This study examines some of the moral and theological convictions that created tensions for early Christians who affirmed that the government's sword is ordained by God for a fallen world but also that Christians should not exercise it at least in warfare. Three important moral pressures toward Christian participation in war were (1) the recognition of prevention or removal of harm as a requirement of neighbor-love, (2) the related sense of responsibility, fault, and guilt for omissions, and (3) the generalization (...) test proposed by Celsus, who asked Christians to consider what would happen if everyone did what they were doing, i.e., refrained from military service. Along with many other factors, these ideas contributed to the legitimation of Christian participation in war. But this legitimation itself created additional tensions, particularly because of the requirements to "turn the other cheek," to "go the second mile," etc. In order to lessen these tensions, the Church and its theologians developed several interrelated distinctions that could reduce the scope or strength of the radical demands: higher/lower; for oneself/ for others; inner/outer; and private/public. (shrink)
"A very good book indeed: there is scarcely an issue anyone has thought to raise about the topic which Childress fails to treat with sensitivity and good judgement....Future discussions of paternalism in health care will have to come to terms with the contentions of this book, which must be reckoned the best existing treatment of its subject."--Ethics. "A clear, scholarly and balanced analysis....This is a book I can recommend to physicians, ethicists, students of both fields, and to those most (...) affected--the patients themselves."--Edmund D. Pellegrino, John Carroll Professor of Medicine and Medical Humanities, Georgetown University Medical Center. (shrink)
: Moral frameworks for evaluating non-donation strategies to increase the supply of cadaveric human organs for transplantation and ways to overcome barriers to organ donation are explored. Organ transplantation is a very complex area, because the human body evokes various beliefs, symbols, sentiments, and emotions as well as various rituals and social practices. From a rationalistic standpoint, some policies to increase the supply of transplantable organs may appear to be quite defensible but then turn out to be ineffective and perhaps (...) even counterproductive because of inadequate attention to these rich and complex features of human body parts. Excessively rationalistic policies neglect deep beliefs, symbols, sentiments, and emotions and the like, and that deficiency marks many actual and proposed policies. In addition, policies are often too individualistic and too legalistic. (shrink)
This essay explores some of the conceptual and moral issues raised by illegal actions in health care. The author first identifies several types of illegal action, concentrating on civil disobedience, conscientious objection or refusal, and evasive noncompliance. Then he sketches a framework for the moral justification of these types of illegal action. Finally, he applies the conceptual and normative frameworks to several major cases of illegal action in health care, such as "mercy killing" and some decisions not to treat incompetent (...) patients. Keywords: illegal actions, mercy killing, non-treatment of incompetent patients, civil disobedience, conscientious objection, evasive non-compliance, moral justification and disobedience, dissent in health care CiteULike Connotea Del.icio.us What's this? (shrink)
Organ allocation policy involves a mixture of ethical, scientific, medical, legal, and political factors, among others. It is thus hard, and perhaps even impossible, to identify and fully separate ethical considerations from all these other factors. Yet I will focus primarily on the ethical considerations embedded in the current debate in the United States about organ allocation policy. I will argue that it is important to putpatientsfirstbut even then significant ethical questions will remain about exactly how to put patients first.
: Managed care organizations can produce conflicts of obligation and conflicts of interest that may lead to problems of conscience for health care professionals. This paper provides a basis for understanding the notions of conscience and conscientious objection and offers a framework for clinicians to stake out positions grounded in personal conscience as a way for them to respond to unacceptable pressures from managers to limit services.
The U.S. regulations for the protection of humans in biomedical and behavioral research were "born in scandal and reared in protectionism." This paper discusses the evolution of these regulations and the gaps that still persist in the ongoing effort to strike a balance between protecting vulnerable populations from research risks and providing all individuals and groups with an equal opportunity to benefit from research. In particular, this paper focuses on racial, social, and economic inequities in the selection of research participants; (...) the exclusion and underrepresentation of the elderly in research, and controversies about U.S. clinical trials conducted in developing countries. (shrink)
This paper analyzes nonviolent resistance and direct action, as seen by its practitioners and theoreticians, from the standpoint of trust and risk-taking. After an examination of the nature of trust, the author indicates how it can illuminate what selected figures such as Gandhi and King have claimed about nonviolence. He offers this analysis not as a defense but as a way of understanding nonviolence that can serve as a starting point for further discussion.
Do pacifists and proponents of justified violence share a starting point? Whether or not just war theory contains an embedded presumption against violence is an important and disputed question. Substantively it is important not only because it has implications for the possibility of dialogue among Christians of different persuasions but also because the belief that the tradition advances no moral reservations about the use of force may have the effect of lowering the moral barriers against the resort to war. Conceptually (...) it is important because it reflects a fundamental methodological disagreement concerning the meaning and resolution of conflicts among moral duties. (shrink)
This paper analyzes some issues that emerge in attempts to distinguish and relate "moral" and "nonmora1' action-guides. It examines one material criterion (otherregardingness) and three formal criteria (universalizability, prescriptivity, and overridingness) and considers whether they constitute necessary and/or sufficient conditions of "morality." It treats these criteria in relation to ideals and prudential, political, and religious considerations. Furthermore, it contends that the classification of action-guides as moral or nonmoral should not prejudge their respective weights or replace substantive moral debate. The formal (...) and material criteria may determine what counts as morality, not how much morality counts. (shrink)
This is an extremely thorough revision of the leading textbook of bioethics. The authors have made many improvements in style, organization, argument and content. These changes reflect advances in the bioethics literature over the past five years. The most dramatic expansions of the text are in the comprehensiveness with which the authors treat different currents in ethical theory and the greater breadth and depth of their discussion of public policy and public health issues. In every chapter, readers will find new (...) material and refinements of old discussions. This is evident in the many new sections on topics like communitarianism, ethics of care, relationship-based accounts, casuistry, case-based reasoning, principle-based common-morality theories, the justification of assistance in dying, rationing through priorities in the health care budget, and virtues in professional roles. The most extensive revisions are in chapters 1, 2 and 8. (shrink)