Western ethics and law have been slow to come to conclusions about the right to choose the time and manner of one's death. However, policies, practices, and legal precedents have evolved quickly in the last quarter of the twentieth century, from the forgoing of respirators to the use of Do Not Resuscitate orders, to the forgoing of all medical technologies, and now, in one U.S. state, to legalized physician-assisted suicide. The sweep of history—from the Quinlan case in New Jersey to (...) legislation in Oregon that allows physician-assisted suicide—has been as rapid as it has been revolutionary. (shrink)
This is an extremely thorough revision of the leading textbook of bioethics. The authors have made many improvements in style, organization, argument and content. These changes reflect advances in the bioethics literature over the past five years. The most dramatic expansions of the text are in the comprehensiveness with which the authors treat different currents in ethical theory and the greater breadth and depth of their discussion of public policy and public health issues. In every chapter, readers will find new (...) material and refinements of old discussions. This is evident in the many new sections on topics like communitarianism, ethics of care, relationship-based accounts, casuistry, case-based reasoning, principle-based common-morality theories, the justification of assistance in dying, rationing through priorities in the health care budget, and virtues in professional roles. The most extensive revisions are in chapters 1, 2 and 8. (shrink)
The principal thesis in this book is that bioethics emerged—in the 1960s through the 1980s—under the influence of philosophers who claimed to have universally valid principles that could steer medicine and research to the solution of ethical problems, including even those arising at the bedside of patients. Tom Koch contends that these philosophers and their allied bioethicists “stole medicine” and its traditional values, substituting a philosophical discourse generally inaccessible to the average person. Philosophers thereby refashioned medical ethics in accordance with (...) their vision of a morally and intellectually robust new field. Koch maintains that philosophers have failed to deliver on their promises and that .. (shrink)
Tom Beauchamp presents a new edition, designed especially for the student reader, of An Enquiry concerning Human Understanding, the classic work in which David Hume gave a general exposition of his philosophy to a broad educated readership. An authoritative new version of the text is preceded by a substantial introduction explaining the historical and intellectual background to the work and surveying its main themes. The volume also includes detailed explanatory notes on the text, a glossary of terms, and a (...) section of supplementary readings. (shrink)
This is the first new scholarly edition since the nineteenth century of one of the greatest works in the history of philosophy: David Hume's Enquiry concerning the Principles of Morals. It is the fourth volume of the Clarendon Hume Edition, which will be the definitive edition for the foreseeable future. In this elegant and lucid Enquiry Hume gives an accessible presentation of his fully developed ethical theory, that is to say his theory of the foundation of morality in human nature. (...) He considered this work to be `of all my writings, historical, philosophical, or literary, incomparably the best'. The distinguished Hume scholar Tom Beauchamp presents an authoritative text accompanied by introduction, annotation, glossary, biographical sketches, bibliographies, and indexes. (shrink)
Tom Beauchamp presents the definitive scholarly edition of two famous works by David Hume, both originally published in 1757. In A Dissertation on the Passions Hume sets out his original view of the nature and central role of passion and emotion. The Natural History of Religion is a landmark work in the study of religion as a natural phenomenon.
This edition represents a thorough-going revision of what has become a classic text in biomedical ethics. Major structural changes mark the revision. The authors have added a new concluding chapter on methods that, along with its companion chapter on moral theory, emphasizes convergence across theories, coherence in moral justification, and the common morality. They have simplified the opening chapter on moral norms which introduces the framework of prima facie moral principles and ways to specify and balance them. Together with the (...) shift of advanced material on theory to the back of the book, this heavily revised introductory chapter will make it easier for the wide range of students entering bioethics courses to use this text. Another important change is the increased emphasis on character and moral agency, drawing the distinction between agents and actions. The sections on truth telling, disclosure of bad news, privacy, conflicts of interest, and research on human subjects have also been throughly reworked. The four core chapters on principles and the chapter on professional-patient relationships retain their familiar structure, but the authors have completely updated their content to reflect developments in philosophical analysis as well as in research, medicine, and health care. Throughout, they have used a number of actual cases to illuminate and to test their theory, method, and framework of principles. (shrink)
This accessible overview of classical and modern moral theory with short readings provides comprehensive coverage of ethics and unique coverage of rights, justice, liberty and law. Real-life cases introduce each chapter. While the book's content is theoretical rather than applied ethics, Beauchamp consistently applies the theories to practical moral problems. Aristotle, Hume, Kant, and Mill are at the book;s core and they are placed in the context of moral philosophical controversies of the last 30 years. In this edition one-third (...) of the reading selections are new and all the selections in chapter 8 on rights are new. Chapter 7 on Hume has been heavily reshaped. Chapter 1 has been reduced to get students past introductory material and into the philosophers. (shrink)
about Hume: David Hume is one of the greatest of philosophers. Today he probably ranks highest of all British philosophers in terms of influence and philosophical standing. His philosophical work ranges across morals, the mind, metaphysics, epistemology, and aesthetics; he had broad interests not only in philosophy as it is now conceived but in history, politics, economics, religion, and the arts. He was a master of English prose. about the Clarendon Hume Edition: The Clarendon Hume will include all of his (...) works except his History of England and minor historical writings; it will be the only thorough critical edition, and will provide a far more extensive scholarly treatment than any previous editions. This edition offers authoritative annotation, bibliographical information, and indexes, and draws upon the major advances in textual scholarship that have been made since the publication of earlier editions--advances both in the understanding of editorial principle and practice and in knowledge of the history of Hume's own texts. General Editors: Professors T. L. Beauchamp, D. F. Norton, M. A. Stewart. The Edition will comprise: Vols. 1 and 2: A Treatise of Human Nature, edited by D. F. Norton Vol. 3: An Enquiry concerning Human Understanding, edited by T. L. Beauchamp Vol. 4: An Enquiry concerning the Principles of Morals, edited by T. L. Beauchamp Vol. 5: The Natural History of Religion and the Dissertation on the Passions Vols. 6 and 7: Essays Vol. 8: Dialogues concerning Natural Religion and other posthumous publications, edited by M. A. Stewart. (shrink)
David Hume (1711-1776) is one of the greatest of philosophers. Today he probably ranks highest of all British philosophers in terms of influence and philosophical standing. His philosophical work ranges across morals, the mind, metaphysics, epistemology, and aesthetics; he had broad interests not only in philosophy as it is now conceived but in history, politics, economics, religion, and the arts. He was a master of English prose. -/- about the Clarendon Hume Edition: -/- The Clarendon Hume will include all of (...) his works except his History of England and minor historical writings; it will be the only thorough critical edition, and will provide a far more extensive scholarly treatment than any previous editions. This edition (which has been in preparation since the 1970s) offers authoritative annotation, bibliographical information, and indexes, and draws upon the major advances in textual scholarship that have been made since the publication of earlier editions--advances both in the understanding of editorial principle and practice and in knowledge of the history of Hume's own texts. -/- General Editors: Professors T. L. Beauchamp (Georgetown University, USA), D. F. Norton (McGill University, Canada), M. A. Stewart (University of Lancaster, England). -/- The Edition will comprise: -/- Vols. 1 and 2: A Treatise of Human Nature, edited by D. F. Norton -/- Vol. 3: An Enquiry concerning Human Understanding, edited by T. L. Beauchamp -/- Vol. 4: An Enquiry concerning the Principles of Morals, edited by T. L. Beauchamp -/- Vol. 5: The Natural History of Religion and the Dissertation on the Passions -/- Vols. 6 and 7: Essays -/- Vol. 8: Dialogues concerning Natural Religion and other posthumous publications, edited by M. A. Stewart. (shrink)
Our primary focus is on analysis of the concept of voluntariness, with a secondary focus on the implications of our analysis for the concept and the requirements of voluntary informed consent. We propose that two necessary and jointly sufficient conditions must be satisfied for an action to be voluntary: intentionality, and substantial freedom from controlling influences. We reject authenticity as a necessary condition of voluntary action, and we note that constraining situations may or may not undermine voluntariness, depending on the (...) circumstances and the psychological capacities of agents. We compare and evaluate several accounts of voluntariness and argue that our view, unlike other treatments in bioethics, is not a value-laden theory. We also discuss the empirical assessment of individuals? perceptions of the degrees of noncontrol and self-control. We propose use of a particular Decision Making Control Instrument. Empirical research using this instrument can provide data that will help establish appropriate policies and procedures for obtaining voluntary consent to research. (shrink)
The practice of obtaining informed consent has its history in, and gains its meaning from, medicine and biomedical research. Discussions of disclosure and justified nondisclosure have played a significant role throughout the history of medical ethics, but the term “informed consent” emerged only in the 1950s. Serious discussion of the meaning and ethics of informed consent began in medicine, research, law, and philosophy only around 1972.
Literature on the mental capacities and cognitive mechanisms of the great apes has been silent about whether they can act autonomously. This paper provides a philosophical theory of autonomy supported by psychological studies of the cognitive mechanisms that underlie chimpanzee behavior to argue that chimpanzees can act autonomously even though their psychological mechanisms differ from those of humans. Chimpanzees satisfy the two basic conditions of autonomy: (1) liberty (the absence of controlling influences) and (2) agency (self-initiated intentional action), each of (...) which is specified here in terms of conditions of understanding, intention, and self-control. In this account, chimpanzees make knowledge-based choices reflecting a richly information-based and socially sophisticated understanding of the world. Finally, two major theories of autonomy (Kantian theory and two-level theory) are rejected as too narrow to adequately address these issues, necessitating the modifications made in the present approach. (shrink)
: Phenomena of moral conflict and disagreement have led writers in ethics to two antithetical conclusions: Either valid moral distinctions hold universally or they hold relative to a particular and contingent moral framework, and so cannot be applied with universal validly. Responding to three articles in this issue of the Journal that criticize his previously published views on the common morality, the author maintains that one can consistently deny universality to some justified moral norms and claim universality for others. Universality (...) is located in the common morality and nonuniversality in other parts of the moral life, called "particular moralities." The existence of universal moral standards is defended in terms of: (1) a theory of the objectives of morality, (2) an account of the norms that achieve those objectives, and (3) an account of normative justification (both pragmatic and coherentist). (shrink)
The scientific, ethical, and policy issues raised by research involving the engraftment of human neural stem cells into the brains of nonhuman primates are explored by an interdisciplinary working group in this Policy Forum. The authors consider the possibility that this research might alter the cognitive capacities of recipient great apes and monkeys, with potential significance for their moral status.
The distinction between clinical research and clinical practice directs how we partition medicine and biomedical science. Reasons for a sharp distinction date historically to the work of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, especially to its analysis of the “boundaries” between research and practice in the Belmont Report (1978). Belmont presents a segregation model of the research-practice distinction, according to which research and practice form conceptually exclusive sets of activities and interventions. This (...) model is still the standard in federal regulations today. However, the Commission’s deliberations and conclusions about the boundaries are more complicated, nuanced, and instructive than has generally been appreciated. The National Commission did not conclude that practice needs no oversight comparable to the regulation of research. It debated the matter and inclined to the view that the oversight of practice needed to be upgraded, though the Commission stopped short of proposing new regulations for its oversight, largely for prudential political reasons. (shrink)
This new edition of Hume's Enquiry concerning the Principles of Morals, published in the Oxford Philosophical Texts series, has been designed especially for the student reader. The text is preceded by a substantial introduction explaining the historical and intellectual background to the work and its relationship to the rest of Hume's philosophy. The volume also includes detailed explanatory notes on the text, a glossary of terms, and a section of supplementary readings.
To address some questions in global biomedical ethics, three problems about cultural moral differences and alleged differences in Eastern and Western cultures are addressed: The first is whether the East has fundamentally different moral traditions from those in the West. Concentrating on Japan and the United States, it is argued that theses of profound and fundamental East-West differences are dubious because of many forms of shared morality. The second is whether human rights theory is a Western invention with no firm (...) traditions in Eastern moral traditions. It is argued that this thesis is unsupported both historically and in contemporary bioethics. The third problem is whether multiculturalist theory casts doubt on claims of universal principles and rights. It is argued that the reverse is true: multiculturalism is a universalistic theory. The argument throughout supports common morality theory. (shrink)
In the relatively short time since 2006—when Theoretical Medicine and Bioethics published an issue on moral issues relevant to the use of nonhuman animals in research —significant changes have occurred for nonhuman animals in many quarters. Public sentiment, new policy initiatives, and scientific studies of nonhuman animals’ capacities have all influenced the ways in which nonhuman animals are perceived and treated in research. Today, a large body of information is available for use in decision making about the acceptability of using (...) nonhuman animals in research. The articles in this issue assess how moral argument and empirical studies stand to guide animal research policies and practices in future years.Many in bioethics have come to regard issues of animal research as a subfield of research ethics, bringing it closer to human research ethics. Animal ethics, like public health ethics, has struggled for recognition in bioethics. As the contributions to this issue show, some in bioe. (shrink)
In the third of his Essays on the Intellectual Powers of Man, Reid devotes the fourth chapter to the concept of‘identity’, and the sixth chapter to Locke’s theory of ‘personal identity’. This latter chapter is widely regarded as a definitive refutation of the thesis that personal identity is no more than memories of a certain sort. It is interesting that the terms ‘identity’ and ‘personal identity’ do not appear as chapter or section titles elsewhere in any of Reid’s works; and (...) Hume is neither mentioned nor his theory of personal identity discussed in the two chapters specifically addressed to the matter. Moreover, while Locke, Reid, and Hume are often anthologized in works on personal identity, Reid is always presented as replying only to Locke. (shrink)
Discussions of research involving vulnerable populations have left the homeless comparatively ignored. Participation by these subjects in drug studies has the potential to be upsetting, inconvenient, or unpleasant. Participation occasionally produces injury, health emergencies, and chronic health problems. Nonetheless, no ethical justification exists for the categorical exclusion of homeless persons from research. The appropriate framework for informed consent for these subjects of pharmaceutical research is not a single event of oral or written consent, but a multi-staged arrangement of disclosure, dialogue, (...) and permission-giving. Payments and other rewards in biomedical research raise issues of whether it is ethical to offer inducements to the homeless in exchange for participation in drug studies. Such inducements can influence desperate persons who are seriously lacking in resources. The key is to strike a balance between a rate of payment high enough that it does not exploit subjects by underpayment and low enough that it does not create an irresistible inducement. This proposal does not underestimate the risks of research, which are often overestimated and need to be appraised in light of the relevant empirical literature. (shrink)
What grounds and justifies conclusions in medical ethics? Is the source external or internal to medicine? Thee influential types of answer have appeared in recent literature: an internal account, an external account, and a mixed internal / external account. The first defends an ethic derived from either the ends of medicine or professional practice standards. The second maintains that precepts in medical ethics rely upon and require justification by external standards such as those of public opinion, law, religious ethics, or (...) philosophical ethics. The third claims that distinct medical ethics have emerged from distinct cultural frameworks, each with norms that govern physicians. There is merit in each perspective, but each overreaches its supporting arguments and fails to appreciate what is legitimate in the theses of its competitors. I propose a fourth account that offers a way to escape limitations of the other three, while retaining their most attractive features. (shrink)
: The belief persists in philosophy, religion, science, and popular culture that some special cognitive property of persons like self-consciousness confers a unique moral standing. However, no set of cognitive properties confers moral standing, and metaphysical personhood is not sufficient for either moral personhood or moral standing. Cognitive theories all fail to capture the depth of commitments embedded in using the language of "person." It is more assumed than demonstrated in these theories that nonhuman animals lack a relevant form of (...) self-consciousness or its functional equivalent. Although nonhuman animals are not plausible candidates for moral personhood, humans too fail to qualify as moral persons if they lack one or more of the conditions of moral personhood. If moral personhood were the sole basis of moral rights, then these humans would lack rights--and precisely for the reasons that nonhuman animals would. (shrink)
Affirmative action refers to positive steps taken to hire persons from groups previously and presently discriminated against. Considerable evidence indicates that this discrimination is intractable and cannot be eliminated by the enforcement of laws. Numerical goals and quotas are justified if and only if they are necessary to overcome the discriminatory effects that could not otherwise be eliminated with reasonable efficiency. Many past as well as present policies are justified in this way.