Background:Decision-making and assessment in emergency situations are complex and result many times in ethical conflicts between different healthcare professionals.Aim:To analyse and describe situations that can generate ethical conflict among nurses working in emergency situations.Methods:Qualitative analysis. A total of 16 emergency nurses took part in interviews and a focus group.Ethical considerations:Organisational approval by the University Hospital, and informed consent and confidentiality were ensured before conducting the research.Result/conclusion:Two categories emerged: one in ‘ethical issues’ and one in ‘emotions and feelings in caring’. (...) The four ethical subcategories are presented: Autonomy, the first sub category: first, the nurse’s ability to practise care on an emergency ward and, second, to support the patient and/or relatives in terms of care and medical treatment. The conflicts arise when the nurse ends up in the middle between the patient and the physician responsible for the diagnosis and treatment from a nature scientific perspective. Reification of injured body: patient was often reified and fragmented, becoming just a leg or arm. Different factors contributed in this perspective. Pain: pain relief was often inadequate but more effectively treated in the emergency medical services than at the emergency department. The nurses highlighted the phenomenon of suffering because they felt that pain was only an object, forgetting the patients’ care need, like separating mind from body. Death: the nurses felt that the emergency services are only prepared to save lives and not to take care of the needs of patients with ‘end-of-life’ care. Another issue was the lack of ethical guidelines during a cardiac arrest. Resuscitation often continues without asking about the patient’s ‘previous wishes’ in terms of resuscitation or not. In these situations, the nurses describe an ethical conflict with the physician in performing their role as the patient’s advocate. The nurses express feelings of distress, suffering, anger and helplessness. (shrink)

No discussion of academic freedom, research integrity, and patient safety could begin with a more disquieting pair of case studies than those of Nancy Olivieri and David Healy. The cumulative impact of the Olivieri and Healy affairs has caused serious self examination within the biomedical research community. The first part of the essay analyses these recent academic scandals. The two case studies are then placed in their historical context—that context being the transformation of the norms of science through increasingly close (...) ties between research universities and the corporate world. After a literature survey of the ways in which corporate sponsorship has biased the results of clinical drug trials, two different strategies to mitigate this problem are identified and assessed: a regulatory approach, which focuses on managing risks associated with industry funding of university research, and a more radical approach, the sequestration thesis, which counsels the outright elimination of corporate sponsorship. The reformist approach is criticised and the radical approach defended. (shrink)

Financial relationships between physicians and industry are widespread. Highly publicized financial relationships between physicians and industry raised disturbing questions about the trustworthiness of clinical research, practice guidelines, and clinical care decisions. Recent incidents spurred calls for stricter conflict of interest policies and led to new federal laws and NIH regulations. These stricter policies have evoked praise, concerns, and objections. Because these new federal requirements need to be interpreted and implemented, spirited discussions of conflicts of interest in medicine will continue.

Patient advocacy organizations (PAOs) advocate for increased research funding and policy changes and provide services to patients and their families. Given their credibility and political clout, PAOs are often successful in changing policies, increasing research funding, and increasing public awareness of medical conditions and the problems of their constituents. In order to advance their missions, PAOs accept funding, frequently from pharmaceutical firms. Industry funding can help PAOs advance their goals but can also create conflicts of interest (COI). Research indicates (...) that bias may occur, even among well-meaning professionals, when people and organizations have financial COI. Industry funding may therefore influence PAOs to act in ways that favor the interests of their donors, which may increase the risk of harm to patients. This article extends the analysis developed in the Institute of Medicine report, Conflicts of Interest in Medical Research, Education, and Practice, and applies the analysis to understand PAOs and their relationships with industry. It argues that the preferred goal of institutional COI policies should not be to promote trust, but to promote trustworthiness and appropriately placed trust. (shrink)

In this article we will draw on experiences from our own research on deep brain stimulation of the central thalamus in the minimally conscious state. We describe ethical challenges faced in clinical research involving medical devices and offer several cautionary notes about its funding and the interplay of market forces and scientific inquiry and suggest some reforms.

This paper presents the results of a national study of the beliefs and perceptions of small business professionals concerning ethics within their company and business in general. The study examined their views on the relationship between success and ethical conduct as well as the extent and nature of ethical conflicts experienced by the respondents. Some comparisons are made with similar studies that have been conducted in the past. Respondents have the most ethical conflicts with customers and employees, and (...) with regard to honesty in contracts/agreements. Most also believe that ethical standards are lower than they were 10 and 20 years ago, primarily because society's moral standards are lower. Additionally, they believe that the behavior of top management has the most influence on decisions in ethical situations. Finally, consistent with prior studies, they believe that they have the most responsibility to customers, ahead of employees and stockholders. (shrink)

Increasingly, transgender minors are seeking medical care such as puberty-suppressing or gender-affirming hormone therapies. Yet, whether these interventions should be performed at all is highly controversial. Some healthcare practitioners oppose irreversible interventions, considering it their duty to protect children from harm. Others view minors, like adults, as transgender individuals who must be protected from discrimination. The underlying ethical question is presented as a problem of priority. Is it primarily relevant that minors are involved? Or should decision makers focus on the (...) fact that they treat transgender individuals? The paper explores the relevance for medical practice. We provide results of an interview study with German healthcare professionals. We discuss the general question whether prioritization among different group memberships of the same person is ethically defensible. We conclude that priority conflicts between group memberships of the same person can be deceptive and should be addressed by an intersectional approach. Eventually, we discuss practical implications. (shrink)

Much of the literature on clinical ethical conflict has been specific to a specialty area or a particular patient group, as well as to a single profession. This study identifies themes of hospital nurses’ and physicians’ clinical ethical conflicts that cut across the spectrum of clinical specialty areas, and compares the themes identified by nurses with those identified by physicians. We interviewed 34 clinical nurses, 10 nurse managers and 31 physicians working at four different Canadian hospitals as part of (...) a larger study on clinical ethics committees and nurses’ and physicians’ use of these committees. We describe nine themes of clinical ethical conflict that were common to both hospital nurses and physicians, and three themes that were specific to physicians. Following this, we suggest reasons for differences in nurses’ and physicians’ ethical conflicts and discuss implications for practice and research. (shrink)

Social attitudes toward usury (here defined using the archaic meaning as the taking of interest on loans) have changed dramatically over the centuries. From antiquity until the Protestant Reformation, usury was regarded as an inherently evil activity. Today, with few exceptions, usury is met with moral indifference. Modern objections to usury are limited to protest against "excessive" interest rates rather than interest per se. With this change in focus, the very meaning of the term "usury" has also changed. Many early (...) pronouncements against the taking of interest emphasized the plight of the poor, but ironically, the poor actually pay the highest rates of interest in the modern American economy. Despite the universality of usury, some socio-economic subcultures still manage to avoid the taking or giving of interest. Orthodox branches of both Judaism and Islam have maintained bans on usury throughout the centuries and up to the present time. This is especially interesting in the case of Judaism, given the popular cultural image of the Jew as usurer. Jewish free loan systems may actually offer a model for modern loan programs that can be designed to aid poor borrowers, who are frequently shut out of mainstream financial services. (shrink)

How should liberal democratic states respond to cultural practices and arrangements that run afoul of liberal norms and laws? This article argues for a reframing of the challenges posed by traditional or nonliberal cultural minorities. The author suggests that viewed from up close, such dilemmas are revealed to be primarily intracultural rather than intercultural conflicts, and reflect the political and practical interests of factions of communities much more than deep moral differences. Using the example of the reform of customary (...) marriage laws in post-apartheid South Africa, this article makes the case for a more pragmatic, politically focused approach to resolving conflicts of culture that it is argued is both more democratic and effective than alternatives recently advanced by liberals and deliberative democracy theorists. (shrink)

Patients in a vegetative state/ unresponsive wakefulness syndrome (VS/UWS) pose ethical dilemmas to those involved. Many conflicts occur between professionals and families of these patients. In the Netherlands physicians are supposed to withdraw life sustaining treatment once recovery is not to be expected. Yet these patients have shown to survive sometimes for decades. The role of the families is thought to be important. The aim of this study was to make an inventory of the professional perspective on conflicts (...) in long-term care of patients in VS/UWS. A qualitative study of transcripts on 2 Moral Deliberations (MD’s) in 2 cases of patients in VS/UWS in long-term care facilities. Six themes emerged: 1) Vision on VS/UWS; 2) Treatment and care plan; 3) Impact on relationships; 4) Feelings/attitude; 5) Communication; 6) Organizational aspects. These themes are related to professionals and to what families had expressed to the professionals. We found conflicts as well as contradictory feelings and thoughts to be a general feature in 4 of these themes, both in professionals and families. Conflicts were found in several actors: within families concerning all 6 themes, in nurse teams concerning the theme treatment and care plan, and between physicians concerning all 6 themes. Different visions, different expectations and hope on recovery, deviating goals and contradictory feelings/thoughts in families and professionals can lead to conflicts over a patient with VS/UWS. Key factors to prevent or solve such conflicts are a carefully established diagnosis, clarity upon visions, uniformity in treatment goals and plans, an open and empathic communication, expertise and understanding the importance of contradictory feelings/thoughts. Management should bridge conflicts and support their staff, by developing expertise, by creating stability and by facilitating medical ethical discourses. Shared compassion for the patient might be a key to gain trust and bridge the differences from non-shared to shared decision making. (shrink)

Editors have increasing pressure as scholarly publishing tries to shore up trust and reassure academics and the public that traditional peer review is robust, fail-safe, and corrective. Hidden conflicts of interest may skew the fairness of the publishing process because they could allow the status of personal or professional relationships to positively influence the outcome of peer review or reduce the processing period of this process. Not all authors have such privileged relationships. In academic journals, editors usually have very (...) specialized skills and are selected as agents of trust, entrusted with the responsibility of serving as quality control gate-keepers during peer review. In many cases, editors form extensive networks, either with other professionals, industry, academic bodies, journals, or publishers. Such networks and relationships may influence their decisions or even their subjectivity towards a set of submitting authors, paper, or institute, ultimately influencing the peer review process. These positions and relationships are not simply aspects of a curriculum, they are potential COIs. Thus, on the editorial board of all academic journals, editors should carry a COI statement that reflects their past history, as well as actual relationships and positions that they have, as these may influence their editorial functions. (shrink)

Editors have increasing pressure as scholarly publishing tries to shore up trust and reassure academics and the public that traditional peer review is robust, fail-safe, and corrective. Hidden conflicts of interest (COIs) may skew the fairness of the publishing process because they could allow the status of personal or professional relationships to positively influence the outcome of peer review or reduce the processing period of this process. Not all authors have such privileged relationships. In academic journals, editors usually have (...) very specialized skills and are selected as agents of trust, entrusted with the responsibility of serving as quality control gate-keepers during peer review. In many cases, editors form extensive networks, either with other professionals, industry, academic bodies, journals, or publishers. Such networks and relationships may influence their decisions or even their subjectivity towards a set of submitting authors, paper, or institute, ultimately influencing the peer review process. These positions and relationships are not simply aspects of a curriculum, they are potential COIs. Thus, on the editorial board of all academic journals, editors should carry a COI statement that reflects their past history, as well as actual relationships and positions that they have, as these may influence their editorial functions. (shrink)

This paper presents the results of a national study of the beliefs and perceptions of small business professionals concerning ethics within their company and business in general. The study examined their views on the relationship between success and ethical conduct as well as the extent and nature of ethical conflicts experienced by the respondents. Some comparisons are made with similar studies that have been conducted in the past. Respondents have the most ethical conflicts with customers and employees, and (...) with regard to honesty in contracts/agreements. Most also believe that ethical standards are lower than they were 10 and 20 years ago, primarily because society's moral standards are lower. Additionally, they believe that the behavior of top management has the most influence on decisions in ethical situations. Finally, consistent with prior studies, they believe that they have the most responsibility to customers, ahead of employees and stockholders. (shrink)

In recent work, Callender and Cohen (2009) and Hoefer (2007) have proposed variants of the account of chance proposed by Lewis (1994). One of the ways in which these accounts diverge from Lewis’s is that they allow special sciences and the macroscopic realm to have chances that are autonomous from those of physics and the microscopic realm. A worry for these proposals is that autonomous chances may place incompatible constraints on rational belief. I examine this worry, and attempt to determine (...) (i) what kinds of conflicts would be problematic, and (ii) whether these proposals lead to problematic conflicts. After working through a pair of cases, I conclude that these proposals do give rise to problematic conflicts. (shrink)

Background:Clinical ethics committees have been broadly implemented in university hospitals, general hospitals and nursing homes. To ensure the quality of ethics consultations, evaluation should be...

A high standard of planetary protection is important for astrobiology, though the risk for contamination can never be zero. It is therefore important to find a balance. If extraterrestrial life has a moral standing in its own right, it will also affect what we have to do to protect it. The questions of how far we need to go to protect extraterrestrial life will be even more acute and complicated when the time comes to use habitable worlds for commercial purposes. (...) There will also be conflicts between those who want to set a world aside for more research and those who want to give the green light for development. I believe it is important to be proactive in relation to these issues. The aim of my project is therefore to identify, elucidate, and if possible, suggest solutions to potential conflicts between astrobiology, planetary protection, and commercial use of space. (shrink)

The essays in this volume, with the exception of Gary Ferngren's, derive from ancestral versions originally presented at a symposium, 'Conflicts with Newborns: Saving Lives, Scarce Resources, and Euthanasia: held May 10-12,1984, at the Mercer University School of Medicine, Macon, Georgia. We wish to express our gratitude to the Georgia Endowment for the Humanities for a generous grant for the symposium and to Mercer University and the Medical Center of Central Georgia for additional financial support. The vit:ws expressed in (...) this volume do not necessarily represent those of the Georgia Endowment for the Humani ties, Mercer University, or the Medical Center of Central Georgia. We have endeavored to bring together a group of individuals with contrast ing viewpoints to display some of the range of approaches to a major problem in public policy: medical decisions regarding the treatment of defective newborns. So many persons contributed to the symposium that acknowledg ment of each would be impossible. Although unnamed, we express our sincere appreciation to each. Three individuals, however, must be recognized: R. Kirby Godsey, President, Mercer University; William P. Bristol, Dean, Mercer University School of Medicine; and Kenneth C. Henderson, Medical Director and Director of Medical Education, Medical Center of Central Georgia. Without their support, the symposium could not have succeeded and this volume would not have been possible. We wish also to express our gratitude to S. G. M. (shrink)

The Ageing of societies is a unique historical development of mankind. Today, such ageing is recognized as a threat for developed societies. There is fear of increasing inequality in health and in access to health care. Apart from the costs of ageing and care, such fear creates intergenerational conflicts. This paper explores what values are at stake when a society ages. At issue here is the social position of the old citizens and the way in which they are regarded (...) by their fellow citizens. Findings indicate the need to contemplate the consequences of ageing for societies and to discuss the impact these have for the values dominating contemporary post-welfare states. European welfare states were based on a balanced combination of three values: freedom, equality, and solidarity. Because these values are misbalanced now, equal accessibility of care and conditions for social participation are disappearing. Therefore, we shall have to think about new ways in which our societies can reaffirm basic human values. (shrink)

: Some industry relationships are a good idea, and that makes banning the dangerous ones difficult.

The present research used archaeological data, i.e., the data obtained from kamekan jar burials in the Mikuni Hills of the northern Kyushu area in the Mid- dle Yayoi period, to test the parochial altruism model. This model argued that out-group hate and in-group favor coevolved via prehistoric intergroup conflicts. If this model is accurate, such an out-group hate and in-group favor could be re- flected in the archaeological remains, such as pottery making; the more frequent intergroup conflicts are (...) and the more each group is opposed, the more independent and coherent each group will be and more evident cultural identity could be estab- lished within each group. We employed an elliptic Fourier analysis for the shapes of kamekan jar burials. We examined whether frequent intergroup conflicts in the period influenced kamekan jar pottery between subareas of the Mikuni Hills. The results suggested that the shapes of kamekan jar burials after the KIIIa type are slightly different between subareas, which is partially consistent with the model. However, the results do not support the model directly. (shrink)

If clinical trials become a commercial venture in which self-interest overrules public interest and desire overrules science, then the social contract which allows research on human subjects in return for medical advances is broken.BackgroundIn the past two decades, the involvement of non-academic sponsors of biomedical research, particularly clinical trial research, has increased exponentially. The value of such sponsored research is difficult to ascertain. However, it is estimated that, between 1980 and 2003, overall research and development expenditures by US pharmaceutical companies (...) increased from $2 billion to $33 billion and that, in 2001, clinical trial research expenditures in Canada totaled $800 million to $1 billion.The source of funding for biomedical research has shifted significantly from predominantly government and private foundations to industry. By 2002,70% of funding for clinical trials came from industry. These factors have affected the conduct of research, particularly clinical trial research, in a variety of ways. (shrink)

: Animal ethics has presented convincing arguments for the individual value of animals. Animals are not only valuable instrumentally or indirectly, but in themselves. Less has been written about interest conflicts between humans and other animals, and the use of animals in practice. The motive of this paper is to analyze different approaches to interest conflicts. It concentrates on six models, which are the rights model, the interest model, the mental complexity model, the special relations model, the multi-criteria (...) model, and the contextual model. Of these, the contextual model is the strongest, and carries clear consequences for the practical use of animals. (shrink)

Hospices consider themselves places that practise a holistic form of terminal care, encompassing physical and psychological symptoms, and also the social and spiritual support for a dying patient. So far, the underlying ethical principles have been treated predominantly in terms of a normative theoretical discussion. The interview study discussed in this paper is a qualitative investigation into general and hospice-related conceptions of morality among full-time and voluntary workers in German inpatient hospices. It examines moral conflicts and efforts leading to (...) their solution. The main ideas identified include moral neutrality towards the patients and their requests, the capability of acceptance, the idea of self-restraint with respect to the dying patient and the principle of respect for the natural course of dying. Essential triggers for moral conflicts were the inadequate education of patients, problems of acceptance in view of incurable disease, and disagreements between members of patients' families. The interviewees expressed their scepticism towards formal institutions of ethical counselling. The study has shown a type of virtue ethics that forms an integral part of the overall concept of hospice care, which cannot be treated separately from a holistic idea of care at the end of life. (shrink)

In this essay I describe how contractarianism might approach interspecies welfare conflicts. I start by discussing a contractarian account of the moral status of nonhuman animals. I argue that contractors can agree to norms that would acknowledge the “moral standing” of some animals. I then discuss how the norms emerging from contractarian agreement might constrain any comparison of welfare between humans and animals. Contractarian agreement is likely to express some partiality to humans in a way that discounts the welfare (...) of some or all animals. While the norms emerging from the contract might be silent or inconsistent in some tragic or catastrophic cases, in most ordinary conflicts of welfare, contractors will agree to norms that produce some determinate resolution. What the agreement says can evolve depending upon how the contractors or the circumstances change. I close with some remarks on contractarian indeterminacy. (shrink)

"Guanxi" involves interpersonal obligations, which may conflict with other obligations people have that are based on general or abstract moral considerations. In the West, the latter have been widely accepted as the general source of obligations, which is perhaps tied to social changes associated with the rise of capitalism. Recently, Western ethicists have started to reconsider the extent to which personal relationships may form a distinct basis for obligation. In administration and management, salient bases for decision-Making include deontological, consequentialist and (...) personalist ethics. The first may be reflected in a bureaucratic approach, the second in a price system, and the third in arrangements like "guanxi". Each has positive and negative aspects, but problems arise when they lead to conflicting obligations, as may occur for an office holder who has some obligations based in deontological considerations and others based in personal relationships. This is a type of conflict of interest. Such conflicts have been considered in the West, and remedies proposed. Problems arise especially in cases where it is not clear how to prioritise different obligations, and this has been noted as a difficulty in the Chinese legal system. Questions that need to be answered include not only questions about how to deal with conflicting obligations, but also questions about what institutions to accept as giving rise to obligations. Institutions themselves may be problematic not only because of their consequences for economic productivity, but because they are internally incoherent, and this may be manifested in frequent conflicts faced by office holders. (shrink)

Increasingly, there is evidence of the potential benefits of an integrated care model. In fact, the American Psychological Association (APA) supports the role of psychologists in integrated healthcare given the positive outcomes for patients in primary care settings such as increased access to mental health services, reduced mental illness stigma, and improved health associated with recognizing the impact of psychosocial factors on physical wellbeing. Less attention has been paid, however, to ethical dilemmas that may arise for psychologists working in integrated (...) healthcare. This paper explores considerations for resolving potential ethical conflicts that may arise for psychologists working in integrated care settings. (shrink)

The primary goal of this chapter is to present a new method—called Logical Argument Mapping —for the analysis of framing processes as they occur in any communication, but especially in conflicts. I start with a distinction between boundary setting, meaning construction, and sensemaking as three forms or aspects of framing, and argue that crucial for the resolution of frame-based controversies is our ability to deal with those “webs” of mutually supporting beliefs that determine sensemaking processes. Since any analysis of (...) framing in conflicts and communication is itself influenced by sensemaking—there is no “frame-neutrality”—the main problem for an analyst is to cope with his or her own cognitive limitations. LAM offers a solution to this problem. The method will be exemplified with an analysis of two conflicting interpretations of how the international community should deal with Hamas after its election victory in 2006. (shrink)

Bioethics has been subject to considerable social criticism in recent years. One criticism that has caused particular discomfort in the bioethics community is that bioethicists, because of the way their work is funded, are involved in profound conflicts of interest that undermine their title to be considered independent moral commentators on developments in biomedicine and biotechnology. This criticism draws its force from the assumption that bioethics is, or ought to be, a type of normative social criticism. Versions of this (...) criticism come from both the political left and right. For instance, such criticisms include allegations that bioethics is inherently socially conservative, that it is inherently “pro-technology”, that it lays spurious claims to moral and social authority and expertise, that its focus on autonomy links it to neoliberal theories of choice, and that it is an ideological mystification of real social relationships and political power. This commentary paper analyses the problem of bioethical conflict of interest, and argues that the types of conflict of interest facing bioethics are inherent to the role of “public intellectual” that bioethicists generally wish to assume. The paper defends this conception of the role of the bioethicist, arguing that bioethicists should be interested and openly so. (shrink)

In this pathbreaking study, Axel Honneth argues that "the struggle for recognition" is, and should be, at the center of social conflicts. Moving smoothly between moral philosophy and social theory, Honneth offers insights into such issues as the social forms of recognition and nonrecognition, the moral basis of interaction in human conflicts, the relation between the recognition model and conceptions of modernity, the normative basis of social theory, and the possibility of mediating between Hegel and Kant.

There has been a growing concern over establishing norms that ensure the ethically acceptable and scientifically sound conduct of clinical trials. Among the leading norms internationally are the World Medical Association's Declaration of Helsinki, guidelines by the Council for International Organizations of Medical Sciences, the International Conference on Harmonization's standards for industry, and the CONSORT group's reporting norms, in addition to the influential U.S. Federal Common Rule, Food and Drug Administration's body of regulations, and information sheets by the Department of (...) Health and Human Services. There are also many norms published at more local levels by official agencies and professional groups.Any account of international standards should cover both scientific and ethical norms at once – the two are conceptually intertwined. Recent sources recognize that “[s]cientifically unsound research on human subjects is unethical in that it exposes research subjects to risks without possible benefit.”. (shrink)

According to naturalized metaphysics, metaphysics should be informed by our current best science and not rely on a priori reasoning. Consequently, naturalized metaphysics tends to dismiss metaphysicians’ attempts to quarrel with science. This paper argues that naturalized metaphysics should instead welcome such conflicts between metaphysics and science. Naturalized metaphysics is not eliminative of metaphysics. So, if such conflicts are driven by the immediate absence in science of an answer to a metaphysical question, then the conflict should not be (...) dismissed, but instead be received as an occasion to do naturalized metaphysics. That conflicts between metaphysics and science might be beneficial for naturalized metaphysics is exemplified by the case of non-spatial theories of quantum gravity. These theories are criticized by metaphysicians who, often following David Lewis, argue that spatial distance is an indispensable fundamental element in any coherent metaphysics due to its role as the world-making relation. The resulting conflict, however, is found to be well-motivated since the non-spatial theories of quantum gravity offer no alternative world-making relation to spatial distance. Rather than dismissing this conflict, naturalized metaphysics should therefore receive the Lewisians’ resistance as a call to search for one. How this plays out as a negotiation between the scientific theory and the metaphysical question is exemplified in the last part of the paper where entanglement is proposed as an alternative world-making relation in loop quantum gravity. (shrink)

The discussion starts with the fact of ethical disagreement in contemporary liberal democracies. In responding to the question of whether such conflicts are reconcilable, it proposes a normative model of deliberative democracy that seeks to avoid the privatization of ethical concerns. It is argued that many contemporary models of democracy privatize ethical matters either because of a view that ethical conflicts are fundamentally irreconcilable or because of a mis trust of the ideal of rational consensus in the fields (...) of law and politics. Against this, the article contends that most ethical disagree ments are reconcilable in principle; it further suggests that mistrust of the ideal of rational consensus in the fields of law and politics is based on misunderstanding. Here, Habermas's model of deliberative democracy is drawn on. His account of public ethical deliberation is criticized and his negative interpretations of civic republicanism and ethical patterning are questioned; however, his model is seen as fundamentally fruitful from the point of view of dealing with ethical conflict. Key Words: civic republicanism • coercion • consensus • deliberative democracy • ethical disagreements • ethical patterning • ethical-political discourses • ethical privatization • Habermas. (shrink)