In a world of rapid technological advances, the moral issues raised by life and death choices in healthcare remain obscure. Life and Death in Healthcare Ethics provides a concise, thoughtful and extremely accessible guide to these moral issues. Helen Watt examines, using real-life cases, the range of choices taken by healthcare professionals, patients and clients which lead to the shortening of life. The topics looked at include: euthanasia and withdrawal of treatment; the persistent vegetative state; abortion; (...) IVF and cloning; and life-saving treatment of pregnant women. (shrink)
Death, Posthumous Harm, and Bioethics offers a highly distinctive and original approach to the metaphysics of death and applies this approach to contemporary debates in bioethics that address end-of-life and post-mortem issues.
Drawing on the moving story of the last year of the life of her own treasured dog, Ody, she presents an in-depth exploration of the practical, medical, and moral issues that trouble pet owners confronted with the decline and death of their ...
In 1985, philosopher Samuel Gorovitz spent seven weeks at Boston's Beth Israel, one of the nation's premier teaching hospitals, where he was given free run as "Authorized Snoop and Irritant-at-Large." In Drawing the Line, he provides an intense, disturbing, and insightful account of his observations during those seven weeks. Gorovitz guides us through an operating room and intensive care units, and takes us to meetings where surgeons discuss the mishaps of the preceding week, where internists map out their approaches to (...) troublesome cases, where the administration discusses competition in the health care market. He follows as residents walk the ragged edge of physical exhaustion, as experienced physicians wrestle with the uncertainties of their demanding profession, as nurses struggle to care for perpetually declining patients. Most important, he examines the ethical questions that permeate their lives--deeply troubling questions such as who should be making life and death decisions--and how should they be made? How should scarce medical resources be allocated? What rules should govern the use of fetal tissue in research and treatment? Where should we draw the line, and how? When Samuel Gorovitz published Doctors' Dilemmas, a previous look at medical ethics, it was hailed by Norman Cousins as "stimulating and valuable...the product of a beautifully formed (and informed) mind." Studs Terkel called it "quite remarkable...a very exciting book indeed." In Drawing the Line, Gorovitz offers an unusual look at contemporary health care, combining a moving, hard-hitting glimpse of daily reality at a major hospital with the thoughtful, provocative reflections of a highly respected philosopher. (shrink)
Amid the controversies surrounding physician-assisted suicides, euthanasia, and long-term care for the elderly, a major component in the ethics of medicine is notably absent: the rights and welfare of the survivor's family, for whom serious illness and death can be emotionally and financially devastating. In this collection of eight provocative and timely essays, John Hardwig sets forth his views on the need to replace patient-centered bioethics with family-centered bioethics. Starting with a critique of the awkward language with which philosphers (...) argue the ethics of personal relationships, Hardwig goes on to present a general statement on the necessity of family-centered bioethics. He reflects on proxy decisions, the effects of elder care on the family, the financial and lifestyle consequences of long-term care, and physician-assisted suicide from the perspective of the family. His penultimate essay, "Is There a Duty to Die?" carries the idea of family-centered ethics to its logical, controversial, conclusion; comments upon this essay from Daniel Callahan, Larry Churchill, Joanne Lynn, and journalist Nat Hentoff offer differing views on this highly charged subject. As advances in medicine prolong patient's lives, the welfare of those ultimately responsible for medical care-the family-must be addressed. Hardwig's courageous and illuminating essays set forth a new direction in bioethics: one that considers the welfare of everyone concerned. (shrink)
1. The traditional position and the pressures for change. The Western legal tradition -- The Christian ethical hinterland -- The exceptional value of human life -- The justification of taking human life -- Suicide -- Christian ethics, assisted suicide, and voluntary euthanasia -- The cultural pressures for change -- 2. The value of human life -- 3. The morality of acts of killing -- 4. Slippery slopes.
In this book, C. G. Prado addresses the difficult question of when and whether it is rational to end one’s life in order to escape devastating terminal illness. He specifically considers this question in light of the impact of multiculturalism on perceptions and judgments about what is right and wrong, permissible and impermissible. Prado introduces the idea of a “coincidental culture” to clarify the variety of values and commitments that influence decision. He also introduces the idea of a “proxy premise” (...) to deal with reasoning issues that are raised by intractably held beliefs. Primarily intended for medical ethicists, this book will be of interest to anyone concerned about the ability of modern medicine to keep people alive, thereby forcing people to choose between living and dying. In addition, Prado calls upon medical ethicists and practitioners to appreciate the value of a theoretical basis for their work. (shrink)
Margaret Pabst Battin has established a reputation as one of the top philosophers working in bioethics today. This work is a sequel to Battin's 1994 volume The Least Worst Death. The last ten years have seen fast-moving developments in end-of-life issues, from the legalization of physician-assisted suicide in Oregon and the Netherlands to furor over proposed restrictions of scheduled drugs used for causing death, and the development of "NuTech" methods of assistance in dying. Battin's new collection covers a (...) remarkably wide range of end-of-life topics, including suicide prevention, AIDS, suicide bombing, serpent-handling and other religious practices that pose a risk of death, genetic prognostication, suicide in old age, global justice and the "duty to die," and suicide, physician-assisted suicide, and euthanasia, in both American and international contexts. As with the earlier volume, these new essays are theoretically adroit but draw richly from historical sources, fictional techniques, and ample factual material. (shrink)
Is it permissible to use a human embryo in stem cell research, or in general as a means for benefit of others? Acknowledging each embryo as an object of moral concern, Louis M.Guenin argues that it is morally permissible to decline intrauterine transfer of an embryo formed outside the body, and that from this permission and the duty of beneficence, there follows a consensus justification for using donated embryos in service of humanitarian ends. He then proceeds to show how (...) this justification commands assent even within moral and religious views commonly thought to oppose embryo use. Beneath his moral reasoning lies a carefully constructed metaphysical foundation incorporating accounts of the ontology of development, embryos, and species. He also incisively discusses nonreprocloning, reprocloning, ectogenesis, and related scientific frontiers. This compelling philosophical study will interest all concerned to understand virtue and obligation in the relief of suffering. (shrink)
Machine generated contents note: Preface; Acknowledgements; 1. Why medicine needs moral leaders; 2. Creating an organizational narrative; 3. Understanding normative expectations in medical moral leadership; Prologue to chapters four and five; 4. Expressing fiduciary, bureaucratic and collegial propriety; 5. Expressing inquisitorial and restorative propriety; Epilogue to chapters four and five; 6. Understanding organizational moral narrative; 7. Moral leadership for ethical organizations; Appendix 1. How the research was done; Appendix 2. Accountability for clinical performance: individuals and (...) organisations; Appendix 3. A brief guide to commonly used ethical frameworks; Index. (shrink)
All investigators funded by the National Institutes of Health are now required to receive training about the ethics of clinical research. Based on a course taught by the editors at NIH, Ethical and Regulatory Aspects of Clinical Research is the first book designed to help investigators meet this new requirement. The book begins with the history of human subjects research and guidelines instituted since World War II. It then covers various stages and components of the clinical trial process: (...) designing the trial, recruiting participants, ensuring informed consent, studying special populations, and conducting international research. Concluding chapters address conflicts of interest, scientific misconduct, and challenges to the IRB system. The appendix provides sample informed consent forms. This book will be used in undergraduate courses on research ethics and in schools of medicine and public health by students who are or will be carrying out clinical research. Professionals in need of such training and bioethicists also will be interested. (shrink)
Summary The author of the paper studies the ethical views of Matthias Bel expressed in his Preface to Johann Arndt's treatise and in Davidian-Solomonian Ethics, which contain a critique of false Christianity and ancient (especially Aristotle's) ethics. Bel refuses any philosophical ethics based on human nature, since man, in his very essence, is sinful and vicious. This leads to the general moral downfall of the young and mankind. He only recognises ethics whose source and the highest good is (...) God. He accepts ancient ethics as long as it is useful for achieving Christian moral values. Bel was a vociferous critic of the morality of the time; he adopted a highly negative stance towards the Jews and Gypsies living in the then Historical Hungary. The author considers Matthias Bel a confident, or enthusiastic, Pietist in the early period of his life and work; later, he rates him as a moderate Pietist. (shrink)
Two recent events have caused renewed anxiety concerning the ethics of donor transplantation. The first is the report of the British Transplantation Society and the second is the Bill introduced by Mr Tam Dalyell MP (see page 61 of this issue) in which he seeks to establish by law that unless an individual in his life time has expressly contracted out his organs may after death be used for transplantation. Dr Mahoney in this paper therefore examines from the point (...) of view of ethics some of the personal and social aspects of both proposals. (shrink)
How is feminism changing the way women and men think, feel, and act? Virginia Held explores how feminist theory is changing contemporary views of moral choice. She proposes a comprehensive philosophy of feminist ethics, arguing persuasively for reconceptualizations of the self of relations between the self and others and of images of birth and death, nurturing and violence. Held shows how social, political, and cultural institutions have traditionally been founded upon masculine ideals of morality. She then identifies a (...) distinct feminist morality that moves beyond culturally embedded notions about motherhood and female emotionality. Examining the effects of this alternative moral and ethical system on changing social values, Held discusses its far-reaching implications for altering standards of freedom, democracy, equality, and personal development. Ultimately, she concludes, the culture of feminism could provide a fresh perspective on--even solutions to--contemporary social problems. Feminist Morality makes a vital contribution to the ongoing debate in feminist theory on the importance of motherhood. For philosophers and other readers outside feminist theory, it offers a feminist moral and social critique in clear and accessible terms. (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)
As palliative care develops across many of the countries of Europe, we find that it continues to raise important ethical challenges. Palliative care practice requires ethical sensitivity and understanding. At the same time the very existence of palliative care calls for ethical explanation. Ethics and palliative care meet over some vital issues: 'the good death', sedation at the end of life, requests for euthanasia, futile treatment, and the role of research. Yet palliative care appears uncertain about (...) its goals and there is evidence that its ethical underpinnings are changing. Likewise, the moral problems of palliative care are only partly served by the four 'principles' of modern bioethics. This innovative book, with contributions by clinicians, ethicists, philosophers and social scientists, provides the first ever picture of palliative care ethics in the European context. It will be of interest to those involved in the delivery and management of palliative care services, as well as to students and researchers. (shrink)
In order to rebut G. E. Moore’s open question argument, ethical naturalists adopt a theory of direct reference for our moral terms. T. Horgan and M. Timmons have argued that this theory cannot be applied to moral terms, on the ground that it clashes with competent speakers’ linguistic intuitions. While Putnam’s Twin Earth thought experiment shows that our linguistic intuitions confirm the theory of direct reference, as applied to ‘water’, Horgan and Timmons devise a parallel thought experiment (...) about moral terms, in order to show that this theory runs against our linguistic intuitions about such terms. My claim is that the Horgan–Timmons argument does not work. I concede that their thought experiment is a good way to test the applicability of the theory of direct reference to moral terms, and argue that the upshot of their experiment is not what they claim it is: our linguistic intuitions about Moral Twin Earth are parallel to, not different from, our intuitions about Twin Earth. (shrink)
All persons, while different from one another, have the same value: this is the author's relatively uncontroversial starting point. Her end point is not uncontroversial: an ideal of justice as human flourishing, based on each person's unique set of capabilities. Because the book's focus is women's health care, gender justice, a necessary component of justice, is central to examination of the issues. Classical pragmatists and feminist standpoint theorists are enlisted in support of a strategy by which gender justice is promoted. (...) Two features of the book are unique: (1) the topics presented cover the entire life span of women, not just those related to reproduction; (2) a range views about moral status are applied not only to fetuses but also to individuals already born. Attention to these features is intended to facilitate ethical consistency or moral integrity and respect for those who hold different moral views. While delineating and defending the book's perspective, the first section provides an overview of bioethics, critiques prevalent approaches to bioethics and models of the physician-patient relationship, and sketches distinguishing aspects of women's health care that are prevalently neglected. Positions about moral status are also presented. The second section identifies topics that are indirectly as well as directly related to women's health, such as domestic violence and caregiving. Brief cases illustrate variables relevant to each topic. Empirical and theoretical considerations follow each set of cases; these are intended to precipitate more expansive and critical examination of the issues raised. The last section is devoted to an egalitarian ideal that may be pursued through an ethic of virtue or supererogation rather than obligation. By embracing this ideal, according to the author, moral agents support a more demanding level of morality than guidelines or laws require. (shrink)
"The work is on an important topic that has been oft debated but rarely systematically studied – the political, cultural, and moral effects of distant news coverage of suffering. [The book] is extremely well steeped in the relevant literature, including semiotics, discourse analysis, meda and social theory and makes a fresh methodological contribution by looking at the codes and formats of news about suffering. It has a fresh vision and answer to some of the stickiest moral and media (...) problems of our time … and deserves to find its place among important books about the moralaspects of media and society in our times." —John D. Peters, F. Wendell Miller Distinguished Professor, University of Ohio This book is about the relationship between the spectators in countries of the west, and the distant sufferer on the television screen; the sufferer in Somalia, Nigeria, Bangladesh, India, Indonesia, but also from New York and Washington DC. How do we relate to television images of the distant sufferer? The question touches on the ethical role of the media in public life today. They address the issue of whether the media can cultivate a disposition of care for and engagement with the far away other; whether television can create a global public with a sense of social responsibility towards the distant sufferer. (shrink)
A history of the Atomic Bomb from Marie Curie to Hiroshima. “I am become Death, the destroyer of worlds” — Oppenheimer quoting the Bhagavad Gita after witnessing the successful demonstration of the atom bomb. The bomb, which killed an estimated 140,000 civilians in Hiroshima and destroyed the countryside for miles around, was one of the defining moments in world history. That mushroom cloud cast a terrifying shadow over the contemporary world and continues to do so today. But how could (...) this have happened? What led to the creation of such a weapon of mass destruction? From the moment scientists contemplated the destructive potential of splitting the atom, the role of science changed. Ethical and moral dilemmas faced all those who realized the implications of their research. Before the Fall-Out charts the chain of events from Marie Curie’s scientific breakthrough through the many colourful characters such as Einstein, Robert Oppenheimer and Lord Rutherford, whose discoveries contributed to the bomb. The story of the atomic bomb spans 50 years of prolific scientific innovation, turbulent politics, foreign affairs and world-changing history. Through personal stories of exile, indecision and soul-searching, to charges of collaboration, spying and deceit, Diana Preston presents the human side of an unstoppable programme with a lethal outcome. (shrink)
My assigned task in today’s colloquium is to review philosophers’ perspectives on the broad question of whether health care rationing ought to target the elderly. This is a revolutionary question, particularly in a society that is so sensitive to apparent discrimination, and the question must be approached carefully if it is to be successfully dealt with. Three subordinate questions attend this one and must be addressed in the course of answering it. The first such question has to do with (...) the issue of justice: how is it fair to target the elderly in achieving reductions in health care costs? Isn’t the proposal, or for that matter, isn’t targeting any age group, morally objectionable as a species of ageism, just as targeting members of a particular race or sex would be racist or sexist? The second subordinate question has to do with the issue of fittingness. Given that we can show in some way that targeting the elderly is not inherently unjust, why would limiting health care to them be a fitting thing for medicine to do? How would it fit, for example, with the traditional commitments of medicine, to sustain life, to relieve suffering, to heal and cure and restore function? And in particular, if medicine has the ability to save and relieve and restore the elderly, why should it replace that set of commitments with a different set for this particular population? The third subordinate question seems political, an arena reserved for one of my speaker colleagues today. There are, I believe, some underlying philosophical dimensions to its answer, and so I will say something about it. The philosophical/political questions is, Given that rationing health care to the elderly is not patently unjust, and given that a case can be made out that the ends of medicine are not violated by such limitation, shy should the elderly, as a group, assent to such a limitation? I want to address these subordinate questions, for I believe them to be the chief stumbling blocks for the possibility of an affirmative answer to our.... (shrink)
New and Emerging Science and Technology (NEST) based innovations, e.g. in the field of Life Sciences or Nanotechnology, frequently raise societal and political concerns. To address these concerns NEST researchers are expected to deploy socially responsible R&D practices. This requires researchers to integrate social and ethicalaspects (SEAs) in their daily work. Many methods can facilitate such integration. Still, why and how researchers should and could use SEAs remains largely unclear. In this paper we aim to relate motivations (...) for NEST researchers to include SEAs in their work, and the requirements to establish such integration from their perspectives, to existing approaches that can be used to establish integration of SEAs in the daily work of these NEST researchers. Based on our analyses, we argue that for the successful integration of SEAs in R&D practice, collaborative approaches between researchers and scholars from the social sciences and humanities seem the most successful. The only way to explore whether that is in fact the case, is by embarking on collaborative research endeavours. (shrink)
In The Ethical Primate, renowned philosopher Mary Midgley tackles important questions about human freedom and morality. Scientists and philosophers have found it difficult to understand how each human being can be both a living part of the natural world and, at the same time, a genuinely free agent. Midgley explores their responses to this seeming paradox and argues that our evolutionary origin, properly understood, explains why human freedom and morality have come about.
From the 1970s to the early-1990s, the discourse surrounding aesthetics largely disappeared from the study of art history, theory and cultural studies. Claims for the aesthetic value of art-works were thought of as elitist and politically regressive. The 1990s witnessed a return to aesthetics, but one that stressed the independent claims of beauty, in reaction to its perceived suppression by ethical and political imperatives. However, beauty is just one aspect of the aesthetic. In recent years, increasing attention has been (...) given to the ways in which aesthetics and ethics are intertwined. In a series of paired essays and responses, a group of the English-speaking world's most distinguished thinkers consider this 'new' aesthetics, demonstrating its cross-disciplinary relevance in terms accessible to a non-specialist readership. (shrink)
Over the past decade much significant new work has appeared in the field of Jewish ethics. While much of this work has been devoted to issues in applied ethics, a number of important essays have explored central themes within the tradition and clarified the theoretical foundations of Jewish ethics. This important text grew out of the need for a single work which accurately and conveniently reflects these developments within the field. The first text of its kind in almost two decades, (...) Contemporary Jewish Ethics and Morality presents wide-ranging and carefully organized recent essays on Jewish ethical theory and practice. Serving as an introduction to Jewish ethics, it acquaints the student with the distinctive methodological issues involved and offers a sampling of Jewish positions on contemporary moral problems. The book features work from both traditionalist and liberal contributors, making this the only volume which encompasses the full range of contemporary Jewish ethical perspectives. Writers such as Harold Schulweis, Judith Plaskow, David Novak, David Hartman, and Blu Greenberg discuss law and ethics, natural law, humility, justice, sex and the family, euthanasia, and other vital issues relating to modern Judaism. Many of the readings appear here for the first time, making this important text the most timely sourcebook in its field. Uniquely qualified to reflect the high level and depth of contemporary work in this area of study, Contemporary Jewish Ethics and Morality is an essential contribution to any course dealing with Jewish ethics. (shrink)
The entwined history of humans and elephants is fascinating but often sad. People have used elephants as beasts of burden and war machines, slaughtered them for their ivory, exterminated them as threats to people and ecosystems, turned them into objects of entertainment at circuses, employed them as both curiosities and conservation ambassadors in zoos, and deified and honored them in religious rites. How have such actions affected these pachyderms? What ethical and moral imperatives should humans follow to ensure (...) that elephants are treated with dignity and saved from extinction? In Elephants and Ethics, Christen Wemmer and Catherine A. Christen assemble an international cohort of experts to review the history of human-elephant relations, discuss current issues of vital concern to elephant welfare, and assess the prospects for the ethical coexistence of both species. Part I provides an overview of the vexatious human-elephant relationship, from the history of our interactions to understanding elephant intelligence and sense of self. It concludes with a discussion of the issues of stress, pain, and suffering as experienced by elephants in human care and the problems inherent in assessing these subjectively. The second part explores how humans use elephants as tools and entertainment. It reviews domestic uses in Asia, examines the history and roles of elephants in zoos and circuses, and discusses the methods and ethics of training and caring for captive elephants. In Part III the contributors examine the fragile and conflict-filled world of human-elephant interactions in the wild. Each chapter delves into a different angle of the "elephant problem" -- the all-too-human problem of our growing populations taking over space that was historically the domain of these pachyderms. The chapters explore attempts to tame and "train" elephants in populous areas, the struggle over balancing species preservation while maintaining biodiversity in protected areas, and the conundrums posed by hunting, tourism, and human-elephant competition on rural land. That the future health and survival of elephants is dependent on human actions is irrefutable. In addressing these issues from multiple perspectives, Elephants and Ethics promotes mutual understanding of the cultural, conservation, and economic difficulties at the root of the many troublesome human-elephant interactions and poses new questions about our responsibility toward these largest of land mammals. (shrink)
Moral Dilemmas is the second volume of collected essays by the eminent moral philosopher Philippa Foot, gathering the best of her work from the late 1970s to the 1990s. It fills the gap between her famous 1978 collection Virtues and Vice (now reissued) and her acclaimed monograph Natural Goodness, published in 2001. In this new collection, Professor Foot develops further her critique of the dominant ethical theories of the last fifty years, and discusses such topics as the (...) nature of moral judgement, practical rationality, and the conflict of virtue with desire and self-interest. Moral Dilemmas, alongside her other two books, completes the summation of her distinctive and lasting contribution to twentieth-century moral philosophy. (shrink)