Applied Ethics

We have, to some extent, a duty to help the needy—to meet their basic needs for food, water, shelter, and health care. Call this the duty of beneficence. Below, I argue that it is best understood as a duty both (a) to adopt helping the needy as “a serious, major, continually relevant, life-shaping end” (HILL 2002, 206) and (b) to never behave in a way (via act or omission) that’s incompatible with having such an end. I call this the Kantian (...) View, and I argue that it has several advantages over four of its rivals. In particular, I argue that it has the advantage of being able to account for all the following: (1) a diachronic (over-time) duty to take a sufficient number of favorable opportunities for helping the needy over the course of our lives, (2) a synchronic (at-a-time) duty to take every golden opportunity to help the needy that arises, and (3) the relationship between the two. (shrink)

The idea of a ‘tobacco-free generation’ promises to make smoking a thing of the past by making cigarettes unavailable to birth cohorts in the future. If implemented, such a generational ban would lead to a society in which some individuals are allowed the freedom to smoke while others are not. This paper examines the ethical significance of this fact through the lens of ‘relational egalitarianism’, an approach to social justice that emphasises equal and respectful social relationships. It explores various dimensions (...) in which a society can fail to live up to the idea of equal status, such as the denial of moral agency, discrimination, stigmatisation, the unequal recognition of interests and violations of political equality. While acknowledging the complexity of practical and ethical challenges, the paper maintains that the generational ban need not violate egalitarian commitments. (shrink)

When the clinician and patient are unable to reconcile differences over treatment, does this mean the latter lacks capacity to decide in such matters? Wellesleyet alanalyse the legal judgements in the case of Ms Sudiksha Thirumalesh where, on the particulars, the Court of Protection answered yes, only for the Court of Appeal to disagree. The authors highlight concerns about using isolated false belief as an indicator of incapacity and advise that such matters may be better resolved by greater discussion of (...) the benefits and burdens of treatment, alongside consideration of their costs. Here, I suggest that a disability perspective is also helpful to such cases, recognising that this was a disagreement from which the patient couldn't walk away. Disability means that particular care is required when considering the burdens and benefits of treatment as these may vary widely in the eye of the beholder. Second, the costs of litigation are particularly high when a disabled person, with life-limiting illness, is left feeling they are using precious time and energy arguing for their existence. Third, any such legal judgments ought to make clear what reasonable adjustments have been offered to include the disabled person in proceedings. Fourth, and relatedly, such disputes should be attentive to the significant risk of epistemic injustice, where disabled patients find themselves less believed, in part because the ‘able-bodied’ have not shared their experiences. Together, these considerations (i) add to the call made by Wellesleyet alfor better discussions and (ii) suggest that early involvement of Rehabilitation Medicine, with expertise in disability and related ethics, could offer an important means to reduce the need for such litigation in the future. (shrink)

Johannes Kniess argues that a generational smoking ban, which prevents all those born after a certain date from buying tobacco, need not violate relational egalitarian commitments.1 Those denied the freedom to smoke need not be regarded as inferior, discriminated against, stigmatised or have their interests neglected. However, his argument focuses on a comparison between the younger cohort, who are permanently denied the freedom to smoke, and existing smokers, who retain the freedom to smoke because withdrawing this would impose greater burdens (...) on them. As illustrated in table 1, there are three relevant groups in society: (1) older smokers, (2) older non-smokers and (3) younger non-smokers. (The ban, if effective, means that there will not be any smokers in the younger cohort, so the potential fourth category is empty.) The comparisons Kniess makes focus on groups 1 and 3, but neglect group 2: those who are old enough to smoke, but who are not already smokers. View this table: Table 1 Groups in society A generational ban involves differential treatment of older cohorts (groups 1 and 2) and younger cohorts (group 3). Kniess argues that such differential treatment can be …. (shrink)

Medical ethics and law (MEL) have a well-established place in medical curricula within the UK, but appropriately assessing MEL in a medical school context can be extremely challenging. The Institute of Medical Ethics convened a working group focused on assessment in 2021, and in this article, we present a summary of the work undertaken by this group. We start by explaining the challenges presented by the assessment of MEL, highlighting the potentially demanding requirements set out by the General Medical Council (...) in the UK. We then explore how MEL is currently assessed in UK medical schools. We go on to consider a number of different forms of assessment and their suitability for assessing ethics and law. Finally, we report the key recommendations from the working group and conclude that we are unconvinced that current approaches to assessing MEL are sufficient to robustly assess the General Medical Council’s learning outcomes. (shrink)

In this article, I explore whether domesticated animals (DAs) of different species belonging to the same community participate in authoring and sustaining, what I call, the fabric of zoodemocracy. The fabric refers to a set of activities, social norms, and values that together sustain our democracies (e.g. cooperation, protest, and helping one’s neighbour). I explore this by situating my intervention within systemic theories of democracy and the political turn in animal rights theory. Specifically, I situate my work within Donaldson and (...) Kymlicka’s zoopolitical project, arguing that animals are owed rights to participation in decision-making as community members. Some, however, challenge the idea that DAs can actually sustain democratic communities because they do not have, for example, the rational capacities to control themselves. Others suggest that there are conceptual and normative problems with the concept of co-authorship advanced by Donaldson and Kymlicka. This article addresses these debates by (1) identifying some of the key elements needed to sustain the fabric of democratic communities; and (2) empirically testing whether DAs have the necessary capacities to sustain such communities. I do this by analysing the data I collected while conducting a multispecies ethnography at VINE sanctuary, Springfield, Vermont, US, for 8 weeks.*. (shrink)

Workism is the phenomenon of people making their work the primary source of meaning and identity in their life. Recent critics of workism have argued that there is a growing trend towards it in many societies and that this is a bad thing. This article brings a philosophical perspective to the debate on workism. It develops a precise account of what workism is and evaluates the main objections raised against it by examining their underlying philosophical assumptions. Ultimately, it is argued (...) that workism, as a way of life, is not as objectionable as its critics suggest. (shrink)

According to the simulation hypothesis, the world we live in is a computer simulation. According to longtermism, we should aim to bring about the best possible future. In this paper, I argue that there is a tension between the two: insofar as we have reason to think we are living in a computer simulation, we have reason to think the longtermist project will fail (or has already failed). I make my case by developing a novel version of the problem of (...) evil. It says that there exist certain forms of evil in our world that longtermist philosophers have argued we should try to eradicate. But then, the existence of those evils give us reason to think our world is not a computer simulation run by a being aligned with longtermist values. In short, the more that longtermists think we could make the world a better place in the future, the more troubling they should find it that the world is not already a better place, given the assumption that we are living in a computer simulation. (shrink)

We systematically review social entrepreneurship literature to analyse how the notion of well-being is perceived. We found that well-being in social entrepreneurship is accounted for in two forms: self-oriented and other-oriented. Our review indicates that both hedonic and eudaimonic well-being have received significant research attention, although the latter has gained more prominence. We found that negative well-being resulting from social entrepreneurial interventions is a matter of concern. Apart from critically synthesizing the literature, this paper offers a number of avenues for (...) future research connecting well-being and social entrepreneurship. (shrink)

Abstract: Longtermist Effective Altruists (EAs) aim to mitigate the risk of existential catastrophes. In this paper, I have three goals. First, I identify a catastrophic risk that EAs have completely ignored. I call it religious catastrophe: the threat that (as Christians and Muslims have warned for centuries) billions of people stand in danger of going to hell for all eternity. Second, I argue that, even by secular EA lights, religious catastrophe is at least as bad and at least as probable (...) and, therefore, at least as important as many of the standard EA catastrophic risks (e.g., catastrophic climate change, nuclear winter). Third, I present the following dilemma for secular EAs: either adopt religious catastrophe as an EA cause or ignore religious catastrophe but also ignore catastrophic risks whose mitigation has a similar or lower expected value (i.e., most or all of them). Business as usual—ignoring religious catastrophe while championing the typical EA causes—is not an option consistent with longtermist EA principles. (shrink)

This article argues that the relations of social and political power that obtain between humans and pets are illegitimate. We begin by showing that pets, a largely neglected population in political philosophy, are subject to socially and politically organised power, which stands in need of justification. We then argue that pets have three moral complaints against the relations of power to which they are subject. First, our power over pets disrespects their moral independence: the fact that they are not simply (...) available to be used to serve the interests or projects of others. Second, our power over pets systematically sets back their interests in exercising control over their own body, actions, and environment. Third, in subjecting pets to asymmetric relations of power in which they are heavily dependent on humans for the satisfaction of their interests, we subject them to objectionable risks of harm. Together, these complaints support our thesis that the power relations central to the institution of pet keeping are illegitimate. The practical upshot is that we have a strong moral reason to abolish this institution. (shrink)

Introduction: Mental health nursing is dependent on nurses’ ability to engage in therapeutic relationships with patients. The ability to manage professional boundaries is equally important, but less explored. This study aims to address the following research questions: How do nurses define their professional, personal, and private roles? What are nurses’ experiences with professional boundaries? What are the implications of nurses’ understanding of these boundaries? Background: Nurse–patient relationships are characterized by asymmetrical power dynamics, which places the responsibility of delineating professional boundaries (...) on the nurse. While ethical codes offer guidance, nurses must identify appropriate boundaries in a dynamic process that relies on the clinical context. Research design: This study used critical discursive psychological analysis to examine data from participant observations, individual interviews, and focus group discussions. Participants and research context: We included 16 nurses working in mental health care in this study, comprising 12 in specialist mental health care and 4 in community mental health care. Ethical considerations: The study was registered with Norwegian Social Science Data Services. Results: Nurses defined professionalism as being an educated caregiver who prioritizes patients’ needs. Professionalism involves personal engagement, while some personal matters remain private. However, nurses experienced challenges in maintaining professional boundaries, facing dilemmas due to the subjective nature of boundaries and patients’ unpredictable responses. Conclusions: While nurses prioritize patients’ needs and best interests, this study demonstrated that personal engagement is considered part of professionalism. However, nurses encounter complex dilemmas in setting professional boundaries. Additionally, these boundaries can either emphasize or de-emphasize the power differential in nurse-patient relationships. (shrink)

In the UK, the Recommended Summary Plan for Emergency Care and Treatment (ReSPECT) is a widely used process, designed to facilitate shared decision-making between a clinician and a patient or, if the patient lacks capacity to participate in the conversation, a person close to the patient. A key outcome of the ReSPECT process is a set of recommendations, recorded on the patient-held ReSPECT form, that reflect the conversation. In an emergency, these recommendations are intended to inform clinical decision-making, and thereby (...) enable the attending clinician—usually a general practitioner (GP) or paramedic—to act in the patient’s best interests. This study is the first to explore the extent to which ReSPECT recommendations realise their goal of informing best interests decision-making in community contexts. Using a modified framework analysis approach, we triangulate interviews with patients and their relatives, GPs and nurses and care home staff. Our findings show that inconsistent practices around recording patient wishes, diverging interpretations of the meaning and authority of recommendations and different situational contexts may affect the interpretation and enactment of ReSPECT recommendations. Enacting ReSPECT recommendations in an emergency can be fraught with complexity, particularly when attending clinicians need to interpret recommendations that did not anticipate the current emergency. This may lead to decision-making that compromises the patient’s best interests. We suggest that recording patients’ values and preferences in greater detail on ReSPECT forms may help overcome this challenge, in providing attending clinicians with richer contextual information through which to interpret treatment recommendations. (shrink)

Attempts to steer research, innovation and business in desirable directions have failed to meet expectations. Corporate social responsibility (CSR) and responsible research and innovation (RRI) seem to be losing ground, while the challenges they sought to address remain. Despite their shortcomings, these concepts remind us of the need to take responsibility for what we as researchers and entrepreneurs bring into the world, and to keep questioning the given framework. -/- Drawing from the experience of the AFINO project, a unique attempt (...) to bring together RRI and CSR and to promote networks, learning and skills building in Norway, this book contextualises and explores the practical challenges of actualising responsible practices even in the propitious Norwegian context. Readers interested in RRI, CSR, transdisciplinarity, and in the governance of research and innovation will find extensive information and insights about the challenges of steering research and business practices towards desirable ends and how to address them. -/- This book is unique in bringing together the perspectives of Responsible Research and Innovation and Corporate Social Responsibility. Draws from the unique experience of the AFINO research centre and network. (shrink)

Most states in the United States have conscience laws protecting conscientious refusal to perform some medical service. Yet many state conscience laws protect providers from being even indirectly involved with some procedure they find objectionable, which can include not only referrals but also simply informing patients of medically indicated but morally contentious options. I argue that such policies are unjust, offering too much protection for integrity in the face of competing values and patient interests. In other words, these policies grant (...) too much weight to integrity. One promising response to this concern is that in addition to integrity, the state should protect professionals so that they avoid complicity that could undermine their moral right to hold others accountable. I argue that this response fails, since it is implausible that these professionals actually lose that right in such contexts. I conclude that these policies should be restricted to better protect patient interests. (shrink)

In this article, I explore concerns that have been raised regarding the relation between love and uptake of reproductive technologies, embryo selection and enhancement. Objections to (certain) uses of these technologies in terms of fractures in love, either parental or between partners, come from a variety of directions, from the conservative to the liberal. I examine two claims: (1) that the separation of procreation from sex and intimacy is a threat to love, and (2) that intervention on the traits of (...) one’s future offspring betrays inadequate parental love. I will place these concerns in a broader context of (a) technologically facilitated threats to – or aids towards maintaining – love and (b) irreversible changes to parent-child relationships that arise at the moment a prospective parent acts on the choice to select or shape the essence of their future child. (shrink)

People usually think that phenomenal consciousness is unique to humans and animals, but panpsychism extends it to other beings and considers consciousness to be fundamental and ubiquitous in the natural world. This extension is the common claim of panpsychists and has ethical implications. Panpsychists differ from each other in the extent of extension of consciousness. Micropsychism extends consciousness to the fundamental particles at the micro-level, and macropsychism extends it to cosmos and all physical objects in the universe. According to micropsychism, (...) fundamental particles have moral status and significant moral standing, but this truth has no practical moral consequences and does not require us to change our behavior towards them. According to macropsychism, the universe has moral status and significant moral standing, and we should act in a way that increases the pleasure and decreases the pain of all beings that we know the cause of their pleasure and pain. Also, macropsychism requires admitting the moral status and significant moral standing of all animate and inanimate beings, and we must behave in such a way that the pleasure of animals and plants increases and their pain decreases, but we do not have any moral obligation regarding inanimate beings. (shrink)

Ethics as a field should, we argue, pay more attention to the (eco)system. Van Rensselaer Potter, one of the pillars of contemporary bioethics, advocated for a global “bios” ethics that literally and metaphorically bridges the gap between biological knowledge and ethical reflection. However, a Potterian Bio-Ethics faces a major obstacle: its acentric focus. Consequently, Global Bio-Ethics remains opaque for those trained under the anthropocentric biomedical ethics that instrumentalizes the environment. This paper aims to demystify two key concepts—Globality and Complexity—and show (...) how a Potterian Bio-Ethics can effectively bridge the gap between knowledge-building in ecology and policy-making in the context of medical and environmental practices. Drawing on an experience in Québec, Canada, to mitigate the threat of antimicrobial resistance using a biosurveillance system, we show the utility of having ethics as an integral part of ecosystem(ic) approaches to bridge health and environment. We conclude by arguing that bioethics (and bioethicists) should become a locus for cascading communication, collaboration, and translation by co-constructing biosurveillance data governance. (shrink)

A global trend of institutionalised pronatalism situates low fertility as a site of demographic disaster – positioning primarily women’s bodies as both its cause and solution. In light of such demographic dread, assisted reproductive technologies (ART) may be utilized by pronatalist states as a strategy for fertility recovery, rather than as a benefit for individual aspiring parents. In other words, ARTs are at risk of being co-opted by nation-states for problematic demographic designs which do not advance emancipatory goals. The underlying (...) issue of pronatalism, however, is not always explicitly acknowledged in feminist bioethics as a barrier to ethical ART usage. In my paper, I argue that it would be a mistake to assume ART can be used for emancipatory ends if we do not, at the same time, critically investigate its connections to institutionalised pronatalism. (shrink)

The German language introduction to animal agency.

This article presents a systematic review of literature on workplace racial microaggressions. Increasingly, workplaces around the world have made concerted efforts to foster diversity, equity, and inclusion in their workforces. However, racial discrimination is a social issue that continues to be endemic to the workplace—including, yet not limited to, the prevalence of racial microaggressions. These microaggressions can, at times, be covert, and undertaken sometimes without the explicit awareness or intention of the perpetrator. Yet, the consequences of these can be very (...) real for the person impacted (the target), which include diminished wellbeing, job satisfaction, and career progression. To capture the overall trends and themes that empirical research has examined related to workplace racial microaggressions, a systematic review of 48 scholarly peer-reviewed articles on the topic was conducted. The review highlights how racial microaggressions have been conceptualized and measured in previous work, and critically examines empirical findings to date. The systematic review reveals that more work needs to be done to advance our understanding of this field of inquiry. To address this, a future research agenda based on identified gaps in the literature is articulated which highlights opportunities for advancement of the literature. Addressing these gaps will provide actionable insights for organizations in addressing the insidious social issue of racial microaggressions in the workplace, and support scholars in the development of future work. (shrink)

This piece in Nature Medicine notes the risks that incorporation of AI systems into health care poses to disabled patients and proposes ways to avoid them and instead create benefit.

Volume 25, Issue 1, January 2025, Page W3-W7.

This is a review of Debra Hawhee's book, A Sense of Urgency. The uncertainty and magnitude of climate change make it difficult to talk about its impact in ways that can help us understand and confront what we face. Hawhee's example-driven book aims to show how the rhetoric of climate change is changing rhetoric itself for the better. While there is much to learn from Hawhee's discussion, the book carries a misplaced optimism about how climate change rhetoric is being used--and (...) abused. The review illustrates this with examples from, for instance, Sen. Ted Cruz's weaponizing of the words of climate change activists and boutique tour company's efforts to capitalize on the first memorial to a dead glacier. (shrink)

This transdisciplinary anthology, a project of the "Chimaira - Working Group for Human-Animal Studies", is the first German-language publication to address the diverse questions surrounding animal agency and power. Human-Animal Studies are thus addressing a gap in previous research on the central concept of agency, which is on the agenda in a wide variety of disciplines. Controversial approaches beyond anthropocentrism, such as actor-network theory and new materialism, are explicitly focused on animal actors for the first time.

This article evaluates experiments seeking to teach human language to various non-human primates and birds, with a focus on the agency, self-expression and resistance to their own predicament that became apparent in the experimental subjects once communication was genuinely attempted with them, and the anthropocentric framing in which it was received and devalued in the general perception. -/- These experiments, the problematic assumptions behind them and the remarkable results deserve far more critical scientific and ethical analysis than they were given; (...) the full scope of what these animals proved capable of is still underestimated. (shrink)

This study empirically examines how gender-diverse leadership teams influence the outcomes of mergers and acquisitions (M&As) by signing performance commitment contracts (PCs) to unveil the efforts of women corporate leaders in the M&A process. Using a sample of Chinese firms from 2009 to 2021, we find that gender-diverse leadership increases the likelihood of signing PCs in M&As. The strength of this effect depends not only by the number of women in leadership and the power they hold but also by the (...) organizational environment that enables women to exercise leadership more effectively, such as meeting frequency and gender equality culture. Furthermore, we find that ethical leadership and risk-averse attitudes are two channels through which women leaders affect PC design at both the firm and PC terms levels. Although M&A parties can benefit from PCs signed by gender-diverse leadership, we observe that the stock market fails to anticipate the incremental value that women leaders may bring to the M&As during the announcements, which implies that the visibility of the value brought by women leaders remains limited in the current Chinese capital market. (shrink)

Fifty-five word stories have proven a useful reflective tool across medicine. This short piece details an episode in which ‘leadership’ came up short. Leadership has to make itself present.

The digital public forum has challenged many of our normative intuitions and assumptions. Many scholars have argued against the idea of free speech as a suitable guide for digital platforms’ content policies. This paper has two goals. Firstly, it suggests that there is a version of the free speech principle which is suitable for platforms that have adopted a commitment to free speech to guide their content curation strategies. I call it the Principle of Epistemic Resilience. Secondly, it aims to (...) analyze some of the practical implications of the principle. It argues that upholding this principle in the digital public forum requires a comprehensive strategy, including (1) the automated removal and demotion of contents that threaten to cause serious harm; (2) changes to engagement optimization algorithms; and (3) changes to affordances inside the platform. These changes are necessary to create a fertile environment for deliberation, which is crucial to epistemic resilience. If such a comprehensive strategy is absent, platforms may actively undermine the societal value of speech. (shrink)

About one-third of Australians use the services of complementary and alternative medicine (CAM); but debate about the role of CAM in public healthcare is vociferous. Despite this, the mechanisms driving CAM healthcare choices are not well understood, especially in rural Australia. From 2016 to 2018, 2,679 persons from the Goulburn Valley, northern Victoria, were surveyed, 28% (755) of whom reporting visiting CAM practitioners. A Generalized Linear Mixed Model was used to assess associations between various socio-demographic variables and the use of (...) CAM services. The strongest significant inverse (p < 0.05) association with CAM use overall was being unemployed, with markedly lower odds of using CAM than those employed full-time (OR 0.22 [0.12, 0.41]). The next strongest inverse relationship was being retired (OR 0.44 [0.30, 0.65]). The strongest positive associations were with English spoken at home (OR 2.38 [1.34, 4.24]), private health insurance (hospital cover) (1.57 [1.28, 1.91]), being Australian born (OR 1.61 [1.14, 2.28]), and female sex (1.25 [1.02, 1.52])). Females had significantly higher odds of using osteopathy than males (OR 1.98 [1.33, 2.96]) but there were no significant sex differences for chiropractic or massage. This is the first such study conducted solely for a rural Australian population. The drivers of CAM use differed from previous nation-wide studies and they varied across modalities. The factors identified here as being associated with CAM use could be used by CAM practitioners in developing person-centred services. Similarly, the findings are relevant to primary-care services in understanding what sectors of society might eschew conventional health care for CAM in rural regions, where health services are often limited. (shrink)

Writers have debated whether germline genome‐editing is person‐affecting or identity‐affecting. The difference is thought to be ethically relevant to whether we should choose genome‐editing or choose preimplantation genetic diagnosis and embryo selection, when seeking to prevent or produce bad conditions (e.g., cystic fibrosis, or deafness) in the individuals who will grow from the embryo edited or selected. We consider the very recent views of three prominent bioethicists and philosophers who have grappled with this issue. We claim that both sides are (...) right, but that the sense in which genome‐editing is person‐affecting is less important, morally, when the aim is to have healthy children. Since this is the predominant objective of engaging in embryo selection and genome‐editing, and since there are certain risks, at least for now, with genome‐editing, it remains better, morally, to engage in embryo selection than genome‐editing. (shrink)

The bioethical literature demonstrates both substantive contest over the moral status of entities such as human embryos, and approaches that aim to find morally sound prescriptions in light of fundamental disagreement and uncertainty about identification of their moral status. Amongst such latter approaches, we find Shaun Pattinson's moral precautionary thesis, for which he provides a renewed defence in his recent book Law at the Frontiers of Biomedicine. Pattinson's overarching moral theory centres on the rights of moral agents. In relation to (...) the question of that theory's application, the moral precautionary thesis addresses how, and with what degree of certainty, one moral agent may identify or recognise another. Pattinson roots his precautionary thesis in the problem of other minds. In this article, I argue that that is a mistaken starting point when held against the consequent epistemic claims that Pattinson makes. Furthermore, in examining Pattinson's reasoning, including against earlier objections that have been levelled, I argue that he generates additional problems for accepting the cogency of his thesis. (shrink)

Il presente lavoro di ricerca apre il pensiero e l’agire dell’aver cura della vita e della salute all’analitica della relazione fondamentale tra essere e speranza nella dimensione della cura. Attraverso l’analisi del rapporto tra “cura”, “limite” e “speranza” nel tempo della tecnica, si sono ricercate le condizioni ermeneutiche di uno sguardo rinnovato verso l’essere della cura, orientato dalla possibilità della speranza. A partire dal confronto con la concettualizzazione heideggeriana dell’ “aver cura”, dalla ricomprensione della nozione jaspersiana di “situazione limite” e (...) dalla possibilità dell’ “apertura” marceliana alla speranza nelle pratiche concrete della cura, la ricerca si è indirizzata verso la valutazione di un’analitica della cura alla luce della speranza e l’indicazione della trascendenza valoriale della cura. La speranza emerge infatti quale «fondamento originario e originante della cura», radice di un con-essere curante comunionale proteso «tra situazionalità limite dell’esistenza e apertura trascendente della speranza». In tale orizzonte si sono scorti gli apporti alla filosofia ed etica della cura, alla luce della speranza di bene che apre e illumina «la dimensione ontologica, esistenziale e trascendente della cura». (shrink)

The philosophical literature on personal relationships is focused on dyads: close relationships between just two people. This paper aims to characterise the value of looser and larger relational networks, particularly from the perspective of liberal political theory. We focus on relational networks' value vis-a-vis the important good of felt security. We begin by characterising felt security and analysing how felt security is produced within dyads. We highlight the ambivalent nature of dyadic relationships as a source of felt security. We then (...) theorise relational networks, explaining how they too can provide felt security. We explore three unappreciated benefits that arise when felt security is garnered from a network, rather than from a dyad. These benefits take liberal political theory as their starting point. We close by considering the implications - for both individual action and institutional design - of using relational networks as a source of felt security. (shrink)

Ethics is implicit in psychologists’ thoughts, actions, and general competence, providing guidelines for practice, but it has a relatively small place in the training trajectory. Even when addresse...

Background Ethics is a fundamental component of nursing education to increase students’ moral competence and moral reasoning abilities. However, the core ethics content that should be included in undergraduate education has not been established to date at the international level. Aim To identify the core contents required in formal undergraduate education to ensure morally competent nurses. Research Design An international workshop-research study design in 2023 reported here according to the COnsolidated criteria for REporting Qualitative research. Participants and Research Context Five (...) countries in the context of Promoting a Morally Competent Nurse project participated. In each country, two workshops took place, one with nurse professionals and one with patients’ representatives for a total of 58 individuals (32 and 26, respectively). After being translated into English language, data were categorized deductively. The Dublin Learning Outcomes Descriptors and the blueprint methodology were applied. Ethical Considerations The research protocol was ethically approved in every country where the study was performed. Results A total of 59 core content elements emerged, with ‘ethics of individualized/tailored/patient-centred care’ ( n = 8) and ‘empathy’ ( n = 6) as the most suggested. Nearly half ( n = 26) of the core content items suggested were reported only once (e.g. ‘priority setting’) while overall several referred to ‘communication skills’ ( n = 17). A diverse richness across countries emerged, with some suggesting a few items, and others providing several. Similarly, professionals and patients in most countries agreed that some contents of individualized care, empathy and responsibility should be taught in nursing education, but several core contents were mentioned by only one group of participants and in one country. Conclusion The lack of convergence on core content to be taught suggests that different views are still present. Merging these perspectives may stimulate a reciprocal understanding between professionals and patients, as well as across countries, and support the identification of commonalities and differences to further harmonize undergraduate education in the field. (shrink)

This is an edited transcript of an interview with Rita Charon. Nathan Carlin conducted the interview in her apartment in New York City on October 18, 2024. They discussed a number of topics, including Charon’s educational journey, her mentors, the founding of narrative medicine, the status of narrative medicine today as well as its future, the relationship between narrative medicine and literature and medicine, and the ethics of writing about patients.

According to Hendricks Impairment Argument (IA), abortion is immoral because it impairs the fetus. Here, I argue it is not sufficient to show merely that abortion impairs, Hendricks must show that it harms the fetus. If the fetus is not numerically identical to the person it will become, then it isn't harmed by an abortion. But if the fetus is numerically identical to the person it will become, it is harmed by the deprivation of a future of value. However, taking (...) this route ultimately undermines the novelty of the impairment argument. (shrink)

Unlike with randomized controlled trials (RCTs) in clinical research, little has been said about the ethical principles that should regulate the use of RCTs in experimental development economics. One well-known principle in clinical research ethics is the principle of clinical equipoise. Some recent commentators suggest that an analogue of clinical equipoise should play a role in experimental development economics. In this article, I first highlight some difficulties with importing the concept to experimental development economics. I then argue that MacKay’s (2018, (...) 2020) notion of policy equipoise avoids these difficulties and has a role to play in experimental development economics. (shrink)

This conceptual paper considers the practice implications of assisted dying for contemporary nursing practice within the United Kingdom in response to the publication of a parliamentary report leading to a private members’ bill that will form the basis of a debate and possible change in legislation. A recurring theme within the nursing research is how nurses should respond to patients expressing an interest or making a request for assisted dying. This paper explores contemporary evidence and argues that the procedure of (...) assisted dying is a complex (manifold) and puzzling (paradoxical) practice. The UK nursing profession may replicate recent healthcare catastrophes if the response to a proposal for assisted dying is based on a technical-rational stance, or if nurses merely coalesce around a single determinant such as patient autonomy. The paper presents two nursing communicative interventions that seek to address how to respond to a patient request for an assisted death that foregrounds the preferences and personhood of the patient whilst providing opportunities for enquiry-based approaches to enhance nursing responses to intractable suffering. (shrink)

Conscious but incapacitated patients need protection from both undertreatment and overtreatment, for they are exceptionally vulnerable, and dependent on others to act in their interests. In the United States, the law prioritizes autonomy over best interests in decision making. Yet U.S. courts, using both substituted judgment and best interests decision making standards, frequently prohibit the withdrawal of life-sustaining treatment from conscious but incapacitated patients, such as those in the minimally conscious state, even when ostensibly seeking to determine what patients would (...) have wanted. In the United Kingdom, under the Mental Capacity Act of 2005, courts decide on the best interests of incapacitated patients by, in part, taking into account the past wishes and values of the patient. This paper examines and compares those ethicolegal approaches to decision making on behalf of conscious but incapacitated patients. We argue for a limited interpretation of best interests such that the standard is properly used only when the preferences of a conscious, but incapacitated patient are unknown and unknowable. When patient preferences and values are known or can be reasonably inferred, using a holistic, all-things-considered substituted judgment standard respects patient autonomy. (shrink)

We expand and transform our habitual agency with countless technologies most moments of the day. Our environments, bodies, thoughts and social interactions are thoroughly shaped and mediated by tapestries of interweaving layers of old and new technologies. Perhaps this intimate relation with technology is at the core of our humanity. But our relation to technology has also repeatedly been feared as a Faustian deal that will be the dystopian end of us, or—in more utopian viewpoints— will bring us beyond our (...) earthbound finitudes toward virtual existences. What many agree on is that dramatic changes to our basic ecological and existential conditions are nearing. I suggest we should look for such critical tipping points and phase shifts not just in our biological bodies and environments but also in the informational and behavioral environments we rely on in our intentional and habitual agency. When thinking particularly about technologically mediated habitual agency an obvious place to start is with Don Ihde’s 4 classic human–technology relations. Interestingly, fellow post-phenomenologist Peter- Paul Verbeek has proposed new additional kinds of relations to e.g. “smart”and virtually “augmenting” technologies. While I find each of these analyses insightful, I worry that a focus on individual relations to particular spatio-temporally circumscribed artifacts falls short—or even obscures—some of the particular new challenges to our agency that networked, and data-driven smart technologies give rise to. I will therefore attempt to broaden the focus to how our agency is scaffolded by not just particular technological artifacts, but by our understanding of the broader informational and behavioral environment. To do this, I start by introducing some core theoretical background ideas that will support a more contextual approach and then proceed to consider both the classic and newer post-phenomenological relations from this more contextual perspective. The goal is not only to affirm the value of analyzing concrete technology relations but also to expand and contextualize the analyses. The latter is key if we want a post-phenomenological analysis that can help us understand how our habitual agency might be transformed as we come to live in increasingly “smart worlds”. These new data and algorithmically driven technologies not only transform our relation to a given context, but due to networked dataflows and “smart” decision-making (1) recursively act on us and (2) collapse and transcend the present context. This chapter will also highlight the uncertainties that informationally leaky and “smart” technologies introduce to our understanding of the kind of affordance space we are in and even what the expected outcomes of our actions will be. I suggest that technology relations with such effects might challenge some of the core contextual stabilities and informational segregations that our habitual agency have hitherto relied on. A further issue is if these new technological configurations challenge our habitual processes in ways we cannot easily adapt to. We certainly seem able to create new habits and adapt to these new technologies locally, but the new information flows, hidden audiences, and context collapses appear to challenge some conditions of agency that are typically out of sight, and the effects of which untraceably shows up well outside the present context. Overall, I shall argue that “smart” technologies can both expand and shrink our habitual agency—but that in terms of our ability to guide our action through various contexts in a perceived world something more fundamental appears to be breaking. (shrink)

"...the mechanism of a blockchain system itself, based on self-auditing, could create the conditions for the human being to be irrevocably chained to a hard materialism where no possible distinction is made between the human being and their possessions...".

There is an important research tradition concerning the financial implications of social and environmental ethics. This study investigates the short- and long-term financial performance of ventures with explicit environmental commitments seeking to raise funds in equity crowdfunding (ECF) markets. Our results indicate that environmental orientation positively influences short-term funding performance, though only when accompanied by the costly signal of robust corporate governance mechanisms. In the long run, environmental orientation also positively impacts performance, albeit with only weak statistical significance when observed (...) alone. Governance again serves as a positive moderator, but its effect is less significant relative to the short term. However, environmental orientation does feature a strongly significant positive impact on long-run performance when combined with a successfully conducted initial ECF campaign. (shrink)

This paper argues that solicitors are required to lawyer relationally when delivering independent legal advice (ILA) to (predominantly) women set to provide suretyship for their intimate partner’s debts. Case law tells us that women providing suretyship may be entering the transaction under the coercion of their partner. Coerced debt is a form of economic abuse, which in turn is a form of domestic abuse. ILA in this context therefore provides an important intervention to potentially assist victims of abuse before entering (...) (potentially more) debt at the hands of their abuser. To make ILA purposeful, solicitors must prioritise relational values/dynamics such as consultation, care, judgement, and empowerment; the anti-thesis of market-exchange lawyering which is characterised by the values such as objectivity and detachment. Market-exchange lawyering is also associated with ethical apathy as lawyers prioritise their client’s means-ends above all else, therefore failing to consider the broader implications of those ends (in terms of their client’s best interests and/or the public interest). Drawing on interview data with 22 solicitors, it is demonstrated that most interviewees provide tick-box ILA prioritising completion. That is, most interviewees prioritised values of commerce over values of care when acting for women who may be experiencing economic abuse. (shrink)