On December 15, 2011, a final report was issued by the Committee on the Use of Chimpanzees in Biomedical and Behavioral Research, which had been convened by the U. S. Institute of Medicine (IOM) in collaboration with National Research Council (NRC) of the National Academies. Within a month of its release, this report was designated by Wired Science one of the “top scientific discoveries of 2011” (Wired Science Staff 2011). The ad hoc Committee responsible for this report was formed at (...) the request of the National Institutes of Health (NIH) in response to congressional inquiry that had been prompted by expressions of public concern.1 The issues addressed in the report are profoundly ethical, despite NIH’s .. (shrink)
The distinction between clinical research and clinical practice directs how we partition medicine and biomedical science. Reasons for a sharp distinction date historically to the work of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, especially to its analysis of the “boundaries” between research and practice in the Belmont Report (1978). Belmont presents a segregation model of the research-practice distinction, according to which research and practice form conceptually exclusive sets of activities and interventions. This (...) model is still the standard in federal regulations today. However, the Commission’s deliberations and conclusions about the boundaries are more complicated, nuanced, and instructive than has generally been appreciated. The National Commission did not conclude that practice needs no oversight comparable to the regulation of research. It debated the matter and inclined to the view that the oversight of practice needed to be upgraded, though the Commission stopped short of proposing new regulations for its oversight, largely for prudential political reasons. (shrink)
Emily Largent, Steven Joffe, and Franklin Miller offer a stimulating contribution to the literature on integrating medical research and practice. We agree on both the need to move toward what the Institute of Medicine has called a learning health care system and the need for new conceptions for integrating research and practice within it. We also agree with the authors’ view, first advanced by Robert Truog and colleagues in 1999, that it can be ethically acceptable to randomize patients without express (...) consent in trials comparing widely used, approved interventions that pose no additional risk. With appropriate oversight, learning health care systems ought to conduct such trials on a regular basis. Our .. (shrink)
Our primary focus is on analysis of the concept of voluntariness, with a secondary focus on the implications of our analysis for the concept and the requirements of voluntary informed consent. We propose that two necessary and jointly sufficient conditions must be satisfied for an action to be voluntary: intentionality, and substantial freedom from controlling influences. We reject authenticity as a necessary condition of voluntary action, and we note that constraining situations may or may not undermine voluntariness, depending on the (...) circumstances and the psychological capacities of agents. We compare and evaluate several accounts of voluntariness and argue that our view, unlike other treatments in bioethics, is not a value-laden theory. We also discuss the empirical assessment of individuals? perceptions of the degrees of noncontrol and self-control. We propose use of a particular Decision Making Control Instrument. Empirical research using this instrument can provide data that will help establish appropriate policies and procedures for obtaining voluntary consent to research. (shrink)
David Hume (1711-1776) is one of the greatest of philosophers. Today he probably ranks highest of all British philosophers in terms of influence and philosophical standing. His philosophical work ranges across morals, the mind, metaphysics, epistemology, religion, and aesthetics; he had broad interests not only in philosophy as it is now conceived but in history, politics, economics, religion, and the arts. He was a master of English prose. -/- The Clarendon Hume Edition will include all of his works except his (...) History of England and minor historical writings. It is the only thorough critical edition, and will provide a far more extensive scholarly treatment than any previous editions. This edition (which has been in preparation since the 1970s) offers authoritative annotation, bibliographical information, and indexes, and draws upon the major advances in textual scholarship that have been made since the publication of earlier editions--advances both in the understanding of editorial principle and practice and in knowledge of the history of Hume's own texts. -/- In this volume, Tom Beauchamp presents two essays from Four Dissertations (1757), the last philosophical work written by Hume, which was subsequently revised by the philosopher in the remaining years of his life. Whilst the bulk of A Dissertation on the Passions was extracted from passages in A Treatise of Human Nature, The Natural History of Religion was an original work when published in 1757, as well as the only major work devoted exclusively to the subject of religion that Hume published in his lifetime. Together with Hume's earlier work on religious topics, this essay drew considerable philosophical commentary from his contemporaries. -/- The last edition of the two works in this volume seen through the press by Hume himself appeared in 1772. It provides the copy-text for this critical edition. The Editor's primarily historical Introduction discusses the genesis, revision, and reception of these two dissertations, which went into ten editions at the author's hand. It will appeal to scholars across many disciplines. (shrink)
This edition represents a thorough-going revision of what has become a classic text in biomedical ethics. Major structural changes mark the revision. The authors have added a new concluding chapter on methods that, along with its companion chapter on moral theory, emphasizes convergence across theories, coherence in moral justification, and the common morality. They have simplified the opening chapter on moral norms which introduces the framework of prima facie moral principles and ways to specify and balance them. Together with the (...) shift of advanced material on theory to the back of the book, this heavily revised introductory chapter will make it easier for the wide range of students entering bioethics courses to use this text. Another important change is the increased emphasis on character and moral agency, drawing the distinction between agents and actions. The sections on truth telling, disclosure of bad news, privacy, conflicts of interest, and research on human subjects have also been throughly reworked. The four core chapters on principles (respect for autonomy, nonmaleficence, beneficence, and justice) and the chapter on professional-patient relationships retain their familiar structure, but the authors have completely updated their content to reflect developments in philosophical analysis as well as in research, medicine, and health care. Throughout, they have used a number of actual cases to illuminate and to test their theory, method, and framework of principles. (shrink)
About Hume David Hume (1711-1776) is one of the greatest of philosophers. Today he probably ranks highest of all British philosophers in terms of influence and philosophical standing. His philosophical work ranges across morals, the mind, metaphysics, epistemology, and aesthetics; he had broad interests not only in philosophy as it is now conceived but in history, politics, economics, religion, and the arts. He was a master of English prose. -/- The Clarendon Hume Edition General Editors: Professor T. L. Beauchamp, Georgetown (...) University, USA, Professor D. F. Norton, McGill University, Canada, and Professor M. A. Stewart, University of Lancaster, England -/- The Clarendon Hume will include all of his works except his History of England and minor historical writings; it will be the only thorough critical edition, and will provide a far more extensive scholarly treatment than any previous editions. This edition (which has been in preparation since the 1970s) offers authoritative annotation, bibliographical information, and indexes, and draws upon the major advances in textual scholarship that have been made since the publication of earlier editions--advances both in the understanding of editorial principle and practice and in knowledge of the history of Hume's own texts. -/- The Edition will comprise: -/- Volumes 1 and 2: A Treatise of Human Nature, edited by D. F. Norton -/- Volume 3: An Enquiry concerning Human Understanding, edited by T. L. Beauchamp -/- Volume 4: An Enquiry concerning the Principles of Morals, edited by T. L. Beauchamp -/- Volume 5: The Natural History of Religion and the Dissertation on the Passions -/- Volumes 6 and 7: Essays -/- Volume 8: Dialogues concerning Natural Religion and other posthumous publications, edited by M. A. Stewart -/- About this work An Enquiry concerning the Principles of Morals was Hume's third great philosophical work, first published in 1751. Hume's aim in this elegant and lucid work was to present in an accessible way his theory of the foundation of morality in human nature, which had developed significantly since he first addressed the subject in the Treatise of Human Nature (1739/40). He discusses moral psychology; freedom, necessity, and causation; practical reasoning; justice; virtues and other moral qualities. He considered this Enquiry to be 'of all my writings, historical, philosophical, or literary, incomparably the best'. -/- About this volume The authoritative version of the text, based upon the 1772 edition that was seen through the press by Hume himself, is presented here accurately and clearly. The editor's introduction sets the work in its historical context; the annotation and glossary provide information about Hume's sources, allusions, citations, and meanings, to help readers towards a full understanding of the text. A biographical appendix identifies the many people mentioned by Hume in the Enquiry. Bibliographies list the works cited by Hume and a selection of the secondary literature. Hume's original index is reproduced, together with a new general index by the editor. (shrink)
David Hume (1711-1776) is one of the greatest of philosophers. Today he probably ranks highest of all British philosophers in terms of influence and philosophical standing. His philosophical work ranges across morals, the mind, metaphysics, epistemology, and aesthetics; he had broad interests not only in philosophy as it is now conceived but in history, politics, economics, religion, and the arts. He was a master of English prose. -/- about the Clarendon Hume Edition: -/- The Clarendon Hume will include all of (...) his works except his History of England and minor historical writings; it will be the only thorough critical edition, and will provide a far more extensive scholarly treatment than any previous editions. This edition (which has been in preparation since the 1970s) offers authoritative annotation, bibliographical information, and indexes, and draws upon the major advances in textual scholarship that have been made since the publication of earlier editions--advances both in the understanding of editorial principle and practice and in knowledge of the history of Hume's own texts. -/- General Editors: Professors T. L. Beauchamp (Georgetown University, USA), D. F. Norton (McGill University, Canada), M. A. Stewart (University of Lancaster, England). -/- The Edition will comprise: -/- Vols. 1 and 2: A Treatise of Human Nature, edited by D. F. Norton -/- Vol. 3: An Enquiry concerning Human Understanding, edited by T. L. Beauchamp -/- Vol. 4: An Enquiry concerning the Principles of Morals, edited by T. L. Beauchamp -/- Vol. 5: The Natural History of Religion and the Dissertation on the Passions -/- Vols. 6 and 7: Essays -/- Vol. 8: Dialogues concerning Natural Religion and other posthumous publications, edited by M. A. Stewart. (shrink)
The scientific, ethical, and policy issues raised by research involving the engraftment of human neural stem cells into the brains of nonhuman primates are explored by an interdisciplinary working group in this Policy Forum. The authors consider the possibility that this research might alter the cognitive capacities of recipient great apes and monkeys, with potential significance for their moral status.
: Phenomena of moral conflict and disagreement have led writers in ethics to two antithetical conclusions: Either valid moral distinctions hold universally or they hold relative to a particular and contingent moral framework, and so cannot be applied with universal validly. Responding to three articles in this issue of the Journal that criticize his previously published views on the common morality, the author maintains that one can consistently deny universality to some justified moral norms and claim universality for others. Universality (...) is located in the common morality and nonuniversality in other parts of the moral life, called "particular moralities." The existence of universal moral standards is defended in terms of: (1) a theory of the objectives of morality, (2) an account of the norms that achieve those objectives, and (3) an account of normative justification (both pragmatic and coherentist). (shrink)
Discussions of research involving vulnerable populations have left the homeless comparatively ignored. Participation by these subjects in drug studies has the potential to be upsetting, inconvenient, or unpleasant. Participation occasionally produces injury, health emergencies, and chronic health problems. Nonetheless, no ethical justification exists for the categorical exclusion of homeless persons from research. The appropriate framework for informed consent for these subjects of pharmaceutical research is not a single event of oral or written consent, but a multi-staged arrangement of disclosure, dialogue, (...) and permission-giving. Payments and other rewards in biomedical research raise issues of whether it is ethical to offer inducements to the homeless in exchange for participation in drug studies. Such inducements can influence desperate persons who are seriously lacking in resources. The key is to strike a balance between a rate of payment high enough that it does not exploit subjects by underpayment and low enough that it does not create an irresistible inducement. This proposal does not underestimate the risks of research, which are often overestimated and need to be appraised in light of the relevant empirical literature. (shrink)
What grounds and justifies conclusions in medical ethics? Is the source external or internal to medicine? Thee influential types of answer have appeared in recent literature: an internal account, an external account, and a mixed internal / external account. The first defends an ethic derived from either the ends of medicine or professional practice standards. The second maintains that precepts in medical ethics rely upon and require justification by external standards such as those of public opinion, law, religious ethics, or (...) philosophical ethics. The third claims that distinct medical ethics have emerged from distinct cultural frameworks, each with norms that govern physicians. There is merit in each perspective, but each overreaches its supporting arguments and fails to appreciate what is legitimate in the theses of its competitors. I propose a fourth account that offers a way to escape limitations of the other three, while retaining their most attractive features. (shrink)
This accessible overview of classical and modern moral theory with short readings provides comprehensive coverage of ethics and unique coverage of rights, justice, liberty and law. Real-life cases introduce each chapter. While the book's content is theoretical rather than applied ethics, Beauchamp consistently applies the theories to practical moral problems. Aristotle, Hume, Kant, and Mill are at the book;s core and they are placed in the context of moral philosophical controversies of the last 30 years. In this edition one-third of (...) the reading selections are new and all the selections in chapter 8 on rights are new. Chapter 7 on Hume has been heavily reshaped. Chapter 1 has been reduced to get students past introductory material and into the philosophers. (shrink)
Hume wrote about fundamental similarities and dissimilarities between human and nonhuman animals. His work was centered on the cognitive and emotional lives of animals, rather than their moral or legal standing, but his theories have implications for issues of moral standing. The historical background of these controversies reaches to ancient philosophy and to several prominent figures in early modern philosophy. Hume develops several of the themes in this literature. His underlying method is analogical arg ument and his conclusions are generally (...) favorable regarding the abilities in animals. Hume does not attribute a moral sense or capacity of judgment to animals, but he does suggest that their actions exhibit moral qualities, such as other-regarding instincts. Hume allows in-kind differences in both demonstrative reason and moral judgment, but in the domains of both causal reason and moral agency he believes there are differences of degree rather than of kind. Hume's most significant philosophical contribution was to move as far as anyone before him to a naturalistic explanation of human and nonhuman minds that invited psychological and epistemological examination of minds by using the identical methods and categories for man and beast. (shrink)
: The belief persists in philosophy, religion, science, and popular culture that some special cognitive property of persons like self-consciousness confers a unique moral standing. However, no set of cognitive properties confers moral standing, and metaphysical personhood is not sufficient for either moral personhood or moral standing. Cognitive theories all fail to capture the depth of commitments embedded in using the language of "person." It is more assumed than demonstrated in these theories that nonhuman animals lack a relevant form of (...) self-consciousness or its functional equivalent. Although nonhuman animals are not plausible candidates for moral personhood, humans too fail to qualify as moral persons if they lack one or more of the conditions of moral personhood. If moral personhood were the sole basis of moral rights, then these humans would lack rights--and precisely for the reasons that nonhuman animals would. (shrink)
Affirmative action refers to positive steps taken to hire persons from groups previously and presently discriminated against. Considerable evidence indicates that this discrimination is intractable and cannot be eliminated by the enforcement of laws. Numerical goals and quotas are justified if and only if they are necessary to overcome the discriminatory effects that could not otherwise be eliminated with reasonable efficiency. Many past as well as present policies are justified in this way.
Animals have moral standing; that is, they have properties (including the ability to feel pain) that qualify them for the protections of morality. It follows from this that humans have moral obligations toward animals, and because rights are logically correlative to obligations, animals have rights.
: The Advisory Committee on Human Radiation Experiments has correctly argued that persons and institutions can sometimes be held responsible for actions taken more than a half-century ago, when practices and policies on the use of research subjects were strikingly different. In reaching its conclusions, the Committee did not altogether adhere to the language and commitments of its own ethical framework. In its Final Report, the Committee emphasizes judgments of wrongdoing, to the relative neglect of culpability; it discusses mitigating conditions (...) that are exculpatory, but does not provide a thoroughgoing assessment of either culpability or exculpation. However, the Committee's shortcomings are mild in comparison to the deficiencies in the "Report of the UCSF Ad Hoc Fact Finding Committee on World War II Human Radiation Experiments" of the University of California at San Francisco. The latter report reaches no significant judgments of either wrongdoing or culpability. The findings that should have been reached by both committees are discussed. (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)