In Medical Ethics, the editors have developed a completely different type book, focusing upon issues not ordinarily dealt with in texts on bioethics.

This paper is divided into three sections. The first presents some examples of the killing/letting die distinction. The second draws a further distinction between what I call negative and positive cases of acting or refraining. Here I argue that the moral significance of the acting/refraining distinction is different for positive and for negative cases. In the third section I apply the above distinction to euthanasia, and argue that mercy killing should be regarded as analogous to positive rather than negative cases. (...) On the basis of this, I then support active rather than passive euthanasia. (shrink)

How one goes about teaching medical ethics greatly depends upon one's interpretation of the discipline itself. Before discussing pedagogical isslIes, the primary focus ofthe paper, I will address the question of what "philosophical" medical ethics is and is not. I will then suggest some alternative approac:hes forincluding such material in a variety of different contexts, including courses geared toward philosophy students, those focusing on undergraduate students preparing for careers in one of the health care professions, and those actually within professional (...) schools, primarily medical schools, with which I am mostfamiliar. I will end with remarks on the implications of medical etllics for medicine and for philosophy. (shrink)

Sometimes we make a decision about an action we will undertake later and form an intention, but our judgment of what it is best to do undergoes a temporary shift when the time for action comes round. What makes it rational not to give in to temptation? Many contemporary solutions privilege diachronic rationality; in some “rational non-reconsideration” (RNR) accounts once the agent forms an intention, it is rational not to reconsider. This leads to other puzzles: how can someone be motivated (...) to follow a plan that is contrary to their current judgment? How can it be rational to form a plan to resist if we can predict that our judgment will shift? I show how these puzzles can be solved in a framework where there are multiple units of agency, distinguishing between the judgments of the timeslice and those of the person over time, and allowing that the timeslice can “self identify”, taking the person over time as the relevant unit of agency and doing intrapersonal team reasoning (with a different causal role for intentions than RNR accounts). On my account, resisting temptation is compatible with synchronic rationality, so synchronic and diachronic rationality are aligned. However, either resisting or succumbing to temptation can be instrumentally rational, depending on the unit of agency that is identified with. In order to show why we ought to resist temptation, we need to draw on a non-instrumental rationale. I sketch possible routes for doing this. (shrink)

In a recent paper in Psychological Science, Kouider and Dupoux reported obtaining unconscious Stroop priming only when subjects had partial awareness of the masked distractor words . Kouider and Dupoux conjectured that semantic priming occurs only when such partial awareness is present. The present experiments tested this conjecture in an affective categorization priming task that differed from Kouider and Dupoux’s in using masked distractors that subjects had practiced earlier as visible words. Experiment 1 showed priming from practiced words when subjects (...) had no partial awareness of those words. Experiment 2 showed that, in the absence of partial awareness, practiced words yielded priming but not-practiced words did not. Experiment 3 corroborated Experiment 1 and 2s results using a different test of partial awareness. These results suggest that unconscious processing of subword elements drives masked semantic priming by practiced words. (shrink)

A collection of dramatic accounts about doctors who have faced the moral dilemma of choosing between obeying rules and doing what is best for a patient offers insight into the essential principles of medical ethics and their impact on ...

Il y a un pari d'envergure, presque une provocation, à montrer l'ampleur et l'acuité des méthodes pratiques qui tissent le propos de Husserl dans un texte qui a été considéré par ses interprètes comme le livre le plus "métaphysique", à savoir celui où l'auteur prend parti pour une thèse philosophique souvent jugée éculée: l'idéalisme. Tout le destin de la phénoménologie s'est joué autour d'une prise de position contre son "tournant idéaliste" en 1913, Heidegger ayant ouvert les hostilités, suivi par Sartre, (...) Ricœur, Derrida et Levinas. A rebours de cette herméneutique constitutive de la critique philosophique, l'auteur cherche ici à faire voir un Husserl "praticien", "épistémologue", c'est-à-dire peu soucieux de défendre une position métaphysique. Cette épistémologie pratique de la phénoménologie peut être caractérisée comme un "empirisme transcendantal". Par là, un sens de la vérité émerge, qui puise sa validité dans l'expérience native du lecteur, c'est-à-dire dans son aptitude à vérifier par lui-même l'accord du concept en relation avec son vécu. La lecture expérientielle proposée prend alors un tour pragmatique, à l'horizon d'un renouvellement de la phénoménologie comme pratique. (shrink)

In the debate over clinicians’ conscience, there is a greater ethical, legal, and scholarly focus on negative, rather than positive, claims of conscience. This asymmetry produces a seemingly unjustified double standard with respect to clinicians’ conscience under the law. For example, a Roman Catholic physician working at a secular institution may refuse to provide physician-aid-in-dying on the basis of conscience, but a secular physician working at a Roman Catholic institution may not insist on providing physician-aid-in-dying on the basis of conscience. (...) This article outlines arguments against this asymmetry and critiques them for failing to distinguish between positive claims of conscience as positive or negative rights. I suggest the asymmetry debate should be focused on whether positive claims of conscience as positive rights ought to enjoy the same protections as negative claims of conscience. Clarifying the debate in this way helps elucidate some of the best reasons for the asymmetry, which these arguments have not addressed. This article does not take a definitive position on whether the asymmetry is justified, but attempts to bring some focus to the debate by directing arguments against the asymmetry to address the significant differences between positive claims of conscience as positive rights and negative claims of conscience. (shrink)

In this paper I explore the relationship between social epistemology and relativism in the context of feminist epistemology. I do this by focusing on one particular branch of feminist epistemology - a branch known as standpoint theory - and investigating the connection between this view and epistemic relativism. I begin by defining both epistemic relativism and standpoint theory, and by briefly recounting the standard way that the connection between these two views is understood. The literature at the moment focuses on (...) an aspect of standpoint theory called the epistemic advantage thesis, and on an aspect of relativism which has been called equality. I then show that the connection between relativism and standpoint theory actually turns on a different aspect of standpoint theory, known as the standpoint thesis, and on an aspect of relativism which has been called non-neutrality. I argue that shifting our attention to these other aspects reveals that standpoint theory is clearly and unavoidably relativist, but that this isn’t a problem - standpoint theory can capture everything that it set out to, even on a relativist understanding of the view. (shrink)

le statut de l'intersubjectivité comme altérité à soi chez Husserl Natalie Depraz. REMERCIEMENTS À Jean-François Courtine tout d'abord, je tiens à exprimer ma très vive gratitude pour la confiance qu'il m'a témoignée en me donnant ...

_Shusterman’s Somaesthetics_ is a wide-ranging collection of penetrating essays by twelve scholars examining in rich detail the many dimensions of philosopher Richard Shusterman’s pragmatism and somaesthetics, complemented by his own chapter of responses to these scholars.

Background In May 2020, England moved to an opt-out organ donation system, meaning adults are presumed to be an organ donor unless within an excluded group or have opted-out. This change aims to improve organ donation rates following brain or circulatory death. Healthcare staff in the UK are supportive of organ donation, however, both healthcare staff and the public have raised concerns and ethical issues regarding the change. The #options survey was completed by NHS organisations with the aim of understanding (...) awareness and support of the change. This paper analyses the free-text responses from the survey. Methods The #options survey was registered as a National Institute of Health Research (NIHR) portfolio trial [IRAS 275992] 14 February 2020, and was completed between July and December 2020 across NHS organisations in the North-East and North Cumbria, and North Thames. The survey contained 16 questions of which three were free-text, covering reasons against, additional information required and family discussions. The responses to these questions were thematically analysed. Results The #options survey received 5789 responses from NHS staff with 1404 individuals leaving 1657 free-text responses for analysis. The family discussion question elicited the largest number of responses (66%), followed by those against the legislation (19%), and those requiring more information (15%). Analysis revealed six main themes with 22 sub-themes. Conclusions The overall #options survey indicated NHS staff are supportive of the legislative change. Analysis of the free-text responses indicates that the views of the NHS staff who are against the change reflect the reasons, misconceptions, and misunderstandings of the public. Additional concerns included the rationale for the change, informed decision making, easy access to information and information regarding organ donation processes. Educational materials and interventions need to be developed for NHS staff to address the concepts of autonomy and consent, organ donation processes, and promote family conversations. Wider public awareness campaigns should continue to promote the positives and refute the negatives thus reducing misconceptions and misunderstandings. Trial registration National Institute of Health Research (NIHR) [IRAS 275992]. (shrink)

Defences of perspectival realism are motivated, in part, by an attempt to find a middle ground between the realist intuition that science seems to tell us a true story about the world, and the Kuhnian intuition that scientific knowledge is historically and culturally situated. The first intuition pulls us towards a traditional, absolutist scientific picture, and the second towards a relativist one. Thus, perspectival realism can be seen as an attempt to secure situated knowledge without entailing epistemic relativism. A very (...) similar motivation is behind feminist standpoint theory, a view which aims to capture the idea that knowledge is socially situated, whilst retaining some kind of absolutism. Elsewhere I argue that the feminist project fails to achieve this balance; its commitment to situated knowledge unavoidably entails epistemic relativism (though of an unproblematic kind), which allows them to achieve all of their feminist goals. In this paper I will explore whether the same arguments apply to perspectival realism. And so I will be asking whether perspectival realism too is committed to an unproblematic kind of relativism, capable of achieving scientific goals; or, whether it succeeds in carving out a third view, between or beyond the relativism/absolutism dichotomy. (shrink)

Moral pluralism poses a foundational problem for secular clinical ethics: How can ethical dilemmas be resolved in a context where there is disagreement not only on particular cases, but further, on...

Enclosed is a guidebook for philanthropists, advocates, and policymakers who want to do the most good possible. This book introduces the philosophy of “longtermism,” the idea that it is particularly important that we act now to safeguard future generations. -/- The future is vast in scale: depending on our choices in the coming centuries, the future could stretch for eons or it could dwindle into oblivion, and be inordinately good or inordinately bad. And yet future generations are utterly disenfranchised in (...) the world today: they cannot participate in our markets, our movements, or our civil society. This presents 21st Century philanthropists with a historically unprecedented opportunity to do good by protecting the long-term future. -/- The essays within are from the pioneers who have developed the intellectual foundations of longtermism, as well as the experts and advocates who are now putting it into practice. Readers will hear the case for longtermism from professors at the University of Oxford and Longview’s own founders; longtermist policy proposals from political philosophers, members of the House of Lords, and the All-party Parliamentary Group for Future Generations; the case for work on biosecurity, artificial intelligence, and climate change from leading experts; and the first ever essay on longtermist cultural change from the former Chief of Cabinet to the Finnish President. -/- Together, these essays chart the path forward toward maximising the good that we do for our grandchildren, our grandchildren’s grandchildren, and every generation beyond. (shrink)

In this paper I make the case for a feminist hinge epistemology in three steps. My first step is to explain hinge epistemologies as contemporary epistemologies that take Wittgenstein’s work in On Certainty as their starting point. My second step is to make three criticisms of this literature as it currently stands. My third step is to introduce feminist epistemologies, which argue that social factors like race and gender affect what different people and groups justifiably believe, and argue that developing (...) a feminist hinge epistemology is both plausible and desirable. (shrink)

In her book Extended Rationality: A Hinge Epistemology (2015), Annalisa Coliva puts forward an anti-sceptical proposal based on the idea that the notion of rationality extends to the unwarrantable presuppositions “that make the acquisition of perceptual warrants possible” (2015: 150). These presuppositions are commonly the target of sceptical arguments, and by showing that they are on the one hand unwarrantable, but on the other are constitutive components of rationality itself, she reveals that they are beyond rational doubt and thus avoids (...) scepticism. Part of Coliva’s defence of using extended rationality in this way involves distancing it from relativist interpretations, which she describes as “devastating” (2015: 120). She proposes two ways that someone might attempt to formulate epistemic relativism from her extended rationality view, and argues that both would be unsuccessful because they require describing alternative conceptions of rationality which are “unintelligible” (in the first case), or “inconceivable” (in the second). The superficial claim of this chapter is that Coliva’s arguments, as they stand, are insufficient to dismiss relativism. She fails to show that the conception of rationality needed for the first formulation of relativism is unintelligible, and overestimates the significance of the second formulation’s conception turning out to be inconceivable. But I also highlight a deeper problem: neither formulation follows a realistic blueprint for relativism, and so these were the wrong possibilities to consider in the first place. To address this issue, I propose a third, more plausible, way in which someone might attempt to formulate relativism on the basis of Coliva’s account. I leave open whether this strategy is successful, or whether a version of Coliva’s criticisms apply to it too. (shrink)

Feminist epistemologies hold that differences in the social locations of inquirers make for epistemic differences, for instance, in the sorts of things that inquirers are justified in believing. In this paper we situate this core idea in feminist epistemologies with respect to debates about social constructivism. We address three questions. First, are feminist epistemologies committed to a form of social constructivism about knowledge? Second, to what extent are they incompatible with traditional epistemological thinking? Third, do the answers to these questions (...) raise serious problems for feminist epistemologies? We argue that some versions of two of the main strands in feminist epistemology – feminist standpoint theory and feminist empiricism – are committed to a form of social constructivism, which requires certain departures from traditional epistemological thinking. But we argue that these departures are less problematic than one might think. Thus, (some) feminist epistemologies provide a plausible way of understanding how (some) knowledge might be socially constructed. (shrink)

What is the proper role of a clinical ethics consultant’s religious beliefs in forming recommendations for clinical ethics consultation? Where Janet Malek has argued that religious belief should have no influence on the formation of a CEC’s recommendations, Clint Parker has argued a CEC should freely appeal to all their background beliefs, including religious beliefs, in formulating their recommendations. In this paper, I critique both their views by arguing the position envisioned by Malek puts the CEC too far from religion (...) and the position envisioned by Parker puts the CEC too close. For a CEC to give recommendations about what is morally prohibited, permissible, or obligatory in the clinic, I propose a view of the CEC that is neither religious nor non-religious but quasi-religious. I argue that a quasi-religious approach avoids the problems of both religious and non-religious views while preserving their benefits. Additionally, a quasi-religious view resists the marginalization of “religious” traditions that occurs when secular ethicists come to think of their approach as somehow distinctly non-religious. (shrink)

Universities and other research institutions are increasingly providing additional training in research integrity to improve the quality and reliability of research. Various training courses have been developed, with diverse learning goals and content. Despite the importance of training that focuses on moral character and professional virtues, there remains a lack of training that adopts a virtue ethics approach. To address this, we, a European Commission-funded consortium, have designed a train-the-trainer programme for research integrity. The programme is based on (1) virtue (...) ethics, (2) the ethos of science, (3) learning by doing and (4) learner-centred teaching. The blended learning programme combines e-learning modules with participatory group sessions. Trainers are taught how to guide researchers through a series of structured exercises for fostering reflection on scientific virtues, and how to promote understanding and application of the European Code of Conduct for Research Integrity. Trainers are provided with adaptable tools and resources that can be used and combined in different ways. The programme implementation began in Spring 2020 and 470 trainers have participated to date. When trainers were asked to grade – between 0 (very bad) and 10 (excellent) – the e-learning modules and the participatory exercises, 60% scored a grade 8 or higher (median = 8, IQR = 2) for the e-learning modules, whereas 80% scored a grade 8 or higher (median = 9, IQR = 1) for the participatory exercises. A majority felt that the training helped them as a trainer to learn about ways to organise and teach a research integrity course (82%) and would recommend the interactive exercises to others (92%). Trainers have educated over 3300 researchers in Europe using our virtue-based approach. The VIRT2UE train-the-trainer programme fosters research integrity by providing trainers with exercises and tools which enable them to stimulate the development of good researchers across Europe. (shrink)

This paper provides a close reading of Erwin Straus’ “The Upright Posture” from a disability studies perspective. Straus argues that the upright posture dominates the human world. But he excludes those who dwell in it otherwise. By reviewing phenomenological disability literature, this paper asks what a disabled phenomenology would look like, one rooted in the problem of inclusion from the outset. Disabled phenomenology addresses ‘subjectivity’ critically, asking: what socio-material arrangements make subjectivity possible in the first place? This project is, I (...) argue, equal parts political economy and existential phenomenology. I conclude with some suggestions for future research. (shrink)

Mainstream epistemologists don’t tend to discuss feminist epistemologies. They often don’t mention them in introductory courses or textbooks, and they almost invariably don’t take themselves to work on them. This is probably due to a suspicion that ‘feminist’ epistemologies are clouded by political motivations. In this paper I will argue two things. First, that this suspicion is misguided – a number of ‘mainstream’ epistemologists (specifically, hinge epistemologists), are in fact doing work which is entirely compatible with feminist epistemologies, and the (...) ‘extra ingredient’ required to turn a hinge epistemology into a feminist epistemology needn’t involve political motivations. And second, that bringing feminist epistemologies into the mainstream can benefit hinge epistemologies – by adding the extra ingredient which turns a hinge epistemology into a feminist epistemology, hinge epistemologists increase the motivations they can appeal to in support of their responses to scepticism. (shrink)

Legal precedent, professional‐society statements, and even many medical ethicists agree that some situations may call for a clinician to engage in an act of lying or nonlying deception of a patient or patient's family member. Still, the moral terrain of clinical deception is largely uncharted, and when it comes to practical guidance for clinicians, many might think that ethicists offer nothing more than the rule never to deceive. This guidance is insufficient to meet the real‐world demands of clinical practice, and (...) this article endeavors to articulate a framework to help clinicians better navigate the ethics of clinical deceit. The framework articulates four morally relevant dimensions of a potential deceptive act that should be examined to better determine the moral justification that might be required: the target of the act, the nature of the information, the nature of the act, and the context of the act. (shrink)

Background:Moral distress is a complex phenomenon frequently experienced by critical care nurses. Ethical conflicts in this practice area are related to technological advancement, high intensity work environments, and end-of-life decisions.Objectives:An exploration of contemporary moral distress literature was undertaken to determine measurement, contributing factors, impact, and interventions.Review Methods:This state of the science review focused on moral distress research in critical care nursing from 2009 to 2015, and included 12 qualitative, 24 quantitative, and 6 mixed methods studies.Results:Synthesis of the scientific literature revealed (...) inconsistencies in measurement, conflicting findings of moral distress and nurse demographics, problems with the professional practice environment, difficulties with communication during end-of-life decisions, compromised nursing care as a consequence of moral distress, and few effective interventions.Conclusion:Providing compassionate care is a professional nursing value and an inability to meet this goal due to moral distress may have devastating effects on care quality. Further study of patient and family outcomes related to nurse moral distress is recommended. (shrink)

Different views on the connection between relativism and feminist epistemologies are often asserted but rarely are these views clearly argued for. This has resulted in a confusingly polarised debate, with some people convinced that feminist epistemologies are committed to relativism (and that this is a reason so be suspicious of them) whilst others make similar criticisms of anti-feminist views and argue that relativism has no place in feminist epistemologies. This chapter is an attempt to clarify this debate. I begin by (...) asking the question “are feminist projects and goals best served by relativism, or by absolutism?” I then sketch out four broad positions one could take on the answer to this question, and evaluate arguments for each one. In the end I conclude that feminist projects can, at least sometimes, be served by relativism, and that the claim they can be served by anti-relativism is under-supported. (shrink)

The diagnostic category of borderline personality disorder (BPD) has come under increasing criticism in recent years. In this paper, we analyze the role and impact of epistemic injustice, specifically testimonial injustice, in relation to the diagnosis of BPD. We first offer a critical sociological and historical account, detailing and expanding a range of arguments that BPD is problematic nosologically. We then turn to explore the epistemic injustices that can result from a BPD diagnosis, showing how they can lead to experiences (...) of testimonial injustice which impede patient engagement in meaning-making activities, thereby undermining standard therapeutic goals. We conclude by showing how our arguments bolster ongoing efforts to replace the diagnostic category of BPD with alternatives such as complex post-traumatic stress disorder. (shrink)

In the literature of collective intentions, the ‘we-intentions’ that lie behind cooperative actions are analysed in terms of individual mental states. The core forms of these analyses imply that all Nash equilibrium behaviour is the result of collective intentions, even though not all Nash equilibria are cooperative actions. Unsatisfactorily, the latter cases have to be excluded either by stipulation or by the addition of further, problematic conditions. We contend that the cooperative aspect of collective intentions is not a property of (...) the intentions themselves, but of the mode of reasoning by which they are formed. We analyse collective intentions as the outcome of team reasoning, a mode of practical reasoning used by individuals as members of groups. We describe this mode of reasoning in terms of formal schemata, discuss a range of possible accounts of group agency, and show how existing theories of collective intentions fit into this framework. (shrink)

In a recent issue of the Journal of Medicine and Philosophy, several scholars wrote on the topic of ethics expertise in clinical ethics consultation. The articles in this issue exemplified what we consider to be two troubling trends in the quest to articulate a unique expertise for clinical ethicists. The first trend, exemplified in the work of Lisa Rasmussen, is an attempt to define a role for clinical ethicists that denies they have ethics expertise. Rasmussen cites the dependence of ethical (...) expertise on irresolvable meta-ethical debates as the reason for this move. We argue against this deflationary strategy because it ends up smuggling in meta-ethical assumptions it claims to avoid. Specifically, we critique Rasmussen’s distinction between the ethical and normative features of clinical ethics cases. The second trend, exemplified in the work of Dien Ho, also attempts to avoid meta-ethics. However, unlike Rasmussen, Ho tries to articulate a notion of ethics expertise that does not rely upon meta-ethics. Specifically, we critique Ho’s attempts to explain how clinical ethicists can resolve moral disputes using what he calls the “Default Principle” and “arguments by parity.” We show that these strategies do not work unless those with the moral disagreement already share certain meta-ethical assumptions. Ultimately, we argue that the two trends of attempting to avoid meta-ethics by denying that clinical ethicists have ethics expertise, and attempting to articulate how ethics expertise can be used to resolve disputes without meta-ethics both fail because they do not, in fact, avoid doing meta-ethics. We conclude that these trends detract from what clinical ethics consultation was founded to do and ought to still be doing—provide moral guidance, which requires ethics expertise, and engagement with meta-ethics. To speak of ethicists without ethics expertise leaves their role in the clinic dangerously unclear and unjustified. (shrink)

According to Duncan Pritchard, there are two kinds of radical sceptical problem; the closure-based problem, and the underdetermination-based problem. He argues that distinguishing these two problems leads to a set of desiderata for an anti-sceptical response, and that the way to meet all of these desiderata is by supplementing a form of Wittgensteinian contextualism with disjunctivist views about factivity. I agree that an adequate response should meet most of the initial desiderata Pritchard puts forward, and that some version of Wittgensteinian (...) contextualism shows the most promise as a starting point for this, but I argue, contra Pritchard, that the addition of disjunctivism is unnecessary and potentially counter-productive. If we draw on lessons from Michael Williams's inferential contextualism then it is both possible, and preferable, to meet the most important of Pritchard's desiderata, undercutting both closure-based and underdetermination-based sceptical problems in a unified way, without the need to resort to disjunctivism. (shrink)

The national standards for clinical ethics consultation set forth by the American Society for Bioethics and Humanities endorse an “ethics facilitation” approach, which characterizes the role of the ethicist as one skilled at facilitating consensus within the range of ethically acceptable options. To determine the range of ethically acceptable options, ASBH recommends the standard model of decision-making, which is grounded in the values of autonomy, beneficence, nonmaleficence, and justice. H. Tristram Engelhardt Jr. has sharply criticized the standard model for presuming (...) contentful moral claims in circumscribing the range of ethically acceptable options, which, he argues, cannot be rationally justified in a pluralistic context. Engelhardt’s solution is a secular clinical ethics based on a contentless principle of permission. The first part of this article lays out Engelhardt’s negative claim, that reason cannot establish contentful moral claims, and his positive claim, that secular clinical ethics ought to be based on a contentless principle of permission. The second part critiques these negative and positive claims. The purpose of this paper is to defend secular clinical ethics expertise—defined as the ability of ethicists to offer justified moral recommendations grounded in consensus positions endorsed by the American Society for Bioethics and Humanities—from the radical critiques of Engelhardt, who argues that no moral or metaphysical claims, and hence no bioethical consensus, can be rationally justified. Engelhardt’s critiques have caused some to worry that secular clinical ethics is in a state of theoretical crisis; this article concludes that Engelhardt’s view is an unstable basis for that worry. (shrink)

While many Catholic hospitals permit the prescription of the emergency contraception drug levonorgestrel for rape victims, some continue to prohibit this practice as a matter of institutional conscience. While the standard approach to this issue has been to offer an argument that levonorgestrel either is or is not morally permissible, we have taken a different tack. We begin by briefly describing and acknowledging that reasonable disagreement exists on this question (part one), and then arguing that the reasonable disagreement itself can (...) serve as a compelling basis for Catholic leadership at hospitals that prohibit emergency contraception for rape victims to accommodate physicians who wish to provide levonorgestrel as a matter of conscience (part two). We end by anticipating and responding to some objections. (shrink)

Given recent legal developments in the United States, now is a critical time to draw attention to how ‘conscientious objection’ is sometimes used by health care providers to discriminate against the LGBTQ community. We review legal developments from 2019 and present several cases where health care providers used conscientious objection in ways that discriminate against the LGBTQ community, resulting in damaged trust by this underserved population. We then discuss two important conceptual points in this debate. The first involves the interpretation (...) of discrimination (provider versus patient-centered views), and we argue for a patient-centered view; the second involves the use of the people versus procedure distinction to reach a compromise between LGBTQ individuals and the clinicians who do not want to treat them. We argue the distinction is problematic when applied to treatment of the LGBTQ population. (shrink)

The legal and ethical asymmetry between honoring positive claims of conscience versus negative claims of conscience was recently analyzed by several articles in this journal. The first author of this article (ALB) identified unique but defeasible reasons against honoring positive claims of conscience, such as the greater threat they post to institutional values and institutional resources than negative claims of conscience. However, ALB wrote, when these reasons can be overcome, positive claims of conscience should enjoy the same ethical and legal (...) respect as negative claims of conscience. This article argues that the prescription of birth control by non-Roman Catholic physicians in Roman Catholic institutions is an example of a positive claim of conscience that can overcome concerns of institutional values and resources, and therefore ought to receive the same ethical respect and legal protection as negative claims of conscience. In making this argument, this article also responds to several of the thoughtful comments raised by Alberto Giubilini and Dominic Wilkinson. (shrink)

The place of science.--The structure of science.--Nature: occurrents.--Nature: complexes.--Awareness.--Operations.--Meaning.--Meaning: correlational symbols.--Meaning: constructs and hypotheses.--The development of knowledge.--Models.--Description.--Explanation.--Quantitative methods.

This book engages with some of the most pressing ethical issues that arise from the use of animals in various business practices, providing interdisciplinary approaches to improving the nonhuman and human lives in animal-related industries. The chapters in this volume provide conceptual, theoretical and practical analyses of these issues that will shape the future direction of business ethics to more fully reflect the impacts and implications of animal-based businesses on society, its members, and nature. The authors in this volume engage (...) with topics including animal suffering and emotions, the commodification of animals, vegetarian and vegan businesses and diets, technological innovations such as gene editing and lab-cultured meat, as well as captivity, corporate disclosure of animal welfare policies, and the possibility of humane jobs as well as the consideration of animals as stakeholders. (shrink)