Lying to one’s patients is wrong. So obvious as to border on a platitude, this truism is one that bioethicists have heartily endorsed for several decades. Deception, the standard line holds, underc...

Although clinical ethics scholarship and practice has largely avoided assuming an activist stance, the many health care crises of the last eighteen months motivated a distinct change: On listserves, in blog postings, and in published essays, activist language has permeated conversations over such issues as the impact of triage policies on persons with disabilities and of color, and how the health care system has historically failed African Americans. In this paper, I defend this turn, arguing that clinical ethicists should embrace (...) activism—generally, and with particular emphasis on institutional, mesolevel concerns. Ethicists are often uniquely situated to understand the structural factors that regularly motivate clinical ethics cases, and they are often in a privileged position to be effective change agents. In making this case, I also stress the need not to overstep one's skills and to be acutely cognizant of the political risks associated with such work. (shrink)

Access to abortion services in the United States continues to decline. It does so not because of significant changes in legislation or court rulings but because fewer and fewer physicians wish to perform abortions and because most states now have "conscientious objection" legislation that makes it easy for physicians to refuse to do so. We argue in this paper that physicians have an obligation to perform all socially sanctioned medical services, including abortions, and thus that the burden of justification lies (...) upon those who wish to be excused from that obligation. That is, such persons should have to show how requiring them to perform abortions would represent a serious threat to their fundamental moral or religious beliefs. We use current California law as an example of legislation that does not take physicians' obligations into account and thus allows them too easily to declare conscientious objection. (shrink)

Clinical ethical consultants are subject to an unavoidable conflict of interest. Their work requires that they be independent, but incentives attached to their role chip relentlessly at independence. This that they be independent, is a problem without any solution, but it can at least be ameliorated through careful management.

The philosophical method is critical to ethics consulting. To be truly effective, ethicists need grounding in ethics theory, abstract reasoning and conceptual analysis. A Practical Guide to Clinical Ethics Consulting allows ethicists to understand problems from practitioners' points-of-view, and allows for a genuine appreciation of the working life of practitioners.

Seminal work in moral neuroscience by Joshua Greene and colleagues employed variants of the well-known trolley problems to identify two brain networks which compete with each other to determine moral judgments. Greene interprets the tension between these brain networks using a dual process account which pits deliberative reason against automatic emotion-driven intuitions: reason versus passion. Recent neuroscientific evidence suggests, however, that the critical tension that Greene identifies as playing a role in moral judgment is not so much a tension between (...) reason and passion, but a tension between distinct forms of deliberative reasoning: analytic versus empathetic. In this paper we present results from several new studies supporting this alternative hypothesis. (shrink)

Objective reporting was once among the foundational norms of U.S. journalism. The emergence of alternative and economically successful partisan models exemplified by Fox News, talk radio, and a ran...

Late in 1990, the Center for the Study of Ethics in the Professions at Illinois Institute of Technology (lIT) received a grant of more than $200,000 from the National Science Foundation to try a campus-wide approach to integrating professional ethics into its technical curriculum.! Enough has now been accomplished to draw some tentative conclusions. I am the grant's principal investigator. In this paper, I shall describe what we at lIT did, what we learned, and what others, especially philosophers, can learn (...) from us. We set out to develop an approach that others could profitably adopt. I believe that we succeeded. (shrink)

The goal of this article is to try to resolve two key problems in the duty-based approach of W. D. Ross: the source of principles and a process for moving from prima facie to actual duty. I use a naturalistic explanation for the former and a nine-step method for making concrete ethical decisions as they could be applied to journalism. Consistent with Ross's position, the process is complicated, particularly in tougher problems, and it cannot guarantee correct choices. Again consistent with (...) Ross, such complexity and uncertainty speak in the method's favor, given the difficulty—factual, motivational, and organizational—of ethics problems and decision making. (shrink)

Much of the work in professional ethics sees ethical problems as resulting from ethical ignorance, ethical failure or evil intent. While this approach gets at real and valid concerns, it does not capture the whole story because it does not take into account the underlying professional or institutional culture in which moral decision making is imbedded. My argument in this paper is that this culture plays a powerful and sometimes determinant role in establishing the nature of the ethical debate; i.e., (...) it helps to define what are viable action options, what is the organization’s genuine mission, and what behaviors will be rewarded or criticized. Given these conclusions, I also argue that consulting ethicists need more than an understanding of ethics theory, concepts and principles; they also need a sufficiently rich understanding of organizational culture and a willingness and an ability to critique that culture. (shrink)

In this article I describe the theoretical underpinnings of 20th-century British philosopher W. D. Ross's approach to linking deontological and teleological decision making. I attempt to fill in what Ross left on the whole unanswered, that is, how to use his duties to resolve dilemmas. A case study in journalism demonstrates how to apply the theory. I conclude with an analysis of what I take to be the strengths and weaknesses in Ross's theory.

The proliferation of news and information sources has motivated a need to identify those providing legitimate journalism. One temptation is to go the route of such fields as medicine and law, namely to formally professionalize. This gives a clear method for determining who is a member, with an array of associated responsibilities and rewards. We argue that making such a formal move in journalism is a mistake: Journalism does not meet the traditional criteria, and its core ethos is in conflict (...) with the professional mindset. We thus shift the focus from whether the person is journalist to whether the work satisfies the conditions that characterize legitimate journalism. In explaining those conditions we also look at mechanisms for enhancing the power of persons doing journalism, drawing upon lessons from the labor movement. We also consider a self-declaration model while urging increased literacy from all participants in the news gathering and consuming enterprise. (shrink)

Joshua Greene and Peter Singer argue, on the basis of empirical evidence, that deontological moral judgments result from emotional reactions while dispassionate reasoning leads to consequentialist judgments. Given that there are good reasons to doubt these emotionally driven intuitions, they argue that we should reject Kantian ethics. I argue that the evidence does not support the claim that consequentialism is inherently more reason-based or less emotion-based than Kantian ethics. This is partly because the experiments employ a functional definition of ‘deontological’ (...) that is so broad as to include any non-consequentialist theory, including virtue ethics, divine command theory, and even rule-utilitarianism. Thus the experiments failed to capture the reasons behind the judgments. Also, the results of the experiments are partly due to the extensive use of moral dilemmas like the footbridge version of the trolley scenario. The options in these dilemmas involve different levels of moral thinking. The consequ.. (shrink)

The global turn in media ethics has presented a tough challenge for traditional models of moral theory: How do we assert common moral standards while also showing respect for the values of those from outside the Western tradition? The danger lies in advocating for either extreme: reason-dependent absolutism or cultural relativism. In this paper, I reject Cliff Christian’s attempts to solve the problem and propose instead a moral theory of universal standards that are discovered via a mix of rationally grounded (...) methods. Such universality refutes relativism but, because it is grounded in evolutionary naturalism and life-world philosophy—as opposed to a Kantian or theological transcendentalism—it also avoids absolutism. (shrink)

Recently, empirically minded philosophers have employed evidence of widespread, fundamental moral disagreement to argue against moral realism. I argue that the empirical evidence does not refute realism because the disagreement is consistent with certain pluralistic versions of moral realism that posit a set of pro tanto normative principles. Others have appealed to pluralism in defense of moral realism but have used pluralism to attack the empirically based approach to ethical theory. Although I argue that the empirical argument against moral realism (...) fails, I defend the approach and suggest better ways that (pluralist) moral realism could be tested empirically. (shrink)

One of the most familiar arguments for expressivist metaethics is the claim that the rival theory, moral realism, cannot provide a satisfying explanation of why moral properties supervene on natural properties. Non-cognitivism, however, has its own problems explaining supervenience. Expressivists try to establish supervenience either by second-order disapproval of type-inconsistent moral evaluations or by pragmatic considerations. But disapproval of inconsistency is merely a contingent attitude that people happen to have; and pragmatic justification does not allow for appraisers to take their (...) own moral attitudes seriously enough. What has been overlooked is a third alternative. The metaethical theory that can best account for supervenience is neither realist nor non-cognitivist but an objectivist version of constructivism. On the constructivist theory, right and wrong are determined by the principles that people would (hypothetically) consent to under ideal conditions. Type-consistency is a required feature of any principles regulating our conduct, if they are to be freely agreed to by ideally rational people. (shrink)

Journalists are regularly criticized for causing harm to others, such as invading privacy, printing, or airing offensive material, and so forth. Although most sensitive journalists readily acknowledge these harms, they frequently argue that the pursuit and coverage of news is nonetheless justified because it fulfills a greater moral purpose - satisfaction of the public's right to know. This article argues that although "the public s right to know" does justify some harmful journalistic behavior, too often the phrase is used without (...) the conceptual precision necessary to justify the competing harm. That is, journalists often confuse having a right to know with having an interest or curiosity in knowing and such conceptual confusion too often allows journalistic behavior to occur that would otherwise be seen as unethical. (shrink)

The Covid-19 pandemic has presented major challenges to society, exposing preexisting ethical weaknesses in the modern social fabric’s ability to respond. Distrust in government and a lessened authority of science to determine facts have both been exacerbated by the polarization and disinformation enhanced by social media. These have impaired society’s willingness to comply with and persevere with social distancing, which has been the most powerful initial response to mitigate the pandemic. These preexisting weaknesses also threaten the future acceptance of vaccination (...) and contact tracing, two other tools needed to combat epidemics. Medical ethicists might best help in this situation by promoting truth-telling, encouraging the rational adjudication of facts, providing transparent decision-making and advocating the virtue of cooperation to maximize the common good. Those interventions should be aimed at the social level. The same elements of emphasizing cooperation and beneficence also apply to the design of triage protocols for when resources are overwhelmed. A life-stages approach increases beneficence and reduces harms. Triage should be kept as simple and straightforward as reasonably possible to avoid unwieldly application during a pandemic. (shrink)

Cognitive neuroenhancement involves the use of medical interventions to improve normal cognitive functioning such as memory, focus, concentration, or willpower. In this paper I give a Kantian argument defending the use of CNE in science, scholarly research, and creative fields. Kant’s universal law formulation of the categorical imperative shows why enhancement is morally wrong in the familiar contexts of sports or competitive games. This argument, however, does not apply to the use of CNE in higher education, scholarly or scientific research, (...) or creative endeavors such as visual art, fiction or poetry, or musical composition. This is because performance in these areas is embedded within practices that differ in morally significant ways from competitive practices. This important difference provides good reason to think that there is nothing morally wrong with the use of CNE in these areas. My approach is not simply to assume a full-fledged Kantian ethical theory and apply it straight away to the enhancement issue but to establish a reflective equilibrium between our moral intuitions, moral principles that support those intuitions, and the nature of the practices involved. (shrink)

Since the introduction of radio and television news, journalism has gone through multiple transformations, but each time it has been sustained by a commitment to basic values and best practices. Journalism Ethics is a reminder, a defense and an elucidation of core journalistic values, with particular emphasis on the interplay of theory, conceptual analysis and practice. The book begins with a sophisticated model for ethical decision-making, one that connects classical theories with the central purposes of journalism. Top scholars from philosophy, (...) journalism and communications offer essays on such topics as objectivity, privacy, confidentiality, conflict of interest, the history of journalism, online journalism, and the definition of a journalist. The result is a guide to ethically sound and socially justified journalism-in whatever form that practice emerges. Journalism Ethics will appeal to students and teachers of journalism ethics, as well as journalists and practical ethicists in general. (shrink)

I defend a strong version of the Kantian claim that actions done solely from duty have moral worth by (1) considering pure cases of acting from duty, (2) showing that love and sympathy, unlike a sense of duty, can often lead us to do the wrong thing, (3) carefully distinguishing moral from non-moral virtues, and (4) by distinguishing pathological sympathy from practical sympathy. Not only is acting purely from a sense of duty superior to acting from love and sympathetic feelings, (...) but the cold-heartedness found in Kant’s examples should be thought of as a virtue rather than a vice. (shrink)

In this article I argue, first, that genuinely effective ombudsmen could help restore news credibility-thereby staving off other, more intrusive external intervention-and that the position must have true sanctioning authority, much like that of the ethics officer in many corporations. I also argue that the effective ombudsman will be one who sufficiently understands the workings of journalism but who is not immersed in its ethos. This distancing is necessary for genuine critical appraisal to be possible.

Volume 19, Issue 11, November 2019, Page 76-77.

To be a professional is to accept the obligation to sometimes participate in activities and to engage with people that one might otherwise choose to avoid. Lawyers, for example, must advocate on behalf of despicable clients, professors must teach and fairly evaluate lazy and insolent students, and physicians must minister to persons whose beliefs—and actions—run afoul of their core values. For example, at least three of the professionals who treated Robert Bower—the person who murdered 14 people in a Pittsburgh synagogue—were (...) Jewish. As the hospital president, Jeffrey Cohen—also Jewish—put it, "We're here to take care of sick people. We're not here to judge you". Professionals must behave in this... (shrink)

Although we think 1 of the basic purposes of journalism is to provide information vital to enhancing citizen autonomy, we also see this goal as being in direct tension with the power news media hold and wield, power that may serve to undercut, rather than enhance, citizen autonomy. We argue that the news media are ethically constrained by proceduralism, resulting in journalists asserting power inappropriately at the individual level, and unwittingly surrendering moral authority institutionally and globally. Anonymity, institutionalization, and routinization (...) cloak power relationships among citizens, journalists and the institutions of which they are a part, ultimately inculcating these distinctly Western values in the global community. (shrink)

Although autonomy is clearly still the paradigm in bioethics, there is increasing concern over its value and feasibility. In agreeing with those concerns, I argue that autonomy is not just a status, but a skill, one that must be developed and maintained. I also argue that nearly all healthcare interactions do anything but promote such decisional skills, since they rely upon assent, rather than upon genuinely autonomous consent. Thus, throughout most of their medical lives, patients are socialised to be heteronomous, (...) rather than autonomous. Yet, at the worst possible time – critical care decision-making – when life and death consequences are attached to the choices, the paradigm shifts and real consent is sought, even demanded, thereby making an often traumatic situation even harder.I go on, though, to also reject paternalistic models of beneficence as an alternative. Rather, I conclude that the problem is so fundamental in healthcare that a genuine solution would require a radical restructuring. I recommend steps that can be taken in the interim to improve the situation and to move toward such a restructuring. (shrink)

It is now widely accepted that a patient's ability to engage in autonomous decision-making can be seriously threatened when she denies significant aspects of her medical condition. In this paper I use a true case to reveal the harmful effects of physician denial upon patient autonomy and well-being. I suggest further that such physician denial may be more common than is generally acknowledged, since aspects of the contemporary medical ethos likely serve to reinforce rather than to undercut such denial.

In deriving his moral code, Hobbes does not appeal to any mind-independent good, natural human telos, or innate human sympathies. Instead he assumes a subjectivist theory of value and an egoistic theory of human motivation. Some critics, however, doubt that his laws of nature can be constructed from such scant material. Hobbes ultimately justifies the acceptance of moral laws by the fact that they promote self-preservation. But, as Hobbes himself acknowledges, not everyone prefers survival over natural liberty. In this essay (...) I show that Hobbes can argue that the desire for self-preservation is rationally required by modifying his subjectivist theory of the good to equate what is good for an agent only with the satisfaction of desires (for her own life) that she has at the time that they are satisfied. It is thus irrational to prefer postmortem glory over survival since an agent must be alive for glory to have any value for her. (shrink)

Most of the philosophical work written on environmental issues focuses on notions such as rights, consequences, duties, etc. And most of the theoretical philosophy done in environmental ethics focuses on questions of whether animals, plants, or ecosystems have inherent value or moral standing independently of their usefulness to humans. A character-based approach has been largely neglected (despite a few important works). In this paper, I consider what a plausible environmental virtue ethics would look like. Specifically, I argue (pace Sandler) that (...) it would not require any distinct eco-virtue but would involve merely widening the scope of traditional virtues to include the non-human world. I further argue that a successful environmental virtue ethics would have to be pluralistic (involving more than one virtue) and would require the formulation of prima facie (rather than absolute) v-rules. Finally, borrowing from Naess, I suggest a way that eco-friendly character could be acquired. (shrink)

While it appears that respect for autonomy has become the fundamental principle in medical ethics, it is not clear what various authors have in mind when they use the term "autonomy." Accounts range from an equation of autonomy with negative freedom to a Kantian emphasis on self-governance. ;My goal here is to characterize that status in persons which we call autonomy and which demands our respect in such applied settings as medicine. What types of behavior must be present for us (...) to honor persons' decisions as autonomous? And what kinds of factors can constrain that behavior? ;My answer is that being autonomous means being as much responsible for one's life as the situation allows and warrants. In explaining what these various claims entail, I note that autonomy is an exercise concept and that it admits of degrees. Being autonomous requires more than simply having the capacity to engage in certain kinds of behaviors; the autonomous person exercises those capacities. Furthermore, persons are more or less autonomous in different situations, and different types of decisions demand varying levels of autonomous behavior in order to warrant our respect. ;In addition to explaining what it means to be autonomous, I discuss the broad range of factors which can constrain autonomy. I extend the traditional analyses of constraints and show how such factors as illness, socio-economic and institutional realities, and interpersonal communication can constrain persons' ability to be autonomous. ;I conclude with an argument that persons have an obligation to be autonomous. This argument is based both on a position of self-respect and on avoidance of harms to others. (shrink)