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)
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.
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.
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)
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 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)
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)
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)
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)
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)
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)
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)
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)
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.
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)
In Abram Brummett and Erica K. Salter's excellent paper, “Mapping the Moral Terrain of Clinical Deception,” they rightly note that it is sometimes ethically appropriate for health care professionals to deceive patients and families. However, they also note that because doing so violates a prima facie duty of honesty, the ethical burden of proof falls upon the deceiver. Hence, they also provide a sophisticated framework for determining whether any given case is warranted. I applaud their overall approach but also critique (...) some of their claims, in particular, their conclusion that lies of commission require greater justification than those of omission and their conflation of the principles of beneficence and nonmaleficence. I also urge them to give greater attention to how power asymmetries should be accounted for and to the impact such deceptive choices might have on the clinician's character. (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)
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)
The Professional Ethics Toolkit is an engaging and accessible guide to the study of moral issues in professional life through the analysis of ethical dilemmas faced by people working in medicine, law, social work, business, and other industries where conflicting interests and ideas complicate professional practice and decision-making. Written by a seasoned ethicist and professional consultant, the volume uses philosophical ideas, theories, and principles to develop and articulate a definitive methodology for ethical decision-making in professional environments. Meyers offers the benefit (...) of his expertise with clear and practical advice at every turn, guiding readers through numerous real-world examples and case studies to illustrate key concepts including role-engendered duties, conflicts of interest, competency, and the principles that underpin and define professionalism itself. Following the format of The Philosopher’s Toolkit, The Professional Ethics Toolkit is an essential companion to the study of professional ethics for use in both the classroom and the working world, encouraging students and general readers alike to think critically and engage intelligently with ethics in their professional lives. (shrink)
One of the responses to the attacks upon the contemporary university, particularly upon the humanities, has been to encourage faculty to engage in so-called ‘public intellectualism.’ In this paper I urge philosophers to embrace this turn, but only if the academy can effectively address how to credit such work in the tenure and promotion process. Currently, public philosophy is typically placed under ‘service’, even though the work is often more intellectually and philosophically rigorous than committee work, even sometimes more than (...) publications. I address this problem by providing an analysis of what is academically valuable about good scholarship and then showing how much of public philosophy achieves those goods. From this I argue that the academy should abandon the traditional categories of teaching/research/service and replace them with a holistic and qualitative single category of “teacher-scholar.” I then recommend that evaluation criteria should be very inclusive, giving credit to the wide range of activities in which faculty participate and I provide some suggestions for how those criteria should read. (shrink)
Editor's Note: Among the core activities of many ethics centers has been helping organizations – businesses, healthcare institutions, professional bodies – evaluate and improve their ethical structures and practices. Much of that work has resulted in incisive and valued critiques that guide practitioners through tough ethics thickets. It has also produced reams of published material and considerable consulting income. All of which points to a telling irony: There is almost no such published analysis of how those same ethics centers should (...) ethically organize their own work and activities. The one exception is the 2005 monograph, Ethics Centers and Conflict of Interest, but it just touches on core issues and is now difficult to obtain. It is now, thus, past time to give these topics sustained attention – hence this (Vol. 21, No. 2, Fall 2021) dedicated issue of Teaching Ethics. (shrink)