Objectives To develop and test two educational programmes (interactive and passive) aimed at improving family doctors' (FD) prescribing practices and patient's knowledge and use of non-opioid analgesics (NOA).Methods The educational programmes were conducted in two family medicine clinics by using a three-stage approach: baseline evaluation, design, and implementation of educational activities, and post-programme evaluation. An interactive educational programme (IEP) was compared with a passive educational programme (PEP); both were participated by FDs and patients. The IEP for FDs comprised of workshops, (...) discussion groups, in-service training and guidelines, while for patients the IEP consisted of an interactive session with a video, leaflets and a discussion. The PEP consisted in delivering the guidelines to the FDs and the leaflets to patients. The effect of the programmes on the FDs was measured through the appropriateness of prescriptions and analysed using the differences-in-differences estimator (D-in-D), and on patients through changes in self-medication and in their knowledge about the proper use and adverse events by analysing the inter- and intra-group differences before and after the programmes.Results The IEP obtained better results to improve appropriate FDs prescription of NOA than PEP (D-in-D = 15%). Regarding the patients, the PEP group reached higher reduction of self-medication than the IEP group (13.4% vs. 9.1%); the knowledge of proper NOA use increased by 8.5% in both groups, whereas knowledge of NOA-related adverse events was better in the IEP (39.6%) than in the PEP group (9.2%).Conclusions The IEP was better to improve the doctors' abilities to prescribe NOAs, and both programmes improved patients' knowledge. (shrink)

Confidence can dissociate from perceptual accuracy, suggesting distinct computational and neural processes underlie these psychological functions. Recent investigations have therefore sought to experimentally isolate metacognitive processes by creating conditions where perceptual sensitivity is matched but confidence differs (“matched-performance / different-confidence”; MPDC). Despite these endeavors’ success, much remains unknown about MPDC effects and how to best harness them in experimental settings. Here we developed a principled approach to comprehensively characterizing MPDC effects through analyzing metaperceptual (i.e., type 2 psychometric) functions relating objective (...) performance to subjective confidence across widely varying performance levels and experimental manipulations. We found that MPDC effect magnitude depends on stimulus properties, observers’ sensitivity level, and critically on trial type order (blocked or interleaved across stimulus property variations). Our findings provide the first comprehensive exploration of MPDC effects, offer a prescriptive guide to metaperceptual analysis, and suggest optimal experimental paradigms for experimentally isolating metacognition and awareness in future studies. (shrink)

This article provides a conceptual framework for studying the influence of mood on managerial ethical decision making. We draw on mood-congruency theory and the affect infusion model to propose that mood influences managerial ethical decision making through deliberate and conscious assessments of the moral intensity of an ethical issue. By accounting for proscriptive and prescriptive morality—i.e., harmful and prosocial behavior, respectively—we demonstrate that positive and negative mood may have asymmetrical and paradoxical effects on ethical decision making. Specifically, our (...) analysis suggests that individuals in a positive mood will be more likely to engage in prosocial behavior but less likely to refrain from activities that have harmful consequences for others, whereas individuals in a negative mood will be more likely to avoid activities that put others at risk or harm but at the same time less prone to engaging in activities that have positive consequences for others. Importantly, we account for the context within which managers make their decisions by examining how situational strength may moderate the influence of mood on managerial ethical decision making. Finally, we discuss how organizations can leverage the double-edged sword effect of mood on ethical decision making and prevent, control and manage the risk of unethical decision making on the part of managers. (shrink)

It is widely accepted that morality does not demand that we do our very best, but our most significant moral traditions do not easily accommodate this intuition. I will argue that the underlying problem is not specific to any particular tradition. Rather, it will be difficult for any moral theory to account for binary moral concepts like permissible/impermissible while also accounting for scalar moral concepts like better/worse. If only the best is considered permissible, morality will seem either unreasonably (...) demanding or implausibly minimal. But if we draw a line of duty below the optimal, then we must explain how the act that is worse is nonetheless permissible. Some have tried to explain this by appealing to non-moral considerations, and others have appealed to agent-relative moral considerations. I argue that no such approach will work. We should instead exploit the distinction between reasons for performing an act and reasons for holding someone accountable for an act’s performance. This approach will also help to clear up a confusion regarding the notion of a moral demand. (shrink)

Morally speaking, what should one do when one is morally uncertain? Call this the Moral Uncertainty Question. In this paper, I argue that a non-ideal moral theory provides the best answer to the Moral Uncertainty Question. I begin by arguing for a strong ought-implies-can principle---morally ought implies agentially can---and use that principle to clarify the structure of a compelling non-ideal moral theory. I then describe the ways in which one's moral uncertainty affects one's moral prescriptions: moral uncertainty constrains the set (...) of moral prescriptions one is subject to, and at the same time generates new non-ideal moral reasons for action. I end by surveying the problems that plague alternative answers to the Moral Uncertainty Question, and show that my preferred answer avoids most of those problems. (shrink)

New technologies regularly bring about profound changes in our daily lives. Romantic relationships are no exception to these transformations. Some philosophers expect the emergence in the near future of love drugs: a theoretically achievable biotechnological intervention that could be designed to strengthen and maintain love in romantic relationships. We investigated laypeople’s resistance to the use of such technologies and its sources. Across two studies (Study 1, French and Peruvian university students, N after exclusion = 186; Study 2, Amazon Mechanical Turk (...) sample, N after exclusion = 693, pre-registered), we found that the use of love drugs designed to strengthen and maintain love in romantic relationships are considered as more morally problematic than psychological therapy with the same aim. In Study 2, we show that this last effect is partially due to the fact that the love resulting from the use of love drugs is perceived as less authentic, intense, and durable. We discuss the specific role of authenticity in the relative moral disapproval of love drugs. (shrink)

Many pharmaceuticals are available to patients only with a physician’s prescription. Although it is often not recognized as such, this is a classic example of paternalism in public policy. Pharmaceuticals are often perceived as carrying dangerous side effects. Access is restricted to protect patients from their own bad decisions. This chapter explores the moral justification for such paternalism and finds it wanting. It raises the question of whether there is adequate justification for this restriction. Consistency requires that pharmaceuticals posing dangers (...) primarily to the individual be available to competent consumers and that even moderate risks to third parties be tolerated. The chapter begins by arguing that all drug usage involves evaluative judgments about the relative benefits and harms of the agents and that physicians must make value judgments in deciding whether to prescribe. (shrink)

There are two fundamental self-regulatory systems for moral action reflecting an approach-oriented system promoting moral action (prescriptive morality) and an avoidance-oriented system restraining immoral action (proscriptive morality). Despite the presence of these systems, individuals may vary in the extent to which the systems regulate their moral responses. One factor that may heighten prescriptive and proscriptive moral self-regulation is individuals’ moral identity. Three studies examined if the systems of moral regulation are more salient among individuals with a (...) strong internalized moral identity. Possessing a strong internalized moral identity was associated with greater salience of the prescriptive system – with heightened perceptions that prescriptive behaviors should be enacted, that prescriptive behaviors are less a matter of personal preference, and that prescriptive behaviors are expected to yield greater social approval – compared to the proscriptive system. Possessing a strong internalized moral identity appears to orient individuals toward engaging in good (rather than only avoiding bad) behaviors. (shrink)

In this article, we consider the problem of a discrepancy between, on the one hand, lay prescriptive judgments on the necessity of altruistic actions and, on the other, attributing moral worth to these actions. Based on Kantian theory of morality, we hypothesized that lay attributions of the moral worth of altruistic actions would be inversely related to normative ought-judgments according to which these actions should be performed, as having positive evolutionary-based utilitarian externalities for the actors. To test this (...) general hypothesis, we conducted two experiments using the same set of vignettes that were constructed based on systematically varying such factors as relatedness, reciprocity, the size of donation, and probability of meeting in the future. The results provide overall confirmation of our assumption, as evaluative judgments about the moral worth were inversely dependent on information provided about possible contributions from such consequentialist, payoff-based mechanisms as kinship and expected reciprocity, while prescriptive judgments were positively influenced by such information cues. (shrink)

The Idea of a Moral Economy is the first modern edition and English translation of three questions disputed at the University of Paris in 1330 by the theologian Gerard of Siena. The questions represent the most influential late medieval formulation of the natural law argument against usury and the illicit acquisition of property. Together they offer a particularly clear example of scholastic ideas about the nature and purpose of economic activity and the medieval concept of a moral economy. In his (...) introduction, editor Lawrin Armstrong discusses Gerard's arguments and considers their significance both within the context of scholastic philosophy and law and as a critique of contemporary mainstream economics. His analysis demonstrates how Gerard's work is not only a valuable source for understanding economic thought in pre-modern Europe, but also a fertile resource for scholars of law, economics, and philosophy in medieval Europe and beyond. (shrink)

The paper reviews the book written by F.M. Kamm, entitled Bioethical Prescriptions: To Create, End, Choose, and Improve Lives. Kamm is one of the most prominent analytical philosophers in moral philosophy, known from such works as Intricate Ethics. She defends the rights-based approach to ethics and is also famous from constructing multilayered moral dilemmas. The review poses methodological questions, of whether scientific-like thought experiments performed in a moral lab, and the Method of Hypothetical Cases are able to transform our ethical (...) dilemmas and provide any solutions. In the final part of the review, the first chapter of the book on Tolstoy’s essay is discussed in more detail. (shrink)

The aim of the paper is to explore and assess the process of responsibility, decoupling point, and disengagement of moral responsibility, in combination with business sustainability in supply chains. The research is based on a qualitative approach consisting of two multifaceted case studies, each including multiple case companies and different empirical research characteristics, and a review of BSus in supply chain literature. The case studies apply moral disengagement to propose how moral responsibility can deteriorate in supply chains, and the literature (...) review identifies elements of BSus in supply chain management. The contribution of this paper is to compare these two research streams and evaluate the efficacy of the concepts proposed in the case studies. Through this study, BSus gains an entirely different and complementary toolkit which should facilitate further and more effective research in SCM. The theory of MDis also provides a foundation for reinforcing explanatory and prescriptive aspects of ‘best practices’ in the SCM literature. The findings also establish a basis for organizing and monitoring supply chains so as to improve BSus efforts. Considering moral responsibility as a flow this research explains why and how certain practices may impede BSus efforts in supply chains. Original and/or innovative outcomes include explanatory and prescriptive insights that emerge from a combination of empirical findings from two case studies, including seven companies and a framework for improving BSus management in supply chains, based on a typology of moral disengagement. (shrink)

California, Arizona, and several other states have recently legalized medical marijuana. My goal in this paper is to demonstrate that even if one grants the opponents of legalization many of their contentious assumptions, the federal government is still obligated to take several specific steps toward the legalization of medical marijuana. I defend this claim against a variety of objections, including the claims: that marijuana is unsafe, that marijuana cannot be adequately tested or produced as a drug, that the availability of (...) synthetic THC makes marijuana superfluous, and especially that legalizing medical marijuana will increase recreational use by ‘sending the wrong message ’. I then go on to argue that given the intransigent position of the federal government on this issue, state governments are justified in unilaterally legalizing medical marijuana as an act of civil disobedience. A large portion of this paper consists of an extensive response to the objection that legalizing medical marijuana will ‘send the wrong message ’– which I take to be the primary impediment to legalization. This objection basically claims that the consequences of withholding legalization (especially preventing increased recreational use) are superior to those of legalizing medical marijuana. I argue that legalization is justified even if one were to grant both that the harms of legalization outweighed its benefits and that utilitarianism is true. This requires a subtle and somewhat extended discussion of utilitarian moral and political theory. (shrink)

This essay seeks to answer the question of how the behavior of wealthy advocates of some version of socialism can be reconciled with their advocacy of those ideas. The answer is that the conception of egalitarianism under which they choose to live is one that redistributes income, not wealth, while the egalitarianism that they advocate for others is that in which all wealth is the property of one person who decides how much will be distributed to others.

A wide range of more objectivist norms appear to leave uncharted an important part of normative space. In the beginning of this paper I briefly outline two broad ways of seeking more subject-directed norms: perspectivism and feasibilism. According to feasibilism, the ultimate reason why more objectivist norms are inadequate on their own is not that they fail to take into account the limits of an agent’s perspective, but that they are not sensitive to limits on what ways of choosing, acting, (...) and believing are feasible in a given situation. I think of these ways of choosing, acting, and believing in terms of an agent's dispositions. In this paper I focus on a knowledge-first implementation of feasibilism, a view in epistemology that supplements a knowledge norm with a norm urging one to manifest dispositions that are among the most knowledge-conducive feasible ones. A view with different norms that sometimes cannot be jointly satisfied raises questions about the status of these norms. By drawing on two general hypotheses about the relationship between succeeding (e.g. knowing) and manifesting dispositions conducive to success, I argue for a view on which the prescriptive and the hypological come radically apart. The result is that an epistemic analogue of a thesis that many have assumed to hold in the moral realm should be rejected. This thesis is Only Blameworthy for Wrongs: we can only ever be blameworthy for acts that are morally wrong. I argue that on the picture presented, we can be epistemically blameworthy for doxastic states that do not violate any prescriptive epistemic norms. I then generalise the considerations to the moral realm, arguing against Only Blameworthy for Wrongs. (shrink)

Bioethical Prescriptions collects F.M. Kamm's articles on bioethics -- revised for publication in book form -- which have appeared over the last 25 years and which have made her among the most widely-respected philosophers working in this field.

There seems a potential tension between Hume's naturalistic project and his normative ambitions. Hume adopts what I call a methodological naturalism: that is, the methodology of providing explanations for various phenomena based on natural properties and causes. This methodology takes the form of introducing ‘the experimental method of reasoning into moral subjects’, as stated in the subtitle of the Treatise; this ‘experimental method’ seems a paradigmatically descriptive one, and it remains unclear how Hume derives genuinely normative prescriptions from this methodology. (...) In resolving this problem, I will argue that Hume's naturalistic methodology – that is, his ‘experimental philosophy’, or what has come to be known as his experimental method – consists of the systematization of phenomena pertaining to human nature. In applying his experimental method to normative subjects, Hume systematizes our normative judgements, deriving general principles of normative justification; he then reflexivel... (shrink)

Part biography and part constructive ethical inquiry, this book is an original interpretation of the Scottish philosopher Adam Ferguson’s ethical method and view of ethical integrity, with an emphasis on his Analysis, Institutes, and Principles.

People’s beliefs about normality play an important role in many aspects of cognition and life (e.g., causal cognition, linguistic semantics, cooperative behavior). But how do people determine what sorts of things are normal in the first place? Past research has studied both people’s representations of statistical norms (e.g., the average) and their representations of prescriptive norms (e.g., the ideal). Four studies suggest that people’s notion of normality incorporates both of these types of norms. In particular, people’s representations of what (...) is normal were found to be influenced both by what they believed to be descriptively average and by what they believed to be prescriptively ideal. This is shown across three domains: people’s use of the word ‘‘normal” (Study 1), their use of gradable adjectives (Study 2), and their judgments of concept prototypicality (Study 3). A final study investigated the learning of normality for a novel category, showing that people actively combine statistical and prescriptive information they have learned into an undifferentiated notion of what is normal (Study 4). Taken together, these findings may help to explain how moral norms impact the acquisition of normality and, conversely, how normality impacts the acquisition of moral norms. (shrink)

Tom Campbell is well known for his distinctive contributions to legal and political philosophy over three decades. In emphasising the moral and political importance of taking a positivist approach to law and rights, he has challenged current academic orthodoxies and made a powerful case for regaining and retaining democratic control over the content and development of human rights. This collection of his essays reaches back to his pioneering work on socialist rights in the 1980s and forward from his seminal book, (...) The Legal Theory of Ethical Positivism (1996). An introductory essay provides an historical overview of Professor Campbell's work and argues for the continuing importance of 'democratic positivism' at a time when it is again becoming clear that courts are ineffective protectors of human rights. (shrink)

There seems a potential tension between Hume’s naturalistic project and his normative ambitions. Hume adopts what I call a methodological naturalism: that is, the methodology of providing explanations for various phenomena based on natural properties and causes. This methodology takes the form of introducing ‘the experimental method of reasoning into moral subjects’, as stated in the subtitle of the Treatise; this ‘experimental method’ seems a paradigmatically descriptive one, and it remains unclear how Hume derives genuinely normative prescriptions from this methodology. (...) -/- In resolving this problem, I will argue that Hume’s naturalistic methodology – that is, his ‘experimental philosophy’ (THN Intro 7), or what has come to be known as his experimental method – consists of the systematisation of phenomena pertaining to human nature. In applying his experimental method to normative subjects, Hume systematises our normative judgments, deriving general principles of normative justification; he then reflexively applies these principles to the pre-philosophical judgments from which they derive, dismissing and/or correcting those that do not accord with his systematised account. I will argue that Hume’s experimental method, far from being wholly descriptive, is in fact thoroughly infused with normativity; furthermore, the very application of this methodology to our normative judgments reveals Hume’s normative ambitions. (shrink)

The aim of this paper is to show that descriptive statements can be action-Guiding; that oughts and imperatives, If they are to be justified at all, Must be derived from statements of fact; that factual-Prudential moral reasoning is logically universalizable; and that the demand for universalizability, And thus ultimately for moral reasoning, Is itself only prudentially justifiable. These points are argued by way of an examination and criticism of hare's discussion of prescription and universalizability in moral reasoning.

R. M. Hare has brought together in this volume the best of his uncollected essays in moral philosophy, several of them previously unpublished or revised for this collection. They span the whole range of his ethical interests, from the most abstract to the most down-to-earth. The volume provides a compelling demonstration of Hare's commitment to bringing together the theoretical and the practical in ethics.

In my book God’s Call1 I gave an historical account of the debate within twentieth century analytic philosophy between moral realism and expressivism. Moral realism is the view that moral properties like goodness or cruelty exist independently of our making judgements that things have such properties. Such judgements are, on this theory, objectively true when the things referred to have the specified properties and objectively false when they do not. Expressivism is the view that when a person makes a moral (...) judgment, she is expressing emotion or desire or will. I used the term ‘orectic’ to refer to these mental states, because we do not have in English a sufficiently general term. In God’s Call, I started with a moral realist whom I called a ‘platonist’, G. E. Moore, and then I traced the argument through the emotivists, A. J. Ayer and Charles Stevenson, and the prescriptivist, R. M. Hare, and Iris Murdoch, whom I called a ‘humble platonist’, and J. L. Mackie’s ‘error theory’, and John McDowell, whose theory I call ‘disposition theory’, and David Brink, the ‘new-wave realist’, and Allan Gibbard, who calls his own theory ‘ norm expressivism ’. My project was to collect together the concessions that the two sides of the debate have made to each other over the course of this history, and then to construct a position which molds these concessions into a single coherent theory. I called this theory ‘prescriptive realism’. (shrink)

R.M. Hare had an ambitious scheme of providing a unified account of meta-ethics and normative ethics by combining expressivism with Kantianism and utilitarianism. The project of this thesis is to defend Hare’s theory in its most ambitious form. This means not just showing how the expressivist, Kantian and utilitarian elements are consistent, or that the three are each correct, but also that they are interdependent. The only defensible form of expressivism is Kantian; the only defensible Kantian theory is both expressivist (...) and utilitarian; the only defensible utilitarianism is Kantian. The thesis is divided into four chapters. Chapter 1 aims to show how expressivism can provide a coherent account of moral judgement and discourse. The argument for expressivism draws on Hare’s thought that the main error of moral realism is to think of moral objectivity as requiring objects, moral properties which are really there in the world. It is shown, using an argument based on the Euthyphro and the Open Question Argument that realism is untenable because it makes this mistake, and this clears the path to expressivism. Chapter 2 is a full account of the issues surrounding the Frege-Geach problem (often pressed against Hare), showing how it can be solved and how exactly the expressivist’s embrace of minimalism about truth interacts with the solution to the Frege-Geach Problem. I include an explanation of how the expressivist is able to solve the most threatening version of the problem: Schroeder’s discussion of negation. Chapter 3 argues for the connection between expressivism and Kantianism. The argument (roughly following Korsgaard) is that Humean versions of expressivism run into a sceptical challenge of normative regress. Kant employed a transcendental argument to resolve this regress, deriving his Formula of Universal Law from the Categorical Imperative. This argument defended with expressivism playing a crucial role. This chapter thus explains how Hare is entitled to universalizability in a way that avoids the shmoralising objection: it is not justified merely by being derived from our moral concepts but rather from our inescapable nature as agents. Chapter 4 illuminates the other connection, between Kantianism and utilitarianism. The largest part of the chapter is spent defending Hare’s argument from universalizability to utilitarianism. Doing so shows how Hare’s utilitarianism depends on his Kantianism, and so also how it indirectly depends on his utilitarianism. I then go on to defend Hare’s distinctive two-level version of utilitarianism, especially against the objections of Bernard Williams. It is also argued that various difficulties for utilitarianism – utility monsters, interpersonal comparison, Korsgaard’s objections – can be met by a form of utilitarianism like Hare’s, which is Kantian, and thus that such a form of utilitarianism is indeed the most defensible. (shrink)

Part biography and part constructive ethical inquiry, this book is an original interpretation of the Scottish philosopher Adam Ferguson’s ethical method and view of ethical integrity, with an emphasis on his Analysis, Institutes, and Principles.

R. M. Hare has brought together in this volume the best of his uncollected essays in moral philosophy, several of them previously unpublished or revised for this collection. They span the whole range of his ethical interests, from the most abstract to the most down-to-earth. The reader will find here the bases of his ethical theory in Kantian prescriptivism, utilitarianism, and the logic of imperatives, and will see that theory applied to issues of bioethics, medical ethics, business ethics, loyalty and (...) obedience, and racism. The essays display the author's characteristic clarity and vigour; some of them are polemical, targeting particular opponents and rival theories. The volume provides a compelling demonstration of Hare's commitment to bringing together the theoretical and the practical in ethics. (shrink)

This paper projects the decision making dilemma faced by managers when assessing moral consequences associated with planning proposals. A case is made for viewing the results of moral behavior as a capital asset. Accepting the idea that moral business behavior proportionally influences the firm's goodwill value, the author advances the recommendation that current U.S. accounting practices become involved with determining the moral wellness of the firm. The suggestion is made that stocks and flows are useful concepts in the development of (...) a financial information system that incorporates benefits associated with morally accepted behavior. As a necessary part of the going concern operational strategy, a case is made for the preservation and advancement of the firm's moral capital. Overall, the intent of this paper is to offer a proposal which links moral behavior with financial decision making. (shrink)

I offer no apology for presenting a simple paper about what is essentially a simple subject: the objectivity of moral judgments. Most of the complications are introduced by those who do not grasp the distinctions I shall be making. I am afraid that they include the majority of moral philosophers at the present time. These complications can be unravelled; but not in a short paper. I have tried to do it in my other writings.

The author re-examines Hare's multiple ways of connecting his metaethical with his normative doctrine, which is in formal sense determined as "Kantian utilitarianism", and in substantive sense as "preference-utilitarianism". Critical references to both dimensions of utilitarian doctrine aim at indication on scopes and limits of Hare's ambitious redefinition of the doctrine. Further on he discusses about so-called "necessary ingredient" of moral reasoning under the name of "sympathetic imagination", which Hare grasps in his developed theory not only as a normative demand (...) but also as a logical thesis. Finally, he considers kinds of preferences that can or cannot be recognized as morally relevant. Autor preispituje Herove visestruke pokusaje povezivanja metaetickog i normativno-etickog ucenja, koje je u formalnom smislu odredjeno kao "kantijanski utilitarizam", a u supstantivnom kao "utilitarizam preferencija". Kriticki osvrti na obe dimenzije utilitaristicke doktrine ciljaju na to da ukazu na domete i granice Herove ambiciozne redefinicije ove teorije. Potom se raspravlja o tzv. "nuznom sastojku" moralnog rasudjivanja pod imenom "simpateticka imaginacija", koju Her u svojoj razvijenoj teoriji poima ne samo kao normativni zahtev vec i kao izvesnu logicku tezu. I najzad, razmatraju se vrste preferencija koje, uz pomoc odredjenog niza kriterijuma, mogu ili ne mogu biti priznate kao moralno relevantne. (shrink)

Empirical ethics research is increasingly valued in bioethics and healthcare more generally, but there remain as yet under-researched areas such as pharmacy, despite the increasingly visible attempts by the profession to embrace additional roles beyond the supply of medicines. A descriptive and critical review of the extant empirical pharmacy ethics literature is provided here. A chronological change from quantitative to qualitative approaches is highlighted in this review, as well as differing theoretical approaches such as cognitive moral development and the four (...) principles of biomedical ethics. Research with pharmacy student cohorts is common, as is representation from American pharmacists. Many examples of ethical problems are identified, as well as commercial and legal influences on ethical understanding and decision making. In this paper, it is argued that as pharmacy seeks to develop additional roles with concomitant ethical responsibilities, a new prescription is needed for empirical ethics research in pharmacy—one that embraces an agenda of systematic research using a plurality of methodological and theoretical approaches to better explore this under-researched discipline. (shrink)

The idea of moral reform requires that morality be more than a description of what people do value, for there has to be some measure against which to assess progress. Otherwise, any change is not reform, but simply difference. Therefore, I discuss moral reform in relation to two prescriptive approaches to common morality, which I distinguish as the foundational and the pragmatic. A foundational approach to common morality (e.g., Bernard Gert’s) suggests that there is no reform (...) of morality , but of beliefs, values, customs, and practices so as to conform with an unchanging, foundational morality. If, however, there were revision in its foundation (e.g., in rationality), then reform in morality itself would be possible. On a pragmatic view, on the other hand, common morality is relative to human flourishing, and its justification consists in its effectiveness in promoting flourishing. Morality is dependent on what in fact does promote human flourishing and therefore, could be reformed. However, a pragmatic approach, which appears more open to the possibility of moral reform, would need a more robust account of norms by which reform is measured. (shrink)

Prescription opioid policies too often reflect over a century's worth of moralizing about the nature of opioid use disorder, the value of pain, and the meaning of suffering. The social and legal penalties to prescribers run in one direction—avoid overprescribing, however defined, at all costs. The lack of shared definitions is problematic for formulating and evaluating opioid policy. For example, the variant definitions of “misuse,” “abuse,” and “addiction” complicate estimates of morbidity. There are also no widely accepted definitions of misprescribing (...) and overprescribing. I offer here a modest attempt at the categorization of misprescribing: inadvertent overprescribing, corrupt overprescribing, qualitative overprescribing, quantitative overprescribing, multiclass overprescribing, and underprescribing. (shrink)

In this article, the Golden Rule, a central ethical value to both Judaism and Confucianism, is evaluated in its prescriptive and proscriptive sentential formulations. Contrary to the positively worded, prescriptive formulation – “Love others as oneself” – the prohibitive formulation, which forms the injunction, “Do not harm others, as one would not harm oneself,” is shown to be the more prevalent Judaic and Confucian presentation of the Golden Rule. After establishing this point, the remainder of the article is (...) dedicated to an inquiry into why this preference between the two Golden-Rule-formulations occurs. In doing so, this article discovers four main benefits to the proscriptive formulations: I) harm-doing, as opposed to generalizable moral goodness, is easier for individuals to subjectively comprehend II) the prevention of harm-doing is the most fundamental ethical priority III) the proscriptive formulation preserves self-directed discovery of what is good, thus preserving moral autonomy IV) individuals are psychologically pre-disposed toward responding to prohibitions rather than counsels of goodness. (shrink)

BackgroundDepressive disorders are a common form of psychiatric illness and cause significant disability. Regulation authorities, the medical profession and the public require high safety standards for antidepressants to protect vulnerable psychiatric patients. Ketamine is a dissociative anaesthetic and a derivative of a hallucinogen. Its abuse is a major worldwide public health problem. Ketamine is a scheduled drug and its usage is restricted due to its abuse liability. Recent clinical trials have reported that ketamine use led to rapid antidepressant effects in (...) patients suffering from treatment-resistant depression. However, various flaws in study designs, and possible biased reporting of results, may have influenced those findings. Further analyses of ketamine use are needed to ensure patient safety.DiscussionThe use of ketamine in research and treatment of depressive disorders is controversial. Recently, mental health professionals raised ethical concerns about an ongoing ketamine trial in the UK. Also, a Canadian agency reviewed the existing evidence and did not recommend prescribing ketamine to treat depressive disorders. Findings obtained from tightly controlled research settings cannot be easily translated to clinical practice as substance abuse is commonly comorbid with depressive disorders. An effective antidepressant should reduce severity of depressive symptoms without liability problems. Although the US FDA has not approved the use of ketamine to treat depressive disorders, some psychiatrists offer off-label repeat prescription of ketamine. Prescribing ketamine for treating depressive disorders requires substantial empirical evidence. Clinicians should also consider research findings on ketamine abuse. Depressive disorders can be chronic conditions and the current evidence does not rule out the risk of substance abuse after repeat prescription of ketamine. Off-label ketamine use in treating depressive disorders may breach ethical and moral standards, especially in countries seriously affected by ketamine abuse. This article presents two real-world clinical vignettes which highlight ethical principles and theories, including autonomy, nonmaleficience, fidelity and consequentialism, as related to off-label ketamine use.ConclusionWe urge clinicians to minimise the risk of harming patients by considering the empirical evidence on ketamine properties and attempting all standard antidepressant therapies before considering the off-label use of ketamine. (shrink)

Justice, equality, and righteousness—these are some of our greatest moral convictions. Yet in times of social conflict, morals can become rigid, making religious war, ethnic cleansing, and political purges possible. Morality, therefore, can be viewed as pathology-a rhetorical, psychological, and social tool that is used and abused as a weapon. An expert on Eastern philosophies and social systems theory, Hans-Georg Moeller questions the perceived goodness of morality and those who claim morality is inherently positive. Critiquing the ethical (...) "fanaticism" of Western moralists, such as Immanuel Kant, Lawrence Kohlberg, John Rawls, and the utilitarians, Moeller points to the absurd fundamentalisms and impracticable prescriptions arising from definitions of good. Instead he advances a theory of "moral foolishness," or moral asceticism, extracted from the "amoral" philosophers of East Asia and such thinkers as Ludwig Wittgenstein and Niklas Luhmann. The moral fool doesn't understand why ethics are necessarily good, and he isn't convinced that the moral perspective is always positive. In this way he is like most people, and Moeller defends this foolishness against ethical pathologies that support the death penalty, just wars, and even Jerry Springer's crude moral theater. Comparing and contrasting the religious philosophies of Christianity, Daoism, and Zen Buddhism, Moeller presents a persuasive argument in favor of amorality. (shrink)

According to Ágnes Heller’s plans in 1989 and 1990, the last volume of her moral trilogy should have been entitled A Theory of Proper Conduct. In 1996 the third volume finally appeared with the title An Ethics of Personality. Its content: a series of philosophical dialogues between many dramatis personæ. The change in style and methodology of the third volume led to many criticisms, amongst them Mihály Vajda’s questioning of the whole project’s consistency. The present paper aims to engage these (...) criticisms by retracing the presence in An Ethics of Personality of the themes that, according to Heller’s previous intentions, should have informed the last part of her moral theory. The contribution analyses Heller’s definitions of modern paideia and moral wisdom, the issue of the possibility of happiness for modern people, and the philosophically problematic concept of moral aesthetics. In conclusion, the ‘literary’ methodology of the book is put in relationship with the non-prescriptive aspect of ethics. (shrink)