Ethics education is recognized as an integral component of health professionals’ education and has been occurring in various guises in the curricula of health professional training in many countries since at least the 1970s. However, there are a number of different aims and approaches adopted by individual educators, programs, and, importantly, different health professions that may be characterized according to strands or trends in ethics education.

Bioethics, Volume 36, Issue 7, Page 765-773, September 2022.

National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In (...) this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing. (shrink)

Alderson critiques our recent book on the basis that it overlooks children’s own views about their medical treatment. In this response, we discuss the complexity of the paediatric clinical context and the value of diverse approaches to investigating paediatric ethics. Our book focuses on a specific problem: entrenched disagreements between doctors and parents about a child’s medical treatment in the context of a paediatric hospital. As clinical ethicists, our research question arose from clinicians’ concerns in practice: What should a clinician (...) do when he or she thinks that parents are choosing a treatment pathway that does not serve the child’s best interests? Alderson’s work, in contrast, focuses on the much broader issue of children’s role in decision-making about treatment and research. We argue that these different types of work are zooming in on different aspects of paediatric ethics, with its complex mix of agents, issues and relationships. Paediatric ethics overall needs a rich mix of approaches,... (shrink)

Is Female Genital Cosmetic Surgery for an adolescent with Body Dysmorphic Disorder ever ethically justified? Cosmetic genital surgery for adolescent girls is one of the most ethically controversial forms of cosmetic surgery and Body Dysmorphic Disorder is typically seen as a contraindication for cosmetic surgery. Two key ethical concerns are that Body Dysmorphic Disorder undermines whatever capacity for autonomy the adolescent has; and even if there is valid parental consent, the presence of Body Dysmorphic Disorder means that cosmetic surgery will (...) fail in its aims. In this article, we challenge, in an evidence-based way, the standard view that Body Dysmorphic Disorder is a contraindication for genital cosmetic surgery in adolescents. Our argument gathers together and unifies a substantial amount of disparate research in the context of an ethical argument. We focus on empirical questions about benefit and harm, because these are ethically significant. Answers to these questions affect the answer to the ethical question. We question the claim that there would be no benefit from surgery in this situation, and we consider possible harms that might be done if treatment is refused. For an adolescent with Body Dysmorphic Disorder, the most important thing may be to avoid harm. We find ourselves arguing for the ethical justifiability of cosmetic labioplasty for an adolescent with Body Dysmorphic Disorder, even though we recognize that it is a counter intuitive position. We explain how we reached our conclusion. (shrink)

Child co-research has become popular in social research involving children. This is attributed to the emphasis on children’s rights and is seen as a way to promote children’s agency and voice. It is a way of putting into practice the philosophy, common amongst childhood researchers, that children are experts on childhood. In this article, we discuss ethical complexities of involving children as co-researchers, beginning with an analysis of the literature, then drawing on data from interviews with researchers who conduct child (...) co-research. We identify six ethical complexities, some of which are new findings which have not been mentioned before in this context. In light of these possible ethical complexities, a key finding is for researchers to be reflexive – to reflect on how the research may affect child co-researchers and participants before the research starts. A separate overriding message that came out in responses from the researchers we interviewed was the need for support and training for child co-... (shrink)

This article deals with the prospect of genetically enhancing intelligence. We identify and contrast social attitudes (disapproval) to the use of future genetic technology with social attitudes (approval) for environmental methods of enhancing intelligence. Using various forms of the argument that the means by which enhancement is achieved has moral significance, we look for differences that could justify the different attitudes. We find that the different attitudes cannot be ethically justified. We predict that the lack of ethical justification for distinguishing (...) between means of enhancement is likely to result in the eventual acceptance of genetic enhancement of intelligence. (shrink)

By looking closely at the ideas of Rosseau, Kant, and Mill, Autonomy and Patients' Decisions traces the modern concept of autonomy from its historical roots, ...

A notable feature of the COVID-19 pandemic is that children are less at risk of becoming infected or, if infected, less likely to become seriously unwell, so ethical discussions have consequently focused on the adult healthcare setting. However, despite a lower risk of children becoming acutely ill with COVID-19, there nevertheless may be significant and potentially sustained effects of COVID-19 on the physical, psychological, and emotional health and well-being of children. Focusing on the context of children’s cancer care, and specifically (...) bone marrow transplant, we describe some of these effects and then address one specific ethical challenge that arises. That is the question of what and how much to tell children whose cancer treatment has been changed because of COVID-19. Drawing on our previous work on the ethical reasons for telling the truth to younger children we link different ethical reasons to the different types of information that could be given to children in this context. We argue that children should be given an explanation of the changes that they will directly experience, including some changes to the process of their actual medical treatment; but not about increased risk associated with these changes, unless they specifically ask for this information. (shrink)

Labiaplasty is a form of genital surgery to reduce large or protruding labia minora. Internationally, the rates of this surgery among women and girls is increasing and is viewed as a worrying trend. Currently, the main clinical strategy is to reassure adolescents that they are normal by talking about the variation of labia size and appearance and showing pictures demonstrating the wide range of normal female genital appearance. For the most part, policy documents recommend against labiaplasty in adolescents, claiming that (...) it is medically non-essential surgery. In this paper, we contrast findings from our interviews with clinicians with the existing literature and policy documents and we point out areas needing more thought. This is qualitative research using semi-structured interviews. We set out to find out on what basis clinicians decide how to treat or manage adolescent patients seeking labiaplasty. We interviewed clinicians who are likely to be approached by under-eighteens requesting labiaplasty. We use interpretive content analysis and thematic analysis to analyse the data. Our findings support the emphasis on education and reassurance as the first step for all patients, but other issues that have not figured previously in the literature that would alter clinical strategies for managing patients emerge as well. Key findings are that reassurance does not always work and that the distinction between functional and appearance concerns is not a solid foundation in itself for deciding whether surgery is ethically appropriate. We conclude that the distinction between functional and appearance concerns is not ethically relevant. It is open to different interpretations and is not regarded by all clinicians as the definitive factor in relation to surgery. The focus of clinicians should be on relieving distress whatever the cause. Appearance reasons may sometimes justify surgery but, also, functional reasons may sometimes not be sufficient justification for surgery. (shrink)

Social networking sites such as MySpace and virtual communities such as on-line support groups can be a rich source of data for researchers. These sites can be an effective way of reaching and researching young people in order to address their particular health needs. Internet-based research is also potentially risky and exploitative. There is some guidance for conducting research online, but there are no detailed or universally accepted ethics guidelines for research of webspaces such as MySpace or virtual communities in (...) which young people participate. One question that arises is — If MySpace is a public webspace, can research be done without consent? In this paper I investigate ethical issues surrounding young people’s consent in cyber research. I identify issues that help determine whether consent is needed, offer suggestions for dealing with consent in cyberspace and add my voice to the call for a resource of case studies — indispensible in the development of guidelines and the education of researchers and research ethics committees. (shrink)

ABSTRACT I examine the impact of addiction on autonomy in terms of the standard literature on addiction – referred to also as ‘substance dependence.’1 Then in terms of the criteria for substance dependence, by developing a set of practical strategies to help people with addictions think more clearly, I test the idea whether addicts can be helped to become more autonomous. Given that unsuccessful attempts to quit constitute part of the criteria of substance dependence, I look at what goes wrong (...) when people try to quit using a substance. The subjective experience of addiction is an important aid in understanding addiction and first person accounts and literary characterisations of addiction provide insight into the addict's mind and assist us in deciding whether addicts can be helped to become more autonomous. (shrink)

Excluding women from participating in clinical drug trials might seem like a good thing. It may seem like a good way to protect women from the risks of being a research subject and a way to prevent fetal harm. However, the exclusion or inadequate representation of women in clinical trials may actually cause harm. Excluding women from clinical trials does not rule out the possibility of damage to offspring. Nor does it guarantee researchers or institutions freedom from legal liability. The (...) issue of women’s exclusion has received substantial attention in the USA but very little in Australia. (shrink)

The American Journal of Bioethics, Volume 12, Issue 1, Page 42-44, January 2012.

(2010). Ashley's Interests Were Not Violated Because She Does Not Have the Necessary Interests. The American Journal of Bioethics: Vol. 10, No. 1, pp. 52-54.

When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.

The Kennedy Krieger lead paint study is a landmark case in human experimentation and a classic case in research ethics. In this paper I use the lead paint study to assist in the analysis of the ethics of research on less expensive, less effective interventions. I critically evaluate an argument by Buchanan and Miller who defend both the Kennedy Krieger lead paint study and public health research on less expensive, less effective interventions. I conclude that Buchanan and Miller’s argument is (...) flawed but that does not mean that research designed to find less effective interventions cannot be justified in some situations. Based on my analysis, I suggest questions to ask when considering such research and I offer some principles to guide us. In the process, light is shed on the various debates and issues raised by the lead paint study; e.g. standards of care, researchers’ responsibilities to research subjects, the distinction between treatment and research and the question of what it is that legitimizes public health research. (shrink)

Johann Gottlieb Fichte’s Foundations of Natural Right represents a turning point in the philosophy of law and the state. In 14 original essays, this volume compiles a collaborative commentary that offers a differentiated interpretation of this controversial classic in legal philosophy. Ideally suited for seminar courses.

Die Berechtigung und Angemessenheit von Strafen ist ein Zentralproblem jeder Staats- und Gesellschaftsphilosophie. Die vorliegende Abhandlung befasst sich mit den Vergeltungstheorien (Retributivismus) und den Theorien der Generalprävention und erarbeitet in einer Kombination von Spezialprävention und Resozialisierung einen eigenen Standpunkt, aus dem sich ein Plädoyer für einen die Würde des Menschen respektierenden Umgang mit Verbrechern herleitet.

Volume 195 in the North Carolina Studies in the Romance Languages and Literatures series.

Experimental research has shown that pairs of stimuli which are congruent and assumed to 'go together' are recalled more effectively than an item presented in isolation. Will this multisensory memory benefit occur when stimuli are richer and longer, in an ecological setting? In the present study, we focused on an everyday situation of audio-visual learning and manipulated the relationship between audio guide tracks and viewed portraits in the galleries of the Tate Britain. By varying the gender and narrative style of (...) the voice-over, we examined how the perceived congruency and assumed unity of the audio guide track with painted portraits affected subsequent recall. We show that tracks perceived as best matching the viewed portraits led to greater recall of both sensory and linguistic content. We provide the first evidence that manipulating crossmodal congruence and unity assumptions can effectively impact memory in a multisensory ecological setting, even in the absence of precise temporal alignment between sensory cues. (shrink)

Das "System der Sittenlehre" von 1798 stellt Fichtes Versuch dar, die Kantische Moralphilosophie so zu reformulieren, dass die weithin als problematisch empfundenen Kantischen Dualismen von Freiheit und Natur, von Pflicht und Neigung, in eine einheitliche Konzeption menschlicher Subjektivitat aufgehoben werden. Sie gilt zudem als die reifste und elaborierteste Darstellung des Standpunkts seiner Jenaer Wissenschaftslehre, in der die praktische Vernunft in die Rolle des hochsten Prinzips der Philosophie ruckt. Dieser kooperative Kommentar ermoglicht dem Leser, die Argumentation des Textes Schritt fur Schritt (...) nachzuvollziehen und dadurch zu einem vertieften Verstandnis dieses zentralen Textes des Deutschen Idealismus zu gelangen. (shrink)

This volume presents an extended version of the contributions presented at the workshop "Kant's Concept of Law" held at the 26th World Congress of the International Association for Philosophy of Law and Social Philosophy (IVR) in 2013. It handles issues of applied legal philosophy in Kant's Doctrine of Right such as ownership, the alleged right of necessity, the right of resistance and the right of revolution. With each of these applied issues, the focus lies, on the one hand, on the (...) relationship between the principles a priori of law and of the duties of rights, as well as their normative requirements - for instance, the duty of independence from the coercion by others - and, on the other hand, empirical situations and their pressing demands. Thus, this volume illustrates how Kant concretely conceives of the doctrine of "first metaphysical of the doctrine of right" as supplying "the immutable principles for any giving of positive law". Each essay of this volume not only undertakes a careful and original interpretation of Kant's theses, but also offers a critical assessment. (shrink)

A deaf lesbian couple who chose to have a deaf child receive a lot of criticismA deaf lesbian couple in the US deliberately tried to create a deaf child. Sharon Duchesneau and Candy McCullough hoped their child, conceived with the help of a sperm donor, would be deaf like the rest of the family. Their daughter, five year old Jehanne, is also deaf and was conceived with the same donor. News of the couple choosing to have a deaf child has (...) only been revealed with the birth of their son Gauvin.1–4To increase their chance of having a deaf baby the women sought a deaf sperm donor from a sperm bank but were told that congenital deafness is “precisely the sort of condition” that disqualifies would-be donors. Rather than dismiss the idea they found their own sperm donor by asking a deaf friend who comes from a family with five generations of deafness.1The women, both professionals in the mental health field, insist that they would still love …. (shrink)

Future automated vehicles of different sizes will share the same space with other road users, e. g., pedestrians. For a safe interaction, successful communication needs to be ensured, in particular, with vulnerable road users, such as pedestrians. Two possible communication means exist for AVs: vehicle kinematics for implicit communication and external human-machine interfaces for explicit communication. However, the exact interplay is not sufficiently studied yet for pedestrians' interactions with AVs. Additionally, very few other studies focused on the interplay of vehicle (...) kinematics and eHMI for pedestrians' interaction with differently sized AVs, although the precise coordination is decisive to support the communication with pedestrians. Therefore, this study focused on how the interplay of vehicle kinematics and eHMI affects pedestrians' willingness to cross, trust and perceived safety for the interaction with two differently sized AVs. In this experimental online study, the participants interacted with the AVs in a shared space. Both AVs were equipped with a 360° LED light-band eHMI attached to the outer vehicle body. Three eHMI statuses were displayed. The vehicle kinematics were varied at two levels. Moreover, “non-matching” conditions were included for both AVs in which the dynamic eHMI falsely communicated a yielding intent although the vehicle did not yield. Overall, results showed that pedestrians' willingness to cross was significantly higher for the smaller AV compared to the larger AV. Regarding the interplay of vehicle kinematics and eHMI, results indicated that a dynamic eHMI increased pedestrians' perceived safety when the vehicle yielded. When the vehicle did not yield, pedestrians' perceived safety still increased for the dynamic eHMI compared to the static eHMI and no eHMI. The findings of this study demonstrated possible negative effects of eHMIs when they did not match the vehicle kinematics. Further implications for a holistic communication strategy for differently sized AVs will be discussed. (shrink)

Children’s linguistic and social skills develop through play with siblings, but there is little research into sibling interaction using naturally occurring data. This conversation analytic case study presents an evidence-based account of how an older sibling responds to verbal challenges from her younger sibling during free play at home. The older sibling employs prosodic, rhetorical and linguistic devices to deflect challenges while avoiding conflict. She does this by acknowledging the grounds of the challenge, before invoking privileged information or epistemic differences (...) to reject it. Structurally, the older sibling inserts extended digressions which obfuscate challenges by engaging the challenger and switching topic. These phenomena blur the traditional accept/reject response dichotomy. The findings provide insight into the complexity of a 5-/6-year-old’s challenge-defence strategies and highlight the importance of face preservation and mitigation of disagreement. We propose that the ability to respond to challenges while maintaining intersubjectivity is a component of communicative competence. (shrink)

An Important distinction between statements of fact and statements of value is widely recognised. Some philosophers are now saying that the distinction has been treated as more determinate than it is, but most philosophers would agree that the distinction is definite and important. The major contributions to Anglo-Saxon moral philosophy of this century have set out to illuminate the nature of this distinction. Ethical statements have been thevalue statements mainly at issue, but on the whole the aim has not been (...) to show wherein they differ from other value statements, but to show what distinguishes them in common with other value statements from factual statements. The characterisations of ethical statements which have become famous areones which if they apply to ethical statements at all apply equally to many other value statements as well. (shrink)