Economist-philosopher Amartya Sen's writings on social and political issues have attracted wide audiences. Section 2 introduces his contributions on: how people reason as agents within society; social determinants of people's (lack of) access to goods and of the effective freedoms and agency they enjoy or lack; and associated advocacy of self-specification of identity and high expectations for ‘voice’ and reasoning democracy. Section 3 considers his relation to social theory, his tools for theorizing action in society, and his limited degree of (...) attention to work by sociologists and to capitalism and power structures. Section 4 characterizes a style marked by conceptual refinement, emphases on complexity and individuality, including personal individuality, and reformist optimism. Section 5 shows the features from Sections 3 and 4 at work in his conception of personhood that advocates freedom to make a reasoned composition of personal identity. Similarly, Section 6 addresses his conception of public reasoning and neglect of the sociology of democracy. It contrasts the ideal of a reasoning polity with features in many countries. Sen's programmes for critical autonomy in personhood and for reasoned politics play, nevertheless, a normic role, while his analytical formats help investigation of obstacles to more widespread agency, voice, and democratic participation. (shrink)

This book is an investigation into the descriptive task of moral philosophy. Nora Hämäläinen explores the challenge of providing rich and accurate pictures of the moral conditions, values, virtues, and norms under which people live and have lived, along with relevant knowledge about the human animal and human nature. While modern moral philosophy has focused its energies on normative and metaethical theory, the task of describing, uncovering, and inquiring into moral frameworks and moral practices has mainly been left to (...) social scientists and historians. Nora Hämäläinen argues that this division of labour has detrimental consequences for moral philosophy and that a reorientation toward descriptive work is needed in moral philosophy. She traces resources for a descriptive philosophical ethics in the work of four prominent philosophers of the twentieth century: John Dewey, Ludwig Wittgenstein, Michel Foucault, and Charles Taylor, while also calling on thinkers inspired by them. (shrink)

ABSTRACT Objective: To describe how local research ethics committees (LRECs) consider and apply research ethics in the evaluation of biomedical research proposals. Design: A qualitative study was conducted using purposeful sampling, focus groups and a grounded theory approach to generate data and to analyse the work of the LRECs. Setting and participants: 11 LRECs of the Mexican Institute of Social Security (IMSS). Results: LRECs considered ethics to be implicit in all types of research, but that ethics (...) reviews were only necessary for projects that included the direct participation of human beings. The LRECs appeared to understand the importance of consent, as in the completion of a consent form, but did not emphasise the importance of the process of acquiring ‘informed’ consent. The committees considered their main roles or functions to be: (a) to improve the methodological quality of research and to verify – if applicable – the ethical aspects; (b) to encourage personnel to undergo research training; (c) to follow‐up research to oversee the adherence to norms and compliance with a specified research timetable. Conclusions: This study provides a valuable insight into how these LRECs understand the ethical review process. The emphasis of the committees was on rules, regulations, improving research methodology and research training, rather than a focus on efforts to protect the rights and well being of research subjects. The results encourage further normative and descriptive lines of investigation concerning education and the development of LRECs. (shrink)

The role of ethicists is to provide a genuine ethical theory to help non-ethicists interpret and solve moral dilemmas, to define what is right or wrong, and, finally, to clarify moral values. Therefore, ethicists are taught to address morality with rational procedures, to set aside their moral intuitions and emotions. Sometimes, professional ethicists are prone to falling into the archangel delusion – the belief that they are beyond the influence of their own emotions. This can lead to ousting moral intuitions (...) from the space of ethical reflection, thus making ethicists unaware of them. They may treat intuitive beliefs about morality as an expression of primal moral feelings. The main question pursued in this article, is how those feelings may influence moral theories, which should be developed by professional ethicists. Ethicists may provide an ethical theory which is merely a rationalisation and justification for their own suppressed moral emotions, rather than the effect of genuine, rational moral reasoning. To help ethicists cope with this delusion, a model of cooperation between descriptive and normative ethics is proposed. Ethicists should therefore use the research tools of descriptive ethics to determine their own intuitions, and the moral emotions in which these intuitions are grounded. --------------- Received: 09/06/2021. Reviewed: 23/07/2021. Accepted: 13/08/2021. (shrink)

In the last twenty years, there has been an enormous growth of scientific research concerning the process of human moral reasoning and moral intuitions. In contemporary descriptive ethics, three dominant approaches can be found – heuristic approach, dual-process theory, and universal moral grammar. Each of these accounts is based on similar empirical evidence combining findings from evolutionary biology, moral psychology, and neuroethics. Nevertheless, they come to different conclusions about the reliability of moral intuitions. The aim of this paper (...) is to critically investigate each of these approaches and compare them with recent scientific findings. Last chapter addresses implications of these findings for moral epistemology and normative ethics. The aim is to show that despite different interpretations of available data, we can reach a satisfying pragmatical conclusion which would be in compliance with the empirical evidence, yet it would not necessarily depend on it. (shrink)

This article offers a discussion of the relevance of empirical studies to normative ethics focusing on the new trend in bioethics called empirical bioethics. The author sees this trend as an answer to a call made by anthropologists decades ago that ethicists should be more aware of the situatedness of the moral institution of life. Through a discussion of two opposing views expressed in the final publications of the EU-funded EMPIRE-project, the middle way is sought between the misconception of (...) bioethics as pure philosophy on one side and the misconception of bioethics as sociology on the other. The author argues that empirical studies may be of relevance to the normative enterprise in at least three ways as illustrated in the EMPIRE-material. First, there is the relevance of empirical facts as descriptive premises in ethical arguments. Second, there is the relevance of empirical studies as means of mapping moral opinion and moral experience which ought to serve as one of two poles between which one oscillates in moral decision making – the other being the normative ethical theories. Third, there is the relevance of empirical studies of the capacity and function of the human mind, which may tell us something about the range of normative principles and rules.Keywords: Ethics, normative ethics, descriptive ethics, empirical bioethics. (shrink)

Ethics of Description: The Anthropological Dispositif and French Modern Travel Writing follows the development of a minor tradition in French literature where metropolitan authors traveling abroad demonstrate their awareness of the ethical conundrums of representing world peoples. During the colonial-modern era, currents of anthropological thought and representational practice are identifiable throughout society, and across literature, the arts, and the sciences. Collectively, they can be theorized as belonging to a dispositif, the anthropological dispositif. The modernization of anthropology serves as an (...) ambivalent interlocutor for the realizations of the writers studied in this book about the difficulties of describing cultural realities that lie largely outside their ken. Anthropology motivates new literary representational strategies that are, alternatively, in keeping with scientific mandates or operate against them. Forty images are analyzed alongside literary works. A postcolonial chapter shows how the ethical awareness of the colonial-modern authors studied have impacted minority self-representation in contemporary France. (shrink)

Ethical guidelines for psychologists are meant to stimulate and help psychologists to act appropriately with respect to clients, colleagues, and other individuals involved in their professional relations. This paper focuses on the similarity of codes of ethics of psychologists in European countries in general, and on specific ethical dilemmas in the area of work and organizations in particular. First, an overview is given of the development of ethical guidelines in Europe and the USA. Second, the results are presented of (...) a survey by E-mail amongst members of the European Federation of Psychologists’ Associations (EFPA) to identify the differences and similarities between ethical guidelines of the affiliate members. Third, the potential dilemmas of stakeholders in work and organizational assessment are addressed. Finally, the results of a survey among Dutch selection psychologists are presented. The purpose of this study was to examine a possible tension between normative behavior and attitudes about normal behavior. It was concluded that ethical guidelines of European countries cover comparable (sub-)principles and that there are indications that individual psychologists agree with the written principles. In addition, suggestions for future research are given. (shrink)

In common with much of theEnglish-speaking world, New Zealandersgenerally oppose the use of animalexperimentation where there is no demonstrableand immediate benefit for human, animal, orenvironmental health. Intrusive experiments onsheep internal and external parasites publishedbetween 1996 and 2000 are reviewed, anddiscussed in relation to these publicsensibilities. A total of 16 publishedexperiments on sheep parasites involvedsurgical manipulations or other intrusiveprocedures. Some of these experiments had noshort-term application, or the only applicationwas in increasing animal production. Otherscould have been modified at some extra expenseso (...) that they were less intrusive. Still otherswere duplications of previous work. All thesemanipulations would be unacceptable accordingto the orthodox morality of the general public.Breeding programs, rotation of grazing,``low-tech'' vaccination, and in vitromodels of sheep can provide insights intopreventing parasite infestation withoutintrusive experiments. Such research protocolsshould take priority over existing programs.The results also confirm earlier reports thatanimal ethics committees are not fulfillingtheir mandated objective of acting as watchdogsfor the public. Possible changes in New Zealandanimal welfare legislation and itsinterpretation by Animal Ethics Committees arediscussed. (shrink)

Evidence shows that during birth women frequently experience unconsented care, coercion, and a loss of autonomy. For many countries, this contradicts both the law and medical ethics guidelines, which emphasize that competent and fully informed women’s autonomy must always be respected. To better understand this discordance, we empirically describe perinatal maternity care providers’ and women’s moral deliberation surrounding coercive measures during birth. Data were obtained from 1-on-1 interviews with providers (N = 15) and women (N = 14), and a (...) survey of women (N = 118). Analyses focused on an in-depth exploration of responses to a question on the permissibility of coercion in birth whose wording was borrowed from a Swiss medical-ethical guideline. Reasons for and against a principle permissibility of coercive measures in birth were grouped into clusters of reasons to build a coherent explanatory framework. Factors considered morally relevant when deliberating on coercion included women’s decisional capacity, beneficence/non-maleficence, authority through knowledge on the part of providers, flaws of the medical system, or the imperative to protect the most vulnerable. Also, we identified various misconceptions, such as the conviction that a pathological birth can justify coercion or that fetal rights can justifiably infringe on women’s autonomy. Information and education on the issue of coercion in birth are urgently needed to enable women to fully exercise their reproductive autonomy, to prevent long-term adverse health outcomes of women and children, and to reconcile the medical vigilance which has lead to a reduction of perinatal morbidity and mortality with women’s enfranchisement in their own care. (shrink)

BackgroundClinical ethics case consultations (CECCs) provide a structured approach in situations of ethical uncertainty or conflicts. There have been increasing calls in recent years to assess the quality of CECCs by means of empirical research. This study provides detailed data of a descriptive quantitative and qualitative evaluation of a CECC service in a department of cardiology and intensive care at a German university hospital.MethodsSemi-structured document analysis of CECCs was conducted in the period of November 1, 2018, to May (...) 31, 2020. All documents were analysed by two researchers independently.ResultsTwenty-four CECCs were requested within the study period, of which most (n = 22; 92%) had been initiated by physicians of the department. The patients were an average of 79 years old (R: 43–96), and 14 (58%) patients were female. The median length of stay prior to request was 12.5 days (R: 1–65 days). The most frequent diagnoses (several diagnoses possible) were cardiology-related (n = 29), followed by sepsis (n = 11) and cancer (n = 6). Twenty patients lacked decisional capacity. The main reason for a CECC request was uncertainty about the balancing of potential benefit and harm related to the medically indicated treatment (n = 18). Further reasons included differing views regarding the best individual treatment option between health professionals and patients (n = 3) or between different team members (n = 3). Consensus between participants could be reached in 18 (75%) consultations. The implementation of a disease specific treatment intervention was recommended in five cases. Palliative care and limitation of further disease specific interventions was recommended in 12 cases.ConclusionsTo the best of our knowledge, this is the first in-depth evaluation of a CECC service set up for an academic department of cardiology and intensive medical care. Patient characteristics and the issues deliberated during CECC provide a starting point for the development and testing of more tailored clinical ethics support services and research on CECC outcomes. (shrink)

The construction industry is usually characterized as a fragmented system of multiple-organizational entities in which members from different technical backgrounds and moral values join together to develop a particular business or project. The greatest challenge in the construction process for the achievement of a successful practice is the development of an outstanding reputation, which is built on identifying and applying an ethical framework. This framework should reflect a common ethical ground for myriad people involved in this process to survive and (...) compete ethically in today’s turbulent construction market. This study establishes a framework for ethical judgment of behavior and actions conducted in the construction process. The framework was primarily developed based on the essential attributes of business management identified in the literature review and subsequently incorporates additional attributes identified to prevent breaches in the construction industry and common ethical values related to professional engineering. The proposed judgment framework is based primarily on the ethical dimension of professional responsibility. The Ethical Judgment Framework consists of descriptive approaches involving technical, professional, administrative, and miscellaneous terms. The framework provides the basis for judging actions as either ethical or unethical. Furthermore, the framework can be implemented as a form of preventive ethics, which would help avoid ethical dilemmas and moral allegations. The framework can be considered a decision-making model to guide actions and improve the ethical reasoning process that would help individuals think through possible implications and consequences of ethical dilemmas in the construction industry. (shrink)

The use of Intelligent Assistive Technology in dementia care opens the prospects of reducing the global burden of dementia and enabling novel opportunities to improve the lives of dementia patients. However, with current adoption rates being reportedly low, the potential of IATs might remain under-expressed as long as the reasons for suboptimal adoption remain unaddressed. Among these, ethical and social considerations are critical. This article reviews the spectrum of IATs for dementia and investigates the prevalence of ethical considerations in the (...) design of current IATs. Our screening shows that a significant portion of current IATs is designed in the absence of explicit ethical considerations. These results suggest that the lack of ethical consideration might be a codeterminant of current structural limitations in the translation of IATs from designing labs to bedside. Based on these data, we call for a coordinated effort to proactively incorporate ethical considerations early in the design and development of new products. (shrink)

BackgroundEthics consultations are established in contemporary health care. Informal ethics consultations often occur and are possibly beneficial, yet they have not been empirically studied. We sought to describe features of informal ethics consultations and to identify facilitators and disruptors of patient participation in such ethics consultations.MethodsWe used a mixed methods (quantitative and qualitative) evaluation design and conveniently sampled 64 sequential informal ethics consultations over a period of 3 years in two academic health care centers in one (...) city in Canada. Data were collected by the two participating ethicists. We used statistical description for the quantitative data and thematic analysis for the qualitative data.ResultsPatients participated in only two (3%) of the informal ethics consultations. Factors that disrupted patient participation in ethics consultations were related to patients’ issues (mental impairments), family issues (family withholding information from the patient), and team members’ issues (efficiency considerations).ConclusionInformal ethics consultations may be used for ethics capacity building of health care providers rather than for engagement with addressed patients. Further research on informal ethics consultations is required, including in different sites. (shrink)

Background On a daily basis, healthcare professionals deal with various ethical issues and it can be difficult to determine how to act best. Clinical ethics support (CES) has been developed to provide support for healthcare professionals dealing with complex ethical issues. A long-term perspective of participating in inter-professional dialogue and reflective-based CES sessions is seemingly sparse in the literature. Research aim The aim was to describe experiences of impact of Inter-professional Ethics Communication in groups (IEC) based on Habermas’ (...) theory of communicative actions, after 6 months from the perspective of an inter-professional team. Research design A qualitative inductive approach was chosen, and individual interviews ( n = 13) were conducted. Interview data were analysed using qualitative content analysis. Participants The participants, 10 females and two males, represented assistant nurses, registered nurses, physicians, occupational therapists, physiotherapists, welfare officers and psychologists. Each had attended at least four IEC sessions. Ethical considerations The study was approved by the Regional Ethical Review Board in Umeå, Sweden, and it has been undertaken in accordance with the Helsinki Declaration. Findings Overall, the descriptions expressed a perceived achievement of a deepened and integrated ethical awareness that increased the participants’ awareness of ethically difficult situations as well as their own ethical thinking, actions and approaches in daily work. Perspectives were shared and the team become more welded. They carried the memories of the reflections within them, which was perceived as supportive when encountered new ethically situations. Discussion Putting words to unarticulated thoughts may stimulate repeated reflections, leading to new insights and alternative thoughts. Conclusion The outcome of IEC sessions 6 months following the last session can be described as an incorporated knowledge that enables actions in ethically difficult situations based on an ethical awareness both at a ‘We-level’ and an ‘I-level’. (shrink)

Mozambique has seen remarkable growth in biomedical research over the last decade. To meet a growing need, the National Committee for Bioethics in Health of Mozambique encouraged the development of ethical review processes at institutions that regularly conduct medical and social science research. In 2012, the Faculty of Medicine of University Eduardo Mondlane and the Maputo Central Hospital established a joint Institutional Committee on Bioethics for Health. This study examines the experience of the first 4 years of the CIBS FM (...) & MCH. This study provides a descriptive, retrospective analysis of research protocols submitted to and approved by the CIBS FM & MCH between March 1, 2013 and December 31, 2016, together with an analysis of the Committee’s respective reviews and actions. A total of 356 protocols were submitted for review during the period under analysis, with 309 protocols approved. Sixty-four percent were submitted by students, faculty, and researchers from UEM, mainly related to Master’s degree research. Descriptive cross-sectional studies were the most frequently reviewed research. The majority were prospective and used quantitative methodologies. The Departments of Internal Medicine at MCH and Community Health at the FM submitted the most protocols from their respective institutions, with 38 and 53% respectively. The CIBS’s average time to final approval for all protocols was 56 days, rising to 161 for the 40 protocols that required subsequent national-level review by the CNBS. Our results show that over its first 4 years, the CIBS FM & MCH has been successful in managing a constant demand for protocol review and that several broad quality improvement initiatives, such as investigator mentoring and an electronic protocol submission platform have improved efficiency in the review process and the overall quality of the protocols submitted. Beyond Maputo, long-term investments in training and ethical capacity building for CIBS across the country continue to be needed, as Mozambique develops greater capacity for research and makes progress toward improving the health of all its citizens. (shrink)

To some extent, perhaps under Moore's chastening influence, eccentric philosophical denials of the existence of physical objects, other people's minds, the past, and so on, have gone out of fashion. All the same there is at least one very common philosophical conclusion which, though not as extravagant as these, is no less paradoxical. This is the dogma that ethical statements could not describe anything at all, and the collateral claim that they could not be true or false. This is, I (...) suggest, as paradoxical as traditional denials of the existence of chairs and tables, since the denial that ethical statements could be descriptive, like the denial that chairs and tables could exist, is opposed by the common observation that ethical statements do describe, just as the other is opposed by the common observation that chairs and tables do exist. I hope to make two things perfectly clear. First of all, that ethical statements do describe states of affairs; and secondly, that the reason ultimately given for saying that they could not describe anything, namely that they differ in verification from statements of fact, is only partly true, and its uncritical acceptance has led to the canonisation of the belief that ethical statements are non-descriptive and have no truth-values. (shrink)

Background:Textbooks are central for the education of professionals in the health field and a resource for practitioners already in the field.Objectives:This article focuses on how 12 textbooks in psychiatric nursing and psychiatry, published in Norway between 1877 and 2012, describe and present people with psychosis.Research design:We used qualitative content analysis.Ethical considerations:The topic is published textbooks, made available to be read by students, teachers and professionals, and no ethical approval was required.Findings:The analysis shows that all 12 textbooks describe and present people (...) who are considered as psychotic from a ‘perspective from above’. In this perspective, the readers are learning about psychosis in the professional’s language and from the author’s viewpoint. Most often the textbooks communicate a universal image of people with psychosis, a description that fits with the diagnostic criteria. The analysis also shows that two textbooks in psychiatric nursing combined this perspective with a ‘perspective from within’. Here, the readers are learning about psychosis from the patients’ own viewpoint. The authors communicate a personal, psychotic universe that differs from various people, even if they have the same diagnosis, and the descriptions are focusing on the patient as a whole person.Discussion and conclusion:Drawing partly on Rita Charon’s writings about narrative knowledge in the health field, and partly on insights from Martha Nussbaum and her concept of narrative imagination, we argue that mental health professionals need to learn about, understand and fathom what patients go through by reading, listening to and acknowledging the patients’ own stories and experiences. Cultivating the capacity for empathy and compassion are at the very heart of moral performance in the mental health field. A valuable moral resource in that regard is leading textbooks and how they describe and present people with severe mental illness. (shrink)

In response to the abundance of parenting literature and a contemporary emphasis on expertise, recent scholars have suggested that how we parent should be determined by values and a family’s particular needs, a combination often referred to as practical wisdom. In this article, I build on previous calls for an ethical approach to being a parent. I argue that being able to share and cultivate one’s unique personality and have one’s aptitudes and interests recognized is a key condition of living (...) well and that parents play an important role in helping their children know and realize their gifts. I put forth an exercise for attending to children, the descriptive review of the child. In doing so, I first describe this practice, illustrate it, and then explain how it can help one live well as a parent. (shrink)

IN this note I propose to make some general remarks concerning the analytical forays carried out into moral discourse by some leading figures in the modern ‘linguistic’ tradition. The philosophers I am going to speak of, may all be said to be attempting some sort of ‘descriptive’ analysis, but my thesis is that philosophers such as Toulmin and Baier are attempting something that is significantly different from what a philosopher such as Nowell-Smith is attempting. I will suggest, in the (...) following section, that the expression—‘the logic of moral discourse’—seems to be understood by these two groups of linguistic philosophers in two different ways and that one of these ways involves a more ambitious claim, than does the other, on behalf of the philosopher embarking upon a conceptual analysis of moral discourse. The manner in which, it seems to me, Toulmin and Baier understand this expression is the one that involves the more ambitious claim. In the final section of this paper I suggest that the more ambitious claim involves overloading the so-called Linguistic method to force it do a job that it seems at least not suited to perform. (shrink)

The contemporary sociology of morality is a form of descriptive ethics that shrinks away from any sort of prescriptive ethics. Building on the moral philosophies of John Dewey, and also of Alasdair MacIntyre and Paul Ricoeur, and in dialogue with recent work by Stefan Bargheer, this article proposes a more ambitious program of critical social ethics that connects concerns with character and the common good but tempers them with attention to alienation and oppression.

Abstract:Most papers in this issue carefully analyze normative and empirical methodologies. I shall argue that (a) there is no purely empirical nor purely normative methodology; (b) some terms escape the division of the normative and descriptive. (c) Most importantly, dialogues such as this one point to a form of integration that allows us to reflect on what it is that each approach presupposes in its study of business ethics. Thus we have made progress in recognizing the importance of (...) each methodology, how each is dependent on the other, and how neither is singularly The Approach to business ethics. (shrink)

BackgroundAlthough nurses are crucial to ensure patients’ peaceful death in hospitals, many nurses experience various ethical conflicts during end-of-life care. Therefore, research on nurses’ entire ethical decision-making process is required to improve nurses’ ethical decision-making in end-of-life care. This study aimed to identify Korean nurses’ ethical decision-making process based on their moral sensitivity to end-of-life patients.MethodsIn total, 171 nurses caring for terminal patients responded to the survey questionnaire. To measure the participants’ moral sensitivity and ethical decision-making process, we used the (...) Korean version of the Moral Sensitivity Questionnaire and Nurses’ Ethical Decision-Making around End of Life Care Scale. Finally, multiple linear regression analysis was used to investigate the effect of moral sensitivity on nurses’ ethical decision-making.ResultsThe mean of moral sensitivity was 4.8 ± 0.5 (out of 7), and that of ethical decision-making was 4.6 ± 0.5 (out of 6). Among the sub-dimensions of ethical decision-making, the highest score was in perceived professional accountability (5.2 ± 0.5), and the lowest in moral reasoning and moral agency (3.9 ± 0.6); the score of moral practice was 4.4 ± 0.7. In the multiple linear regression model, moral sensitivity (β = 0.852, p <.001), clinical department (β = − 7.018, p =.035), ethics education (β = 20.450, p <.001), job satisfaction (β = 5.273, p <.001), and ethical conflict (β = − 2.260, p = 0.031) were influential ethical decision-making factors.ConclusionsThis study revealed a gap between nurses’ thoughts and practices through the ethical decision-making process. They failed to lead their thought to moral practice. It also implies that moral sensitivity could positively affect nurses’ ethical decision-making. To make nurses morally sensitive, exposing them to various clinical cases would be helpful. Additionally, ethics education and clinical ethics supporting services are valuable for improving nurses’ ethical decision-making. If nurses improved their ethical decision-making regarding end-of-life care, their patients could experience a better quality of death. (shrink)

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants described 219 unique ethical experiences that spanned many of (...) the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting. (shrink)

There is growing interest in clinical ethics. However, we still have sparse knowledge about what is actually going on in the everyday practice of clinical ethics consultations. This paper introduces a descriptive evaluation tool to present, discuss and compare how clinical ethics case consultations are actually carried out. The tool does not aim to define ‘best practice’. Rather, it facilitates concrete comparisons and evaluative discussions of the role, function, procedures and ideals inherent in clinical ethics (...) case consultation practices. The tool was developed during meetings of the European Clinical Ethics Network. Based on written reports and participation in the network meetings, the development and the content of the tool and the results of its application in presenting and discussing 10 case consultations are summarized. The tool facilitated understanding of the details of clinical ethics case consultations across individuals and institutions with various experiences and cultures, and comparison between various practices. (shrink)

This paper presents an integrative, descriptive model of ethical decision making, with special attention given to issues of measurement. After building the model, hypotheses are developed from a portion of it. These hypotheses are tested in an exploratory analysis to determine if further research and testing of this model and the measurement instruments it employs are warranted.

By a logical theory I mean a formal system together with its semantics, meta-theory, and rules for translating ordinary language into its notation. Logical theories can be used descriptively (for example, to represent particular arguments or to depict the logical form of certain sentences). Here the logician uses the usual methods of empirical science to assess the correctness of his descriptions. However, the most important applications of logical theories are normative, and here, I argue, the epistemology is that of wide (...) reflective equilibrium. The result is that logic not only assesses our inferential practice but also changes it. I tie my discussion to Thagard's views concerning the relationship between psychology and logic, arguing against him that psychology has and should have only a peripheral role in normative (and most descriptive) applications of logic. (shrink)

Teleosemantics is the view that mental content depends on etiological function. Moral adaptationism is the view that human morality is an evolved adaptation. Jointly, these two views offer new venues for naturalist metaethics. Several authors have seen, in the conjunction of these views, the promise of assigning naturalistically respectable descriptive content to moral judgments. One such author is Neil Sinclair, who has offered a blueprint for how to conduct teleosemantic metaethics with the help of moral adaptationism. In this paper, (...) I argue that the prospects for assigning descriptive content to moral judgments on the basis of teleosemantics are bad. I develop my argument in dialogue with Sinclair’s paper and argue that, although Sinclair’s account of the evolution of morality is plausible, the teleosemantic account of the descriptive content of moral judgments which he bases thereon suffers from crucial shortcomings. I argue further that, given some minimal plausible assumptions about the evolution of morality made by Sinclair, no assignment of descriptive content is possible. Contrary to prevailing assumptions, the combination of moral adaptationism and teleosemantics suggests that moral judgments lack descriptive content. (shrink)

As part of a project to examine health care ethics consultation in Canada, we surveyed individuals who were considered by themselves or others to play a significant role in health care ethics consultation. Since one goal of the project was to examine the education and abilities necessary for consultants, we sought to determine the qualifications and skills currently possessed by persons considered to be ethics consultants. For the purposes of the questionnaire, health care ethics consultation was (...) defined broadly to include consultation on ethical issues in clinical care or in clinical research, ethics consultation to Clinical Ethics Committees, Research Ethics Committees, and policy formulation committees in health care institutions; clinical ethics work was defined more broadly still to include, in addition to the above, ethics education, administration, research and writing on bioethics other than the above, and public speaking.Three hundred and fifty questionnaires were sent to individuals and institutions across Canada that were thought to have some involvement in health care ethics consultation. Two hundred and fifty-three questionnaires were returned for a response rate of 72%. This report presents initial findings of the study and attempts to provide a comprehensive overview of the current state of ethics consultation within Canada. The survey examines demographics, educational background, time spent on ethics, institutional affiliations, approaches to the role of consultation, research related issues, and attitudes toward certification. (shrink)

When cases are described thinly to protect patient confidentiality, they teach us only what we put into them. Thick description, like myth, allows a fuller moral response.

Traditionally, the development of moral theories has been considered one of the main aims of moral philosophy. In contrast, Wittgenstein was very critical of the use of theories both in philosophy in general and in moral philosophy in particular, and philosophers inspired by his philosophy have become some of the most prominent critics of both particular, contemporary moral theories and the idea of moral theory as such. Nonetheless, this article aims to show how Wittgenstein’s later philosophy offers us resources for (...) a revised understanding of the role and status of moral theories according to which theories are neither normative nor explanatory, but are rather to be understood as generalisations of particular descriptions of various forms of moral grammar. (shrink)

In an engaging and provocative paper, Linda Trevino and Gary Weaver spell out the differences between the methodological approach characteristic of the natural sciences on the one hand and that of normative inquiry on the other (Trevino and Weaver, 1991). Near the end of their paper they raise a haunting question that will have increasing significance as the management literature in ethics evolves: namely, “Can the two approaches be integrated?”As C. P. Snow (1962) noted, no one can deny either (...) the stark differences between the two worlds of normative and empirical inquiry, or the mutual suspicion shown by their inhabitants. The methodology of natural science implies a non-normative, thoroughly descriptive vision of the world in which reality awaits discovery by the scientist prepared to use increasingly sophisticated techniques. In contrast, the methodology of normative inquiry, i.e., that of traditional moral philosophy, implies a world-vision in which most important issues are allocated to ethics, where empirical pursuits are frequently trivial and always require ethical guidance, and where empirical theories contain normative presuppositions unrecognized as normative even by their scientific adherents. (shrink)

In an engaging and provocative paper, Linda Trevino and Gary Weaver spell out the differences between the methodological approach characteristic of the natural sciences on the one hand and that of normative inquiry on the other (Trevino and Weaver, 1991). Near the end of their paper they raise a haunting question that will have increasing significance as the management literature in ethics evolves: namely, “Can the two approaches be integrated?”As C. P. Snow (1962) noted, no one can deny either (...) the stark differences between the two worlds of normative and empirical inquiry, or the mutual suspicion shown by their inhabitants. The methodology of natural science implies a non-normative, thoroughly descriptive vision of the world in which reality awaits discovery by the scientist prepared to use increasingly sophisticated techniques. In contrast, the methodology of normative inquiry, i.e., that of traditional moral philosophy, implies a world-vision in which most important issues are allocated to ethics, where empirical pursuits are frequently trivial and always require ethical guidance, and where empirical theories contain normative presuppositions unrecognized as normative even by their scientific adherents. (shrink)

I argue that the Universal Law formulation of the Categorical Imperative is best interpreted as a test or decision procedure of moral rightness and not as a criterion intended to explain the deontic status of actions. Rather, the Humanity formulation is best interpreted as a moral criterion. I also argue that because the role of a moral criterion is to explain, and thus specify what makes an action right or wrong, Kant's Humanity formulation yields a theory of relevant descriptions.

Objective: The field of clinical ethics is relatively new and expanding. Best practices in clinical ethics against which one can benchmark performance have not been clearly articulated. The first step in developing benchmarks of clinical ethics services is to identify and understand current practices.Design and setting: Using a retrospective case study approach, the structure, activities, and resources of nine clinical ethics services in a large metropolitan centre are described, compared, and contrasted.Results: The data yielded a unique (...) and detailed account of the nature and scope of clinical ethics services across a spectrum of facilities. General themes emerged in four areas—variability, visibility, accountability, and complexity. There was a high degree of variability in the structures, activities, and resources across the clinical ethics services. Increasing visibility was identified as a significant challenge within organisations and externally. Although each service had a formal system for maintaining accountability and measuring performance, differences in the type, frequency, and content of reporting impacted service delivery. One of the most salient findings was the complexity inherent in the provision of clinical ethics services, which requires of clinical ethicists a broad and varied skill set and knowledge base. Benchmarks including the average number of consults/ethicist per year and the hospital beds/ethicist ratio are presented.Conclusion: The findings will be of interest to clinical ethicists locally, nationally, and internationally as they provide a preliminary framework from which further benchmarking measures and best practices in clinical ethics can be identified, developed, and evaluated. (shrink)

In medical ethics, business ethics, and some branches of political philosophy (multi-culturalism, issues of just allocation, and equitable distribution) the literature increasingly combines insights from ethics and the social sciences. Some authors in medical ethics even speak of a new phase in the history of ethics, hailing "empirical ethics" as a logical next step in the development of practical ethics after the turn to "applied ethics." The name empirical ethics is ill-chosen (...) because of its associations with "descriptive ethics." Unlike descriptive ethics, however, empirical ethics aims to be both descriptive and normative. The first question on which I focus is what kind of empirical research is used by empirical ethics and for which purposes. I argue that the ultimate aim of all empirical ethics is to improve the context-sensitivity of ethics. The second question is whether empirical ethics is essentially connected with specific positions in meta-ethics. I show that in some kinds of meta-ethical theories, which I categorize as broad contextualist theories, there is an intrinsic need for connecting normative ethics with empirical social research. But context-sensitivity is a goal that can be aimed for from any meta-ethical position. (shrink)

Packed with examples pulled straight from recent headlines, ENGINEERING ETHICS, Sixth Edition, helps engineers understand the importance of their conduct as professionals as well as reflect on how their actions can affect the health, safety and welfare of the public and the environment. Numerous case studies give readers plenty of hands-on experience grappling with modern-day ethical dilemmas, while the book's proven and structured method for analysis walks readers step by step through ethical problem-solving techniques. It also offers practical application (...) of the Engineering Code of Ethics and thorough coverage of critical moral reasoning, effective organizational communication, sustainability and economic development, risk management, ethical responsibilities, globalized standards for engineering and emerging challenges relating to evolving technology. Important Notice: Media content referenced within the product description or the product text may not be available in the ebook version. (shrink)

Background In the globalizing world, nurses often meet humans from different cultures and values. This fact has led them to make ethical decisions, which do not comply with their own moral jurisdictions at care setting. Objectives The objective of the study was to investigate the relationships between moral development levels of the nurses and their scores of nursing principled thinking and practical consideration during decision making for ethical dilemmas. Methods This was a descriptive correlational study. Nursing Dilemma Test, Moral (...) Development Scale for Professionals and socio-demographic form were used. Study was conducted with 227 nurses. Ethical considerations: An institutional authorization, an ethics approval from non-interventional ethics committee of the respective university, permission from the authors of the scales used and informed consents from the nurses were obtained in order to conduct the study. Results In this study, nurses were found to be at post-conventional level according to Kohlberg’s moral development theory. Sociodemographic and working characteristics of the nurses have not affected their scores of moral development level and their scores of nursing principled thinking, practical consideration and familiarity. Nurses take attention for moral principles during decision making although not at a desirable level, and they are relatively affected by environmental factors Conclusion Although nurses are familiar with ethical problems at scenarios including ethical dilemmas, they cannot make decisions in accordance with their moral development levels during decision making for ethical dilemmas. Nurses should be instructed and supported for ethical decision making by recognizing factors that may be effective on their decision making. (shrink)

This paper argues for the normative significance of attention. Attention plays an important role when describing an individual’s mind and agency, and in explaining many central facts about that individual. In addition, many in the public want answers and guidance with regard to normative questions about attention. Given that attention is both descriptively central and the public cares about normative guidance with regard to it, attention should be central also in normative philosophy. We need an ethics of attention: a (...) field of study of which normative pressures, if any, govern attention. Like the ethics of belief, the ethics of attention will connect those normative questions to issues regarding the nature of attention, i.e. to what is subject to such normative pressures. Philosophers should develop an ethics of attention that helps to provide normative guidance and that is commensurate in its richness to the descriptive significance of attention. The second half of the paper sketches a framework that may help us to get started at developing the ethics of attention. (shrink)

This paper investigates how principals can be supported in their work as teacher leaders. My focus is on how principals can help teachers respond ethically to classroom challenges. I argue that in aiding teachers, school leaders themselves need support and ongoing development. I turn to the care of the self to conceptually explore ethical self-cultivation. I then argue that a practice, Descriptive Inquiry, serves as a way for principals to care for themselves. To make this argument, I draw on (...) a qualitative study of four long-term elementary school principals. (shrink)

What is ethics? Where do moral standards come from? Are they based on emotions, reason, or some innate sense of right and wrong? For many scientists, the key lies entirely in biology---especially in Darwinian theories of evolution and self-preservation. But if evolution is a struggle for survival, why are we still capable of altruism? In his classic study The Expanding Circle, Peter Singer argues that altruism began as a genetically based drive to protect one's kin and community members but (...) has developed into a consciously chosen ethic with an expanding circle of moral concern. Drawing on philosophy and evolutionary psychology, he demonstrates that human ethics cannot be explained by biology alone. Rather, it is our capacity for reasoning that makes moral progress possible. In a new afterword, Singer takes stock of his argument in light or recent research on the evolution of morality.--Publisher's description. (shrink)