Margaret Otlowski investigates the complex and controversial issue of active voluntary euthanasia. She critically examines the criminal law prohibition of medically administered active voluntary euthanasia in common law jurisdictions, and carefully looks at the situation as handled in practice. The evidence of patient demands for active euthanasia and the willingness of some doctors to respond to patients' requests is explored, and an argument for reform of the law is made with reference to the position in the Netherlands (where (...) active voluntary euthanasia is now openly practiced). (shrink)

This paper explores the legality and ethics of an individual securing insurance (life, disability or other forms of income protection insurance for which there is individual risk assessment) in anticipation of undergoing genetic testing. It also seeks to examine the situation from the perspective of genetic counsellors and the extent of their obligations in providing information and advice to individuals contemplating genetic testing. These are matters of importance for health care professionals, human research ethics committees as well, of course, as (...) individuals who may be contemplating undertaking genetic testing. (shrink)

The issue of genetic discrimination has attracted growing attention and has been the focus of a recent major Australian inquiry. It is, however, a complex and loaded notion, open to interpretation. This paper explores the concept of genetic discrimination in both its theoretical and practical dimensions. It examines its conceptual underpinnings, how it is understood, and how this understanding fits within the legal framework of disability discrimination. The paper also examines the phenomenon in practice, including the ‘fear factor’ and the (...) resulting implications for the development of regulatory policy. The paper argues that we need to be discerning in our interpretation of this term, and differentiate between discriminatory conduct which is legal and illegal. Further, it is argued that a concerted societal response to the ‘problem’ of genetic discrimination is needed involving targeted legal reforms as well as broader non-legal strategies. (shrink)

BackgroundThe use of genetic test results in risk-rated insurance is a significant concern internationally, with many countries banning or restricting the use of genetic test results in underwriting. In Australia, life insurers’ use of genetic test results is legal and self-regulated by the insurance industry (Financial Services Council (FSC)). In 2018, an Australian Parliamentary Inquiry recommended that insurers’ use of genetic test results in underwriting should be prohibited. In 2019, the FSC introduced an industry self-regulated moratorium on the use of (...) genetic test results. In the absence of government oversight, it is critical that the impact, effectiveness and appropriateness of the moratorium is monitored. Here we describe the protocol of our government-funded research project, which will serve that critical function between 2020 and 2023.MethodsA realist evaluation framework was developed for the project, using a context-mechanism-outcome (CMO) approach, to systematically assess the impact of the moratorium for a range of stakeholders. Outcomes which need to be achieved for the moratorium to accomplish its intended aims were identified, and specific data collection measures methods were developed to gather the evidence from relevant stakeholder groups (consumers, health professionals, financial industry and genetic research community) to determine if aims are achieved. Results from each arm of the study will be analysed and published in peer-reviewed journals as they become available.DiscussionThe A-GLIMMER project will provide essential monitoring of the impact and effectiveness of the self-regulated insurance moratorium. On completion of the study (3 years) a Stakeholder Report will be compiled. The Stakeholder Report will synthesise the evidence gathered in each arm of the study and use the CMO framework to evaluate the extent to which each of the outcomes have been achieved, and make evidence-based recommendations to the Australian federal government, life insurance industry and other stakeholders. (shrink)

In Australia, along with many other countries, limited guidance or other support strategies are currently available to researchers, institutional research ethics committees, and others responsible for making decisions about whether to return genomic findings with potential value to participants or their blood relatives. This lack of guidance results in onerous decision-making burdens—traversing technical, interpretative, and ethical dimensions—as well as uncertainty and inconsistencies for research participants. This article draws on a recent targeted consultation conducted by the Australian National Health and Medical (...) Research Council to put forward strategies for supporting return of finding decision-making. In particular, we propose a pyramid of decision-making support: decision-making guidelines, technical and interpretative assistance, and ethical assistance for intractable “tough” cases. Each step of the pyramid involves an increasing level of regulatory involvement and applies to a smaller subsection of genomic research findings. Implementation of such strategies would facilitate a growing evidence base for return of finding decisions, thereby easing the financial, time, and moral burdens currently placed on researchers and other relevant decision-makers while also improving the quality of such decisions and, consequently, participant outcomes. (shrink)

This paper provides a legal overview of key issues associated with donation of genetic samples and information from a donor perspective. In particular, it addresses the property status of samples as well as issues in respect of consent, privacy, commercialisation and benefit sharing. The paper highlights the need for appropriate protection and safeguards for individuals, but also, importantly, for understanding what donors actually think and want in terms of genetic research and the use of their samples and information. The paper (...) seeks to emphasise the importance of transparency and accountability in the conduct of research in order to maximise donor participation and confidence and public trust in general. (shrink)

_BMC Medical Ethics_ is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies. _BMC __Medical Ethics _is part of the _BMC_ series which publishes subject-specific journals focused on the needs of individual research communities across all areas of biology and medicine. We do not make editorial decisions on the basis of the interest of a study or (...) its likely impact. Studies must be scientifically valid; for research articles this includes a scientifically sound research question, the use of suitable methods and analysis, and following community-agreed standards relevant to the research field. Specific criteria for other article types can be found in the submission guidelines. _BMC series - open, inclusive and trusted_. (shrink)

BackgroundBiobanks provide an important foundation for genomic and personalised medicine. In order to enhance their scientific power and scope, they are increasingly becoming part of national or international networks. Public trust is essential in fostering public engagement, encouraging donation to, and facilitating public funding for biobanks. Globalisation and networking of biobanking may challenge this trust.MethodsWe report the results of an Australian study examining public attitudes to the networking and globalisation of biobanks. The study used quantitative and qualitative methods in conjunction (...) with bioethical analysis in order to determine factors that may contribute to, and threaten, trust.ResultsOur results indicate a generally high level of trust in biobanks and in medical research more broadly. Key factors that can reduce perceived trustworthiness of biobanks are commercialisation and involvement in global networking.ConclusionsWe conclude that robust ethical oversight and governance standards can both promote trust in global biobanking and ensure that this trust is warranted. (shrink)

Anti-selection occurs when information asymmetry exists between insurers and applicants. When an applicant knows they are at high risk of loss, but the insurer does not, the applicant may try to use this knowledge differential to secure insurance at a lower premium that does not match risk.

This new essay collection by distinguished philosopher Margaret Gilbert provides a richly textured argument for the importance of joint commitment in our personal and public lives. Topics covered by this diverse range of essays range from marital love to patriotism, from promissory obligation to the unity of the European Union.

Margaret Gilbert presents the first full-length treatment of a central class of rights: demand-rights. To have such a right is to have the standing or authority to demand a particular action of another person. Gilbert argues that joint commitment is a ground of demand-rights, and gives joint commitment accounts of both agreements and promises.

One of the most distinguished living social philosophers, Margaret Gilbert develops and extends her application of plural subject theory of human sociality, first introduced in her earlier works On Social Facts and Living Together. Sociality and Responsibility presents an extended discussion of her proposal that joint commitments inherently involve obligations and rights, proposing, in effect, a new theory of obligations and rights. In addition, it demonstrates the extensive range and fruitfulness of plural subject theory by presenting accounts of social (...) rules, scientific change, political obligation, collective remorse, collective guilt, shared intention and an important class of rights and obligations. (shrink)

This book is available either individually, or as part of the specially-priced Arguments of the Philosphers Collection.

The moral expertise of clinical ethicists is not a question of mastering codelike theories and lawlike principles. Rather, ethicists are architects of moral space within the health care setting, as well as mediators in the conversations taking place within that space.

To be truly reflective, moral thinking and moral philosophy must become aware of the contexts that bind our thinking about how to live. These essays show how to do this, and why it makes a difference.

Work on representing women's voices in ethics has produced a vision of moral understanding profoundly subversive of the traditional philosophical conception of moral knowledge. I explicate this alternative moral "epistemology," identify how it challenges the prevailing view, and indicate some of its resources for a liberatory feminist critique of philosophical ethics.

The use of ethics in everyday nursing practice will become increasingly important to the individual nurse, and nursing as a profession, as technology has a greater impact on health status and the provision of health care. Resource allocation is only one example of an ethical issue in which nursing must have input. Nursing can expand its contribution to society by ensuring that it plays a major role in shaping public policy and legislation. If nursing is to continue to serve the (...) public, the involvement of nurses within the political process must be accepted as an ethical necessity. (shrink)

Prepare for practice with the essential text dedicated to Canadian legal and ethical issues! Focused solely on the ever-changing, and often complex health care landscape in Canada, Ethical & Legal Issues in Canadian Nursing 4th, Edition expertly covers the often intertwined ethical and legal issues that health care professionals face today. This fourth edition includes discussion points at the end of every chapter along with tables and illustrations to help you fully comprehend the material. Plus, the clear and straightforward writing (...) style presents information just as you will encounter it in your day-to-day practice, ensuring you're even more prepared to make an impact from the start! -- From the publisher. (shrink)

Studies of participatory governance generally examine the input and/or output side of policy processes. Often neglected is the throughput: Does the state have the political and technical capacity to implement the decisions that deliberative bodies make? In this study of Brazilian river-basin committees, the authors find that activists inside and outside the state often must collaborate to overcome resistance to change and provide state officials with resources they lack. They argue that this does not constitute the transfer of state responsibility (...) to private actors but rather the mobilization of a state's capacity to defend the public interest. (shrink)

This article will compare and contrast two very different accounts of convention: the game-theoretical account of Lewis in Convention, and the account initially proposed by Margaret Gilbert (the present author) in chapter six of On Social Facts, and further elaborated here. Gilbert’s account is not a variant of Lewis’s. It was arrived at in part as the result of a detailed critique of Lewis’s account in relation to a central everyday concept of a social convention. An account of convention (...) need not be judged by that standard. Perhaps it reveals the nature of an important phenomenon. Looked at in that light, these very different accounts are not incompatible. Indeed, neither should be ignored if one is seeking to understand the way in which human beings arrive at some degree of social order. (shrink)

It is widely accepted that only the victim of a wrong can forgive that wrong. Several philosophers have recently defended “third-party forgiveness,” the scenario in which A, who is not the victim of a wrong in any sense, forgives B for a wrong B did to C. Focusing on Glen Pettigrove's argument for third-party forgiveness, I will defend the victim's unique standing to forgive, by appealing to the fact that in forgiving, victims must absorb severe and inescapable costs of distinctive (...) kinds, a plight that third parties do not share. There are, nonetheless, significant, even essential, roles played by third parties in making forgiveness possible, reasonable, or valuable for victims of serious wrongs. I take a closer look at the links between victims, wrongdoers, resentment, and forgiveness in showing why the victim alone can forgive. (shrink)

: International instruments now defend a "right to the truth " for victims of political repression and violence and include truth telling about human rights violations as a kind of reparation as well as a form of redress. While truth telling about violations is obviously a condition of redress or repair for violations, it may not be clear how truth telling itself is a kind of reparations. By showing that concerted truth telling can satisfy four features of suitable reparations vehicles, (...) I defend the idea that politically implemented modes of truth telling to, for, and by those who are victims of gross violation and injustice may with good reason be counted as a kind of reparations. Understanding the doubly symbolic character of reparations, however, makes clearer why truth telling is unlikely to be sufficient reparation for serious wrongs and is likely to be sensitive to the larger context of reparative activity and its social, political, and historical background. (shrink)

Many contexts shape and limit moral thinking in philosophy and life. Human conditions of vulnerability and interdependency, of limited awareness and control, of imperfect insight into ourselves and others are inevitable contexts that neither moral thought nor theory should forget. To be truly reflective, moral thinking and moral philosophy must become aware of the contexts that bind our thinking about how to live. This collection of essays by Margaret Urban Walker seek to show how to do this, and why (...) it makes a difference. Contingent and changeable contexts that shape moral thinking include our individual histories, our social positions, and institutional roles, relationships, cultural settings, and social arrangements, and the specific moral idioms we pick up along the way. The paradigms and specialized language of ethical theory are contexts, too; they shape how moral theory looks and what or whom it looks at. Ethical theory and practice are meaningless without these Moral Contexts. (shrink)

Feminist discussions of ethics in the Western philosophical tradition range from critiques of the substance of dominant moral theories to critiques of the very practice of "doing ethics" itself. I argue that these critiques really target a certain historically specific model of ethics and moral theory-a "theoretical-juridical" one. I outline an "expressive-collaborative" conception of morality and ethics that could be a politically self-conscious and reflexively critical alternative.

When a woman is pregnant, how should we understand the moral status of the life within her? How should we understand its status as conceptus, as embryo, when an early or again matured fetus? According to some, human life in all of these forms is inviolable: early human life has a moral status equivalent to a person from the moment of conception. According to others, such life has no intrinsic status, even late in pregnancy. According to still others, moral status (...) emerges when sentience does. Until the fetus is conscious - a point somewhere at the end of the second trimester, it has no moral status at all; after it is conscious, it does. (shrink)

The third and fourth books of Cicero's _Tusculan Disputations_ deal with the nature and management of human emotion: first grief, then the emotions in general. In lively and accessible style, Cicero presents the insights of Greek philosophers on the subject, reporting the views of Epicureans and Peripatetics and giving a detailed account of the Stoic position, which he himself favors for its close reasoning and moral earnestness. Both the specialist and the general reader will be fascinated by the Stoics' analysis (...) of the causes of grief, their classification of emotions by genus and species, their lists of oddly named character flaws, and by the philosophical debate that develops over the utility of anger in politics and war. Margaret Graver's elegant and idiomatic translation makes Cicero's work accessible not just to classicists but to anyone interested in ancient philosophy and psychotherapy or in the philosophy of emotion. The accompanying commentary explains the philosophical concepts discussed in the text and supplies many helpful parallels from Greek sources. (shrink)

For those open to the possibility that philosophical thought can improve life, David Hume's Essays: Moral, Political, and Literary have something to say. In the first comprehensive study of the Essays, Margaret Watkins engages closely with these neglected texts and shows how they provide important insights into Hume's perspective on the breadth and depth of human life, arguing that the Essays reveal his continued commitment to philosophy as a discipline that can promote both social and individual progress. Addressing topics (...) such as politics, war, slavery, the priesthood, the development of industry, aesthetics, emotional disorders, egoism, friendship, sexuality, gender relations, and the nature of philosophy itself, the volume examines Hume's purposes and aims against the backdrop of the eighteenth century society in which he lived. It will be of interest to scholars of modern thought in philosophy, politics, history, and economics. (shrink)

This chapter examines one of the most serious problems with the principle of self‐determination, viz., that this concept does not tell us who the peoples are that are entitled to self‐determination or the jurisdictional unit that they are entitled. It examines indigenous, historical, superior culture, and occupancy arguments for rights to a particular territory and suggests normative principles for thinking about jurisdictional units.