Decisions related to births in the “gray zone” of periviability are particularly challenging. Despite published management guidelines, clinicians and families struggle to negotiate care management plans. Stakeholders must reconcile conflicting values in the context of evolving circumstances with a high degree of uncertainty within a short time period. Even skilled clinicians may struggle to guide the patient in making value–laden decisions without imposing their own values. Exploring the experiences of one pregnant woman and her caregivers, this case (...) study highlights how bias may undermine caregivers’ ability to meet their obligation to enhance patient autonomy and the moral distress they may experience when a patient’s values do not align with their own. Management strategies to mitigate the potential impact of bias and related moral distress are identified. The authors then describe one management strategy used in this case, facilitated ethics consultation, which is focused on thoughtful consideration of the patient’s perspective. (shrink)

Plural and conflicting values are often held to be conceptually problematic, threatening the very possibility of ethics, or at least rational ethics. Rejecting this view, Stocker first demonstrates why it is so important to understand the issues raised by plural and conflicting values, focusing on Aristotle's treatment of them. He then shows that plurality and conflict are commonplace and generally unproblematic features of our everyday choice and action, and that they do allow for a sound and (...) rational ethics. (shrink)

Conflicting Values of Inquiry explores how certain non-epistemic values had been turned into epistemic ones, how they had an effect on epistemic content, and how they became ideologies of knowledge playing various roles in inquiry and application throughout early modern Europe.

My paper has two aims. The first is to challenge the widespread assumption that the personified Laws of Athens, whom Socrates gives voice to during the second half of the _Crito express Socrates' own views. I shall argue that the principles which the Laws espouse not only differ from those which Socrates sets out in his own person within the dialogue, but are in fact in conflict with Socrates' states principles. (edited).

ABSTRACT While UNESCO's Universal Draft Declaration on Bioethics and Human Rights highlights appropriate ethical values, its principles are stated in absolute terms and conflict with one another. The Draft Declaration fails to sufficiently address the possibility of conflict between principles, and it provides no real guidance on how to strike a balance between them in cases where conflict occurs. The document's inadequate treatment of conflicting values is revealed by examination of cases where principles aimed at the promotion (...) of autonomy and liberty conflict with those aimed at benefit maximization and harm minimization. I argue that liberty (and autonomy) may be less important in the context of health care than in other contexts, and I conclude by suggesting specific ways in which some of UNESCO's principles should be revised in order to better address the reality of conflicting values. (shrink)

How should we make choices where the values we subscribe to give conflicting recommendations? I will be defending a reduction of decision making under conflict to decision making under indeterminacy, in the spirit of Broome. To defend this, I set out and endorse the basic features of decision making under conflict that Ruth Chang identifies. I show that we find exactly those features in cases of decision making under indeterminacy not involving conflicting values. Further, my theory (...) of decision making under indeterminacy predicts and explains these features. Particular attention will be paid to the aspect that Chang emphasizes as the decisive problem for the Broomean reduction: the resolutional residue, or angst, that decision making under conflict evinces. (shrink)

Pushing back against the potential trivialization of moral psychology that would reduce it to emotional preferences, this book takes an enactivist, self-organizational, and hermeneutic approach to internal conflict between a basic exploratory drive motivating the search for actual truth, and opposing incentives to confabulate in the interest of conformity, authoritarianism, and cognitive dissonance, which often can lead to harmful worldviews. The result is a new possibility that ethical beliefs can have truth value and are not merely a result of ephemeral (...) altruistic or cooperative feelings. It will interest moral and political psychologists, philosophers, social scientists, and all who are concerned with inner emotional conflicts driving ethical thinking beyond mere emotivism, and toward moral realism, albeit a fallibilist one requiring continual rethinking and self-reflection. It combines 'basic emotion' theories with hermeneutic depth psychology. The result is a realist approach to moral thinking emphasizing coherence rather than foundationalist theory of knowledge. (shrink)

Essays examine various sides of medical ethics issues such as euthanasia, organ transplants, and living wills.

Continuing tensions exist between mainstream bioethics and advocates of the disability rights movement. This paper explores some of the grounds for those tensions as exemplified in From Chance to Choice: Genetics and Justice by Allen Buchanan and coauthors, a book by four prominent bioethicists that is critical of the disability rights movement. One set of factors involves the nature of disability and impairment. A second set involves presumptions regarding social values, including the importance of intelligence in relation to other (...) human characteristics, competition as the basis of social organization, and the nature of the parent–child relationship. The authors’ disapproval of certain aspects of the disability rights movement can be seen to be associated with particular positions regarding these factors. Although the authors intend to use a method of ‘broad reflective equilibrium,’ we argue that their idiosyncratic commitment to particular concepts of disability and particular social values produces a narrowing of the moral significance of their conclusions regarding disability rights. (shrink)

One INTRODUCTION: IN SEARCH OF THE VOICES OF NURSES IN CHINA Two motives launched this study to search for the voices of nurses in China. ...

The article by Potter and Rif S. El-Mallakh read empathically, invokes a sense of fulfilment in their experiences, serving as inspiration for others to learn and practice ethics better. It describes their growth that has culminated to this sense of fulfilment and inspirational dignity. Crucial for this desirable growth has been, I want to highlight, their good investment in virtuous relationships and diligent processes. I also highlight from their article a potential conceptual restriction to growing in our learning and practicing (...) of ethics. That is, the restriction that occurs when blinded by too narrow a view on what ethics is about or where its emphasis is supposed to be. (shrink)

In this article, I present my view that only through value conflicts can we become aware of the relevant values influencing science. The discussion about values in science has been ongoing for the past decades; unfortunately, a crucial part of the discussion—value awareness—has not been addressed. This article tries to bridge this gap by focusing on the problem of value recognition through analyzing several cases of value conflicts. I will show that unless some value conflict occurs, the (...) class='Hi'>values influencing science remain invisible to us. This means that to discuss the relevant influences of values in science, we need to focus on value conflicts occurring in science. Only then can we recognize the values influencing science and have a meaningful debate about them. This article is the first foray into the issue of value recognition and can help clarify some unaddressed issues in the values in science debate. (shrink)

Does the way we think about our personal self-complexity affect how we accept others? Researchers have offered various conceptualizations of how individuals manage their complex identities, while others have identified links between cognitive complexity and acceptance of outgroups. This paper integrates the two bodies of work by positing a route by which personal identity conflicts may lead to cognitive and cultural pluralism. For individuals committed to multiple identities perceived as conflicting, the intra-psychic experience of value conflicts may lead to (...) a recognition of self-complexity, which is then transposed from the personal domain to the social one and expressed as a pluralistic attitude towards others. This argument find support in a study of Israeli Jewish Orthodox psychoanalytic therapists who belong to what they perceive as non-pluralistic religious groups, yet express value pluralism, which they attribute to their complex identities. One of the educational implications of this study is that facilitating engagement with internal complexity, multiple identities and personal value conflicts may promote pluralistic thinking for individuals in religious societies. (shrink)

ABSTRACTThe question of how to engage with stakeholders in situations of value conflict to create value that includes a plurality of conflicting stakeholder value perspectives represents one of the crucial current challenges of stakeholder engagement as well as of value creation stakeholder theory. To address this challenge, we conceptualize a discursive sharing process between affected stakeholders that is oriented toward discursive justification involving multiple procedural steps. This sharing process provides procedural guidance for firms and stakeholders to create pluralistic stakeholder (...) value through the discursive accommodation of diverging stakeholder value perspectives. The outcomes of such a discursive value-sharing process range from stakeholder value dissensus to low and increasing levels of stakeholder value congruence to stakeholder value consensus. Hence, this article contributes to the emerging literature on integrative stakeholder engagement by conceptualizing a procedural framework that is neither overly oriented towards dissensus nor consensus. (shrink)

The analytical tension between legal norms, moral values, and national interests seems no uncharted territory in political science, but has found very little interest in legal academia. For lawyers, moral values and national interests are largely “unknowns,” dealt with by other disciplines. Looking a bit deeper, the picture becomes more nuanced, however. As part of a roundtable on “Balancing Legal Norms, Moral Values, and National Interests,” this essay argues that norms, values, and interests are not different (...) universes of legal normativity, morality, and specific interests, but are interrelated concepts. Values clearly influence norms and often underpin them, while seemingly concrete norms (rules) are themselves often fragile constructs trying to balance competing interests. Value systems are quite diverse within societies, and this is even truer for interests; each society is a dynamic system of social interaction where conflicting interests are constantly playing out. In a way, underlying conflicts of values and interests are constantly being renegotiated in the legal system, with the norms enshrined in the text of statutes and treaties serving to constitute transitory reference points. (shrink)

Background:The foundation of all nursing practice is respect for human rights, ethical value and human dignity. In perioperative practice, challenging situations appear quickly and operating theatre nurses must be able to make different ethical judgements. Sometimes they must choose against their own professional principles, and this creates ethical conflicts in themselves.Objectives:This study describes operating theatre nurses’ experiences of ethical value conflicts in perioperative practice.Research design:Qualitative design, narratives from 15 operating theatre nurses and hermeneutic text interpretation.Ethical consideration:The study followed ethical principles (...) in accordance with the Helsinki Declaration and approval was granted by the local university ethics committee.Findings:The result showed that value conflicts arose in perioperative practice when operating theatre nurses were prevented from being present in the perioperative nursing process, because of current habits in perioperative practice. The patient’s care became uncaring when health professionals did not see and listen to each other and when collaboration in the surgical team was not available for the patient’s best. This occurred when operating theatre nurses’ competence was not taken seriously and was ignored in patient care.Conclusion:Value conflicts arose when operating theatre nurses experienced that continuity of patient care was lacking. They experienced compassion with the patient but still had the will and ability to be there and take responsibility for the patient. This led to feelings of despair, powerlessness and of having a bad conscience which could lead to dissatisfaction, and even resignations. (shrink)

Conflict zone entrepreneurs—local entrepreneurs running small businesses in conflict settings—have paradoxical impacts on stability: holding the ability both to foster peace but also to enhance conflict. Prior scholarly work has been unable to explain this divergence, as existing entrepreneurial indicators do not account for fundamental peacebuilding elements. In response, the article consolidates divergent fields of study, applies paradox theory to analyze underlying tensions in the field, and reframes entrepreneurship through a peacebuilding lens based on intergroup inclusivity and value-creating business practices. (...) Using several cases, this article shows how entrepreneurial activity in conflict zones can foster sustainable peace, limited peace, or conflict, arguing that entrepreneurship based on value-creating and inclusive practices can result in pro-peace outcomes. The article offers policy recommendations for local governments and the humanitarian sector seeking to use entrepreneurship in conflict zones to promote peace. (shrink)

Takes up particular issues of conflict and plurality in Aristotle's ethics and moral psychology. Argues that Aristotle explicitly allows for dirty hands as well as conflicts of values and of desires. This involves discussing issues in Aristotle's treatment of voluntariness, mixed acts, eudaimonia, and pleasure. It is argued that for Aristotle, being a good person does not mean that choices among values can be executed lightly, nor does it ensure that the good never experience lack of eudaimonia, since (...) even they have to deal with dirty hands and conflict of values. (shrink)

Is the purpose of political philosophy to articulate the moral values that political regimes would realize in a virtually perfect world and show what that implies for the way we should behave toward one another? That model of political philosophy, driven by an effort to draw a picture of an ideal political society, is familiar from the approach of John Rawls and others. Or is political philosophy more useful if it takes the world as it is, acknowledging the existence (...) of various morally non-ideal political realities, and asks how people can live together nonetheless? The latter approach is advocated by “realist” thinkers in contemporary political philosophy. In Value, Conflict, and Order, Edward Hall builds on the work of Isaiah Berlin, Stuart Hampshire, and Bernard Williams in order to establish a political realist’s theory of politics for the twenty-first century. The realist approach, Hall argues, helps us make sense of the nature of moral and political conflict, the ethics of compromising with adversaries and opponents, and the character of political legitimacy. In an era when democratic political systems all over the world are riven by conflict over values and interests, Hall’s conception is bracing and timely. (shrink)

This paper proceeds from an analysis (Callaway 1992, pp. 239-240) of a role of conflict in the origin of value commitments, a pervasive sociological pattern in the development of unifying group values which transforms personal conflicts, or differences, into large-scale collective conflicts. I have urged that these forces are capable of distorting even the cognitive processes of science and that they are a chief reason why value claims are regarded as incapable of objective evaluation. The thesis of the present (...) paper is that romantic collectivism (uncritical attachment to an identification group) renders members passive with respect to the ideals or content embodied in collective identity and that this is often exploited to convert groups into instruments of personal power. The issue is examined by reference to Reinhold Niebuhr's 1932 thesis of the inevitability of group egoism and inter-group conflicts and an opposing pragmatist conception of moral development, self-identity, and the individual's relationship to reference communities. (shrink)

Ten years ago there was little talk about adding “professionalism” to the medical curriculum. Educators seemed to believe that professionalism was like the studs of a building—the occupants assume them to be present, supporting and defining the space in which they live or work, but no one talks much about them. Similarly, educators assumed that professional values would just “happen,” as trainees spent years working with mentors and role models, as had presumably been the case in the past. To (...) continue the metaphor, when educators did discuss ethics and values, they tended to focus more on external building codes than on the nature of construction materials. Building codes are designed to ensure the public's safety by establishing procedures and standards. Likewise, the “new” bioethics of autonomy and informed consent that entered the medical curriculum in the 1970s and 1980s was oriented primarily toward protecting human rights by codification. In fact, educators explicitly warned students against acting on their personal or professional values in a misguided way—that is, in the absence of adequate ethical constraints, a type of behavior that came to be labeled, pejoratively, as paternalism. (shrink)

Background: Smart sensors have been developed as diagnostic tools for rehabilitation to cover an increasing number of geriatric patients. They promise to enable an objective assessment of complex movement patterns. -/- Objective: This research aimed to identify and analyze the conflicting ethical values associated with smart sensors in geriatric rehabilitation and provide ethical guidance on the best use of smart sensors to all stakeholders, including technology developers, health professionals, patients, and health authorities. -/- Methods: On the basis of (...) a systematic literature search of the scientific databases PubMed and ScienceDirect, we conducted a qualitative document analysis to identify evidence-based practical implications of ethical relevance. We included 33 articles in the analysis. The practical implications were extracted inductively. Finally, we carried out an ethical analysis based on the 4 principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice. The results are reported in categories based on these 4 principles. -/- Results: We identified 8 conflicting aims for using smart sensors. Gains in autonomy come at the cost of patient privacy. Smart sensors at home increase the independence of patients but may reduce social interactions. Independent measurements performed by patients may result in lower diagnostic accuracy. Although smart sensors could provide cost-effective and high-quality diagnostics for most patients, minorities could end up with suboptimal treatment owing to their underrepresentation in training data and studies. This could lead to algorithmic biases that would not be recognized by medical professionals when treating patients. -/- Conclusions: The application of smart sensors has the potential to improve the rehabilitation of geriatric patients in several ways. It is important that patients do not have to choose between autonomy and privacy and are well informed about the insights that can be gained from the data. Smart sensors should support and not replace interactions with medical professionals. Patients and medical professionals should be educated about the correct application and the limitations of smart sensors. Smart sensors should include an adequate representation of minorities in their training data and should be covered by health insurance to guarantee fair access. (shrink)

Leeds (1990) levels an objection against the criterion of rational choice I have proposed (Levi 1997, Ch. 6; 1980; 1986), pointing out that the criterion is sensitive to the way possible consequences are partitioned. Seidenfeld, Kadane and Schervish (1989) call into question the defense of the cross product rule by appeal to Pareto Unanimity Principles that I had invoked in my 1986. I offer clarifications of my proposals showing that the difference between my views and those of my critics concerns (...) the extent to which full belief, probabilistic belief, and value judgment are separable. (shrink)

Endeavors have been made to found and incorporate ethical values in most aspects of healthcare, including health technology assessment. Health technologies and their assessment are value-laden and could trigger problems with dissemination if they contradict societal norms. Per WHO definition, preconception expanded carrier screening is a new health technology that warrants assessment. It is a genetic test offered to couples who have no known risk of recessive genetic diseases and are interested pregnancy. A test may screen for carrier status (...) of several autosomal recessive diseases and X-linked at one go. The technique has been piloted in the Netherlands and is discussed in other countries. The aim of the study was to examine values and value conflicts that healthcare experts recounted in relation to the discussion of implementation and use of preconception ECS in Sweden. We interviewed ten experts, who were associated with influencing health policymaking in Sweden. We employed systematizing expert interviews, which endeavor to access experts’ specialist knowledge. There were four female and six male informants, of which four were physicians, three bioethicists, one a legal expert, one a theologian and one a political party representative in the parliament. The participants functioned as members of two non-governmental bodies and three governmental organizations. We employed thematic analysis to identify themes, categories and subcategories. Two main themes surfaced: values and value conflicts. The main categories of Respect for persons, Solidarity, Human dignity, Do no harm, Health and Love formed the first theme, while values conflicting with autonomy and integrity respectively, constituted the second theme. Concepts relating to respect for persons were the most commonly mentioned among the participants, followed by notions alluding to solidarity. Furthermore, respondents discussed values conflicting with Swedish healthcare ones such as equality and solidarity. The experts highlighted values and concepts that are distinctive of welfare states such as Sweden and delineated how preconception ECS could challenge such values. Moreover, the analysis revealed that certain values were deemed more substantive than others, judging by the extent and detail of inference; for example, respect for persons and solidarity were on top of the list. (shrink)

The term “euthanasia” is used in conflicting ways in the bioethical literature, as is the term “assisted suicide,” resulting in definitional confusion, ambiguities, and biases which are counterproductive to ethical and legal discourse. I aim to rectify this problem in two parts. Firstly, I explore a range of conflicting definitions and identify six disputed definitional factors, based on distinctions between (1) killing versus letting die, (2) fully intended versus partially intended versus merely foreseen deaths, (3) voluntary versus nonvoluntary (...) versus involuntary decisions, (4) terminally ill versus non-terminally ill patients, (5) patients who are fully conscious versus those in permanent comas or persistent vegetative states, and (6) patients who are suffering versus those who are not. Secondly, I distil these factors into six “building blocks” and combine them to develop an unambiguous, value-neutral taxonomy of “end-of-life practices.” I hope that this taxonomy provides much-needed clarification and a solid foundation for future ethical and legal discourse. (shrink)

. The potential for financial conflicts of interest to influence scientific research has become a significant concern. Some commentators have suggested that the development of standardized study protocols could help to alleviate these problems. This paper identifies two problems with this solution: scientific research incorporates numerous methodological judgments that cannot be constrained by standardized protocols; and standardization can hide significant value judgments. These problems arise because of four weaknesses of standardized guidelines: incompleteness, limited applicability, selective ignorance, and ossification. Therefore, the (...) standardization of study designs should not serve as an alternative to addressing the interests and power relations that pervade science policy-making. Policy makers should take at least two steps to prevent powerful interest groups from co-opting standardized guidelines. First, their development and review should be made as transparent as possible and should be subjected to broadly-based deliberation. Second, standardized guidelines should be supplemented with efforts to scrutinize the conditions under which financial COIs tend to have the most worrisome effects so that additional steps can be taken to eliminate and mitigate those conditions. (shrink)

Rural development and economic change has generally been associated with growth and the in-migration of nonlocal firms or their branch plants and offices. Such change has been critiqued and at times resisted because of its implicit “urbanism” and conflict with rural values and modes of social interaction. The inevitability of the conflict has always been assumed, given the perspectives of development groups and many rural residents. This paper examines the apparent conflicts between the rural ethos and the “growth ethos,” (...) and the considers the necessity for the pursuit of the forms of growth that tend to undermine rural values. The severely limited set of changes in the local economy considered by the common forms of growth-sponsoring economic development groups is then examined. Finally, the existence of alternative forms of economic change are hypothesized and their viability demonstrated. We conclude that improved economic well-being for rural residents need not sacrifice their values and lifestyles on the altar of urban-influenced “economic growth.”. (shrink)

The authors present an approach to conceptualising and predicting environmental conflicts in which conflicts are analysed as a continuum of disagreement over values and options. They also operationalise this approach using an online values-centred survey tool, the ‘public-to-public decision support system’ (P2P-DSS). The authors put values and conflict in environmental management into perspective. Next, they review how values are defined in scholarship and operationalised for decision support. The relevance of values research to con-flict management is (...) presented. With reference to a real-world aggregate-mining conflict, the authors demonstrate how P2P-DSS can be used to collect data and categorise conflicts to enhance environmental management decision-making. The authors argue that P2P-DSS has potential to support values-sensitive thinking for environmental conflict management. They then set out research priorities to investigate the theoretical and practical implications of this approach. This work contributes to advancing values research in environmental conflict management and expanding values-based decision-making. (shrink)

From the world's foremost authority on the interdisciplinary study of time comes this remarkable work on the intersection of time and human values.

This study investigates how values are instilled to children in conflict with the law in a Philippines youth facility through the houseparent–resident relationship. Although a wealth of literature has examined the condition of child residents in youth rehabilitation institutions, little is known about the relationship between the child residents and the houseparents assigned to care for them, particularly, how the values the houseparents instil in the children impacts on their rehabilitation. Through an ethnographic study of a child facility (...) and in-depth interviews of the CICL residents and their houseparents, the study presents a rich description of the kind of relationship between these carers and their wards. The totalizing effect of the institution is mitigated by the genial relationship between the houseparents and the child residents. In particular, the Filipino values of personalism as applied by the houseparents in their parenting tasks positively impacts on the child residents they are caring for. The findings gathered from this study will provide critical information on what values the social workers, caregivers, houseparents and other staff of a youth facility should impart to the CICL to help achieve the facility’s rehabilitative goals. (shrink)