such as the Organization of Islamic Conferences' Islamic Fiqh Academy (OIC-IFA) equate brain death with cardiopulmonary death, while others such as the Islamic Organization of Medical Sciences (IOMS) analogize brain death to an intermediate state between life and death. Still other councils have repudiated the notion (...) entirely. Similarly, the ethico-legal assessments are not uniform in their acceptance of brain-stem or whole-brain criteria for death, and consequently their conceptualizations of, brain death. Within the medical literature, and in the statements of Muslim medical professional societies, brain death has been viewed as sanctioned by Islamic law with experts citing the aforementioned rulings. Furthermore, health policies around organ transplantation and end-of-life care within the Muslim world have been crafted with consideration of these representative religious determinations made by transnational, legally-inclusive, and multidisciplinary councils. The determinations of these councils also have bearing upon Muslim clinicians and patients who encounter the challenges of brain death at the bedside. For those searching for ‘Islamically-sanctioned’ responses that can inform their practice, both the OIC-IFA and IOMS verdicts have palpable gaps in their assessments and remain clinically ambiguous. In this paper we analyze these verdicts from the perspective of applied Islamic bioethics and raise several questions that, if answered by future juridical councils, will better meet the needs of clinicians and bioethicists. (shrink)
Missouri, the "Show Me State," has become the epicenter of several important national public policy debates, including abortion rights, the right to choose and refuse medical treatment, and, most recently, early stem cell research. In this environment, the Center for Practical Bioethics (formerly, Midwest Bioethics Center) emerged and grew. The Center's role in these "cultural wars" is not to advocate for a particular position but to provide well researched and objective information, perspective, and advocacy for the ethical (...) justification of policy positions; and to serve as a neutral convener and provider of a public forum for discussion. In this article, the Center's work on early stem cell research is a case study through which to argue that not only the Center, but also the field of bioethics has a critical role in the politics of public health policy. (shrink)
I consider the problem liberalism poses for bioethics.Liberalism is a view that advocates that the state remain neutralto views of the good life. This view is sometimes supported by askeptical moral epistemology that tends to propel liberalismtoward libertarianism. I argue that the possibilities for sharedagreement on moral matters are more promising than is sometimesappreciated by such a view of liberalism. Using two examples ofpublic debates of moral issues, I show that commonly sharedintuitions may ground moral principles even if they (...) may be givendifferent weight by persons of different moral and religioustraditions. Nevertheless, the fact that the intuition andprinciple is widely shared may be sufficient to chart somedirections for public policy or cooperative action even if theydo not lead to complete agreement. As a result, I argue that aliberal communitarianism that presupposes a fairly minimalistepistemology is a legitimate approach to achieving sharedagreement in a pluralistic society. (shrink)
The American Society for Bioethics and Humanities debated for several years about whether it should adopt positions and, if so, on what range of issues. The membership recently approved an amendment to its bylaws permitting the Society to adopt positions on matters related to academic freedom and professionalism but not on substantive moral and policy issues. This resolution is problematic for a number of reasons, including the lack of a categorical difference between these types of claims and the (...) Society's inability to speak on behalf of patients and research subjects. The implementation of the amendment also raises several issues. The Society will need to refrain from speaking too specifically and to articulate the responsibilities of its members. If the Society fails to address these concerns, it runs the risk of denigrating its public image and that of the profession. (shrink)
