This book is a comprehensive and unique text and reference in medical ethics. By far the most inclusive set of primary documents and articles in the field ever published, it contains over 100 selections. Virtually all pieces appear in their entirety, and a significant number would be difficult to obtain elsewhere. The volume draws upon the literature of history, medicine, philosophical and religious ethics, economics, and sociology. A wide range of topics and issues are covered, such as law and medicine, (...) truth-telling by the physician, research, population policy, genetics, abortion, dying, and individual rights in medical care. The selections span the centuries, beginning with material from the works of Hippocrates, continuing through Thomas Percival, John Stuart Mill, and Claude Bernard, down to modern commentators like Henry K. Beecher, Walsh McDermott, David L. Bazelon, Paul Freund, H. L. A. Hart, John Rawls, Paul Ramsey, Richard McCormick, Rashi Fein, and Bernard Barber. The text has eight major divisions, beginning with sections on the ethical dimensions of the physician-patient relationship in history; the moral bases of medical ethics; and regulation, compulsion, and protection of the consumer in clinical medicine and public health. Each of these sections includes key essays that appear for the first time. All of the book's major divisions contain primary documents: codes such as the Hippocratic Oath, Medieval Law for the Regulation of Medicine, and the first as well as the most recent code of the American Medical Association; court decisions, including those on Karen Quinlan and on abortion in the United States and West Germany; government documents such as the statement of the National Commission on the Protection of Human Subjects, the Tuskegee Syphilis Report, the British Parliamentary debate on euthanasia, and the Council of Europe on rights of the sick and dying; and various published guidelines such as the Harvard Medical School brain death criteria, the American Hospital Association on patient's rights, and Pope Pius XII on the prolongation of life. Cases that illustrate moral dilemmas are provided for discussion purposes. Each section is preceded by a succinct editor's introduction. The documents and essays are of practical value for practitioners and students in medicine, law, ethics, and counselling, and for individual patients and groups concerned with medical care. Through encompassing divergent viewpoints, the essays and primary documents were selected to encourage humane practices and deepen understanding of the multiple traditions that shaped and do shape the development of medicine. (shrink)

Health-promoting nudges have been put into practice by different agents, in different contexts and with different aims. This article formulates a set of criteria that enables a thorough ethical evaluation of such nudges. As such, it bridges the gap between the abstract, theoretical debates among academics and the actual behavioral interventions being implemented in practice. The criteria are derived from arguments against nudges, which allegedly disrespect nudgees, as these would impose values on nudgees and/or violate their rationality (...) and autonomy. Instead of interpreting these objections as knock-down arguments, I take them as expressing legitimate worries that can often be addressed. I analyze six prototypical nudge cases, such as Google’s rearrangement of fridges and the use of defaults in organ donation registration. I show how the ethical criteria listed are satisfied by most—but not all—nudges in most—but not all—circumstances. (shrink)

Mainstream moral theories deal with situations in which the outcome of each possible action is well-determined and knowable. In order to make ethics relevant for problems of risk and uncertainty, moral theories have to be extended so that they cover actions whose outcomes are not determinable beforehand. One approach to this extension problem is to develop methods for appraising probabilistic combinations of outcomes. This approach is investigated and shown not to solve the problem. An alternative approach is then developed. Its (...) starting-point is that everyone has a prima facie moral right not to be exposed to risk. However, this right can be overridden if the risk-exposure is part of an equitable system for risk-taking that works to the advantage of the individual risk-exposed person. (shrink)

Purposeful infection of healthy volunteers with a microbial pathogen seems at odds with acceptable ethical standards, but is an important contemporary research avenue used to study infectious diseases and their treatments. Generally termed ‘controlled human infection studies’, this research is particularly useful for fast tracking the development of candidate vaccines and may provide unique insight into disease pathogenesis otherwise unavailable. However, scarce bioethical literature is currently available to assist researchers and research ethics committees in negotiating the distinct issues raised (...) by research involving purposefully infecting healthy volunteers. In this article, we present two separate challenge studies and highlight the ethical issues of human challenge studies as seen through a well-constructed framework. Beyond the same stringent ethical standards seen in other areas of medical research, we conclude that human challenge studies should also include: independent expert reviews, including systematic reviews; a publicly available rationale for the research; implementation of measures to protect the public from spread of infection beyond the research setting; and a new system for compensation for harm. We hope these additions may encourage safer and more ethical research practice and help to safeguard public confidence in this vital research alternative in years to come. (shrink)

Although ethical investment is a growing phenonenon which attracts a signficant amount of media interest, relatively little has been written about the internal operations of ethical investment funds. Using a variety of sources, including interviews with a fund manager and participant observation at meetings of the fund’s ethical advisory committee, this paper examines the decision making of one ethical unit trust operating in the United Kingdom. In particular, it describes the development of the ethical (...) class='Hi'>criteria and the ways in which their implementation was monitored. Several significant parallels between publicly stated ethical investment criteria and corporate codes of ethics are then discusssed. (shrink)

New technologies and practices, such as drug testing, genetic testing, and electronic surveillance infringe upon the privacy of workers on workplaces. We argue that employees have a prima facie right to privacy, but this right can be overridden by competing moral principles that follow, explicitly or implicitly, from the contract of employment. We propose a set of criteria for when intrusions into an employee''s privacy are justified. Three types of justification are specified, namely those that refer to the employer''s (...) interests, to the interests of the employee her- or himself, and to the interests of third parties such as customers and fellow workers. For each of these three types, sub-criteria are proposed that can be used to determine whether a particular infringement into an employee''s privacy is morally justified or not. (shrink)

The Farm Animal Welfare Council’s concept of a Good Life gives an idea of an animal’s quality of life that is over and above that of a mere life worth living. The concept needs explanation and clarification, in order to be meaningful, particularly for consumers who purchase farm animal produce. The concept could allow assurance schemes to apply the label to assessments of both the potential of each method of production, conceptualised in ways expected to enhance consumers’ engagement such as (...) ‘naturalness’ and ‘freedom’; and the concept of a life worth living as a safeguard threshold below which no animal’s actual welfare should fall, based on each animal’s overall affective states. This may provide a framework for development of the Good Life concept, within scientific and sociological fields, in order to allow reliable and influential use by assessors, consumers and retailers. (shrink)

Due to the rapid advance of the pandemic caused by COVID-19, several countries perceived that human and material resources would be insufficient to meet the demand of infected patients. The aim of this study is to analyze the knowledge of health professionals working in the pandemic about the application of ethical criteria in decision-making in situations of resource scarcity. This is a cross-sectional, descriptive, and quantitative survey study, conducted from June to December 2020, with health professionals working in (...) the COVID-19 pandemic in Brazil. We applied a questionnaire to assess the professionals’ knowledge about ethical criteria in decision-making in the allocation of scarce resources during the pandemic, containing 14 questions and possible score from 0 to 70, which was developed by researchers from documents and protocols validated by organizations from various countries, available in the first months of the pandemic, a sociodemographic characterization questionnaire and a self-assessment questionnaire regarding knowledge about bioethics. A total of 197 health professionals participated in the study, 37.6% of whom were nurses and 22.8% of whom were physicians, working in the Family Health Unit (28.4%) with a degree at the level of specialization (46.2%). Moreover, (9.5%) of nurses, (18.2%) of dental surgeons and (24.4%) of physicians reported that they have no prior knowledge about bioethics. Physicians and hospital workers scored higher on the knowledge assessment questionnaire. The mean score of the participants was 45.4 (SD = 7.2). Investments in training and professional education in the field of health focused on Bioethics are necessary, considering models and ethical theories that help professionals, managers and society to better position themselves in the face of pandemic contexts. (shrink)

ZusammenfassungAktuelle Positionspapiere wie das der Sektion Ethik der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin „Therapiezieländerung und Therapiebegrenzung in der Intensivmedizin“, die „Münchner Leitlinie zu Entscheidungen am Lebensende“ und die Erlanger „Empfehlungen zur Behandlungsbegrenzung auf Intensivstationen“ konzentrieren sich auf die Begründung und Erstellung praxistauglicher Entscheidungspfade. Dabei bleibt kaum Raum für die Darlegung der moraltheoretischen Grundlagen zur formalen Handlungsbewertung einer Indikationsstellung am Lebensende. Der Beitrag will anhand einer intensivmedizinischen Entscheidungssituation zeigen, dass im Falle einer Therapiezieländerung aus Indikationsgründen eine aristotelische Argumentation zentrale (...) Bedeutung erhält. Sie besteht in der begründeten Festlegung eines realistisch erreichbaren Ziels und des dahin führenden Therapiepfades. Klinische Ethikberatung, so das Resultat, kann demnach nicht nur die Bedeutung von inhaltlichen Prinzipien unterstreichen, sondern muss auch ihre Kenntnis der formalen Handlungsbewertung zur Geltung bringen. (shrink)

Today''s headlines suggest that economic criteria alone is the basis for business decision-making. This paper argues that while profitability is a legitimate end of business, it must be moderated by ethical considerations. But can business be both successfuland ethical? Practical examples highlight individuals who chose profitability over ethical responsibility and those who chose and continue to choose both. The authors propose that there is an ethical person profile. Corporate managers can resolve the profits vs ethics (...) dilemma by modeling ethical behavior. (shrink)

Dialogues between companies and actors of society often start as a result of a public scandal or in a situation of crisis. They can lead to short-term public relations activism or to long-term reputation gains. On the basis of cases and of a typology of forms of dialogues, the author develops ethical criteria and conditions for a successful dialogue – the ethical basis for such criteria being values such as equality, freedom and participation. A special focus (...) is put on challenges that often result from dialogues such as the ethical judgment of compromises. This article proposes ethical criteria to evaluate compromises. This leads to a model of ethical dialogue. (shrink)

Volume 19, Issue 5, May 2019, Page 66-68.

This paper stems from the current global worsening of the scarcity of resources for healthcare, which will deepen even more in future public emergencies. This justifies strengthening the reflection on the allocation of resources which, in addition to considering technical issues, should also involve ethical concerns. The two plans in which the allocation of resources develops—macro and micro—are then systematized, both requiring the identification of ethical criteria for the respective complex decision-making. Then, we describe how the complexity (...) at the macro level focuses on the joint consideration of the rectitude of the principles, the goodness of the ends, and the integrity—respectively the deontological, teleological, and procedural perspectives; and at the micro level, it focuses in prioritizing people, which can result in the exclusion of some, as happened with the elderly during peaks of COVID-19. The main objective of this article is to show that, in public health emergency situations, in which the daily criteria for prioritizing access to health care are not efficient, it is possible not only to ration the available means but also to rationalize them. We argue that rationing and rationalization are different concepts, entail different consequences, have different ethical foundations, and draw different guidelines for patient care. We apply them to the distribution of intensive care and vaccines to the elderly thus demonstrating the ethically legitimate domain of implementation of each of these two prioritization criteria. We conclude that rationalization respects more strictly the core ethical principles of our common morality. (shrink)

Advances in psychopharmacology raise the prospects of enhancing neurocognitive functions of humans by improving attention, memory, or mood. While general ethical reflections on psychopharmacological enhancement have been increasingly published in the last years, ethical criteria characterizing physicians’ role in neurocognitive enhancement and guiding their decision-making still remain highly unclear. Here it will be argued that also in the medical domain the use of cognition-enhancing drugs is not intrinsically unethical and that, in fact, physicians should assume an important (...) role in gating their usage. For finding normative orientation, concepts of disease, normality or medicine will not be helpful since—due to their cryptonormative nature—they rather hamper than allow targeted discussion and decision-making. As an alternative, the common and widely accepted bioethical criteria of beneficence, non-maleficence, autonomy and distributive justice allow a clinically applicable, highly differentiated context- and case-sensitive approach. By embedding decision-making in a participative physician–patient relationship extrinsic objections against neurocognitive enhancement (e.g. invalid perceptions about efficacy, benefit or risk; questionable voluntariness; restrained decision-making capacity) can be curtailed. (shrink)

This paper presents the results of and conclusions from a survey of 2,830 college and university undergraduate business andphilosophy departments regarding their business ethics offerings. The impetus for this survey included seeking a better understandingof the problems for which business ethics courses are the solution. It was proposed that, if we knew what it is that professors teachingbusiness ethics believe they are teaching-not in terms of content or methods, but in terms of what criteria they are using to assessstudents' (...) achievement of the course objectives-we would have a better understanding of what issues business ethics attempts toresolve. The survey focused on ranking six possible assessment criteria drawn from the literature on teaching business ethics.In addition to disclosing the specific survey results, the paper draws conclusions based on the fact that there are statistically significantdifferences between the rankings assigned to the six assessment criteria by business professors as contrasted with philosophyprofessors. The results of the survey indicate that there is more uniformity expressed in the responses by the philosophy professorsteaching business ethics than by the business professors. (shrink)

This paper presents the results of and conclusions from a survey of 2,830 college and university undergraduate business andphilosophy departments regarding their business ethics offerings. The impetus for this survey included seeking a better understandingof the problems for which business ethics courses are the solution. It was proposed that, if we knew what it is that professors teachingbusiness ethics believe they are teaching-not in terms of content or methods, but in terms of what criteria they are using to assessstudents' (...) achievement of the course objectives-we would have a better understanding of what issues business ethics attempts toresolve. The survey focused on ranking six possible assessment criteria drawn from the literature on teaching business ethics.In addition to disclosing the specific survey results, the paper draws conclusions based on the fact that there are statistically significantdifferences between the rankings assigned to the six assessment criteria by business professors as contrasted with philosophyprofessors. The results of the survey indicate that there is more uniformity expressed in the responses by the philosophy professorsteaching business ethics than by the business professors. (shrink)

This article aim to show the aesthetics and ethics values whose relation traces could be found in theological text studies. We use bibliographic review as methodology to this research. Considering these elements and how it was found we ask: how can we validate such elements to understand the theological text? When we are analyzing ethics behaviors can we consider the found results as intrinsic values in such discoveries and can it be compared in different times, in other words, it is (...) available if we bring it out to our time without prejudice considering criteria. We know values and beliefs can change according different times, but the main question that translates our doubt is: how can we consider the ethical and aesthetical values described in different times avoiding damage then to be impartial in the research? In spite of lots of doubts rose, what can support on our research reading are historic and current images we can validate as support line to comparative analysis considering ethics and aesthetics values found. This text will be presented as communication in this event.Key Words: Methodology. Ethics and research. Aesthetics and research. Theological methodology. (shrink)

Healthcare facilities in receiving countries regularly encounter guest workers whose need for acute or subacute care triggers the prospect of termination of employment and repatriation. In these scenarios, country‐specific migration and employment policies and norms of medical professionalism and ethics offer some guidance, but also create tensions. It is not clear under what conditions such medical repatriation is ethically permissible.This paper analyses the application of a previously articulated criteria for the ethical medical repatriation of undocumented immigrants, to the (...) situation of documented guest workers, with focus on the context of Singapore. We examine how these standards could be adapted and applied to the provision of care for guest workers, and argue that healthcare institutions and medical professionals have a duty to intervene in employers’ decisions to repatriate guest workers for medico‐economic reasons when repatriation essentially amounts to ‘patient dumping’. Barriers and challenges in implementing the criteria, and their possible solutions will be discussed. (shrink)

How do ethical investment funds choose their ethical criteria? How intelligent is this process from an ethical point of view? This paper reports on his field work carried out as part of the Bath University ‘Morals and Money’ Project. After completing this research, Dr. Craig Mackenzie left academia to become ethics development officer at Friends Provident. He can be contacted at 15 Old Bailey, London, EC4M 7AP; [email protected].

Expressing doubts about death criteria can serve healthy purposes, but can also cause a number of harms, including decreased organ donation rates and distress for donor families and health care staff. This paper explores the various causes of doubts about death criteria—including religious beliefs, misinformation, mistrust, and intellectual questions—and recommends responses to each of these. Some recommended responses are relatively simple and noncontroversial, such as providing accurate information. However, other responses would require significant changes to the way we (...) currently do business. Policymakers should establish minimum national standards for determining death to foster a trustworthy system; academics and publishers have a duty to publish only materials that substantially engage and advance the debate to minimize the harm caused by divided expert opinion; and opposition to the dead donor rule should be conceptually separated from doubts about death criteria. (shrink)

Responsible investing (RI) is a growing phenomenon in the international investment arena. This article investigates the level of knowledge of members of South African pension/provident funds with regard to RI and the importance with which they view various ethical, environmental, social and governance (ESG) criteria. Respondents ( n = 281) indicated a relatively low level of understanding of the concept of RI. Significant differences were noted in the perceptions of respondents about the relative importance of ethical and (...) ESG criteria based on their gender and level of education. The findings could assist asset owners in reformulating their investment mandates, which in turn, will enable fund managers to invest in a more responsible manner. (shrink)

While triage protocols share a common goal—maximizing life by selecting patients who would most benefit from critical care—there are many variations in the selection of criterion to respond to situ...

Developing World Bioethics, Volume 21, Issue 4, Page 227-236, December 2021.

BackgroundThe research shows a growing trend in using an electronic platform to supplement or replace traditional paper-based informed consent processes. Instead of the traditionally written informed consent document, electronic informed consent may be used to assess the research subject’s comprehension of the information presented. By doing so, respect for persons as one of the research ethical principles can be upheld. Furthermore, these electronic methods may reduce potential airborne infection exposures, particularly during the pandemic, thereby adhering to the beneficence and (...) nonmaleficence principle. This scoping review aims to identify the ethics related criteria that have been included in electronic informed consent processes and to synthesize and map these criteria to research ethics principles, in order to identify the gaps, if any, in current electronic informed consent processes.MethodsThe search was performed based on internet search and three main databases: PubMed, SCOPUS and EBSCO. PRISMA Extension for Scoping Reviews : Checklist and Explanation guideline was used to report this work.ResultsOf 34 studies that met the inclusion criteria, 242 essential original constructs were collated, and 7 concepts were derived. Digital content showed the highest percentage of collated original constructs followed by accessibility, comprehension engagement, autonomy, confidentiality, language, and parental consent. Twenty-five new items were synthesized for eConsent criteria which may provide guidance for ethical review of research involving eConsent.ConclusionThe current study adds significant value to the corpus of knowledge in research ethics by providing ethical criteria on electronic informed consent based on evidence-based data. The new synthesized items in the criteria can be readily used as an initial guide by the IRB/rec members during a review process on electronic informed consent and useful to the future preparation of a checklist. (shrink)

In I 7 Aristotle lays down criteria for what is to count as human happiness. Happiness for man is self-sufficient, complete without qualification, peculiar to humans, excellent, and best and most complete. Many interpreters agree that in X 6–8 Aristotle uses these along with other criteria to disqualify the life of amusement and rank one happy life above another.

Ariane Lewis reviewed medicolegal challenges to Death by Neurologic Criteria (DNC) in the United Kingdom in order to identify and discuss the ethical issues raised (Lewis 2024). Here I briefly clar...

In I 7 Aristotle lays down criteria for what is to count as human happiness. Happiness for man is self-sufficient , complete without qualification , peculiar to humans , excellent , and best and most complete . Many interpreters agree that in X 6–8 Aristotle uses these along with other criteria to disqualify the life of amusement and rank one happy life above another.

Although medicolegal challenges to the use of neurologic criteria to declare death in the USA have been well-described, the management of court cases in the United Kingdom about objections to the use of neurologic criteria to declare death has not been explored in the bioethics or medical literature. This article (1) reviews conceptual, medical and legal differences between death by neurologic criteria (DNC) in the United Kingdom and the rest of the world to contextualize medicolegal challenges to (...) DNC; (2) summarizes highly publicized legal cases related to DNC in the United Kingdom, including the nuanced 2022 case of Archie Battersbee, who was transiently considered dead by neurologic criteria, but ultimately determined to be in a vegetative state/unresponsive-wakeful state; and (3) provides an overview of ethical issues raised by medicolegal challenges to DNC in the United Kingdom and a comparison to the management of these challenges in the USA. (shrink)

How do ethical investment funds choose their ethical criteria? How intelligent is this process from an ethical point of view? This paper reports on his field work carried out as part of the Bath University ‘Morals and Money’ Project. After completing this research, Dr. Craig Mackenzie left academia to become ethics development officer at Friends Provident. He can be contacted at 15 Old Bailey, London, EC4M 7AP; [email protected].

This article assesses the quality of Integrative Social Contracts Theory (ISCT) as a social contract argument. For this purpose, it embarks on a comparative analysis of the use of the social contract model as a theory of political authority and as a theory of social justice. Building on this comparison, it then develops four criteria for any future contractarian theory of business ethics (CBE). To apply the social contract model properly to the domain of business ethics, it should be: (...) (1) self-disciplined, i.e., not aspire results beyond what the contract model can realistically establish; (2) argumentative, i.e., it should seek to provide principles that are demonstrative results of the contractarian method; (3) task-directed, i.e., it should be clear what the social contract thought-experiment is intended to model; and (4) domain-specific, i.e., the contractarian choice situation should be tailored to the defining problems of business ethics. (shrink)

Medical criteria rooted in evidence-based medicine are often seen as a value-neutral ‘trump card’ which puts paid to any further debate about setting priorities for treatment. On this argument, doctors should stop providing treatment at the point when it becomes medically futile, and that is also the threshold at which the health purchaser should stop purchasing. This paper offers three kinds of ethical criteria as a counterweight to analysis based solely on medical criteria. The first set (...) of arguments concerns futility, probability and utility; the second, justice and fairness; the third, consent and competence. The argument is illustrated by two recent case studies about futility and priority-setting: the US example of ‘Baby Ryan’ and the UK case of ‘Child B’. (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.

Ethical reflection on Artificial Intelligence has become a priority. In this article, we propose a methodological model for a comprehensive ethical analysis of some uses of AI, notably as a replacement of human actors in specific activities. We emphasize the need for conceptual clarification of relevant key terms in order to undertake such reflection. Against that background, we distinguish two levels of ethical analysis, one practical and one theoretical. Focusing on the state of AI at present, we (...) suggest that regardless of the presence of intelligence, the lack of morally relevant features calls for caution when considering the role of AI in some specific human activities. (shrink)

This article is the result of an empirical research project analyzing the decision behaviour of Austrian managers in ethical dilemma situations. While neoclassical economic theory would suggest a pure economic rational basis for management decisions, the empirical study conducted by the authors put other concepts to a test, thereby analyzing their importance for managerial decision making: specific notions of fairness, reciprocal altruism, and commitment. After reviewing some of the theoretical literature dealing with such notions, the article shows the results (...) of an online survey working with scenarios depicting ethical dilemma situations. By judging such scenarios the respondents showed their preference for the named concepts, though with different degrees of confirmation. The results (with all limitations of an online survey in mind) support the theoretical work on the named concepts: Fairness elements (including Rawlsian principles of justice and an understanding of fairness as conceived by a reference transaction) play a major part in management decisions in ethical dilemma situations. Also, commitment as a behaviour that sticks to rules even if personal welfare is negatively touched, and reciprocal altruism as a cooperative behaviour that expects a reciprocal beneficial action from other persons have been concepts used by Austrian managers when analyzing ethical dilemmas. The article also tries to put the results into a comparative perspective by taking into account other studies on ethical decision factors conducted with, e.g. medical doctors or journalists, and by discussing intercultural implications of business ethics. (shrink)