Trust not only disposes us to feel betrayed, trust can be betrayed. Understanding what a betrayal of trust is requires understanding how trust can ground an obligation on the part of the trusted person to act specifically as trusted. This essay argues that, since trust cannot ground an appropriate obligation where there is no prior obligation, a betrayal of trust should instead be conceived as the violation of a trust-based obligation to respect an already existing obligation. Two forms of trust (...) are evaluated for their potential to ground such a second-order obligation. One form counts as a gift to the trusted person only because it does not involve an expectation of trustworthiness; the other form cannot count as a gift but confers an honor because it does include an expectation of trustworthiness. Only trust that confers an honor generates a second-order obligation whose violation would be a betrayal of trust. -/- . (shrink)

When a patient lacks sufficient capacity to make a certain treatment decision, whether because of deficits in their ability to make a judgement that reflects their values or to make a decision that reflects their judgement or both, the decision must be made by a surrogate. Often the best way to respect the patient’s autonomy, in such cases, is for the surrogate to make a ‘substituted’ judgement on behalf of the patient, which is the decision that best reflects the patient’s (...) values and identity-infused beliefs as they were when the patient last possessed capacity. It is by now well-known that there is troubling evidence that surrogates do only slightly better than chance at making accurate substituted judgements. The use of a patient preference predictor, an algorithm that predicts patient preferences based on characteristics like the patient’s age, gender, socioeconomic status and education level, could help. Rid and Wendler have done important work making a moral case for using the PPP.1 If it were shown to enhance accuracy, it is not at all obvious what objections there could be to its use. Yet several subtle criticisms of the PPP have emerged in the literature. In their feature article, Jardas, Wasserman and Wendler select six of the most prominent objections to the PPP in the literature and defend the PPP against them.2 Along the way they make significant contributions to broader issues concerning the proper uses of statistical evidence and limits on the kinds of preferences there can be reasons of autonomy to respect. Since I found the authors’ answers to the final two objections—that the PPP relies on naked statistical evidence and that it uses non-endorsed reasons—to be especially interesting and provocative, I will examine those answers and raise a few questions about …. (shrink)

Among the various methods of deceit, lying is often thought to be a special affront on the grounds that it invites the victim’s trust. Such an explanation is incomplete without an account of the moral significance of trust. This article distinguishes two morally problematic relations to trust, betrayals and abuses, and, appealing to the idea that we should be grateful to be trusted, attempts to explain these wrongs as violations of distinct demands of gratitude for trust. Only the wrong of (...) abuse, not betrayal, is useful for distinguishing methods of deceit. Although lying commits an abuse of trust, it turns out that it is really the broader category of deceit by means of communication that is special in this way. -/- . (shrink)

Deception is a useful methodological device for studying attitudes and behavior, but deceptive studies fail to fulfill the informed consent requirements in the U.S. federal regulations. This means that before they can be approved by Institutional Review Boards, they must satisfy the four regulatory conditions for a waiver or alteration of these requirements. To illustrate our interpretation, we apply the conditions to a recent study that used deception to show that subjects judged the same wine as more enjoyable when they (...) believed it had a higher price. (shrink)

Bioethics is the study of ethical issues arising out of advances in the life sciences and medicine. Historically, bioethics has been associated with issues in research ethics and clinical ethics as a result of research scandals such as the Tuskegee Syphilis Study and public debates about the definition of death, medical paternalism, health care rationing, and abortion. As biomedical technologies have advanced, challenging new questions have arisen for bioethics and new sub-disciplines such as neuroethics and public health ethics have entered (...) the scene. This volume features ten original essays on five cutting-edge controversies in bioethics written by leading philosophers. I. Research Ethics: How Should We Justify Ancillary Care Duties? II. Clinical Ethics: Are Psychopaths Morally Accountable? III. Reproductive Ethics: Is There A Solution to the Non-Identity Problem? IV. Neuroethics: What is Addiction and Does It Excuse? V. Public Health Ethics: Is Luck Egalitarianism Implausibly Harsh? S. Matthew Liao and Collin O’Neil’s concise introduction to the essays in the volume, the annotated bibliographies and study questions for each controversy, and the supplemental guide to additional current controversies in bioethics give the reader a broad grasp of the different kinds of challenges in bioethics. (shrink)

Bioethics: 50 Puzzles, Problems, and Thought Experiments collects 50 cases—both real and imaginary—that have been, or should be, of special interest and importance to philosophical bioethics. Cases are collected together under topical headings in a natural order for an introductory course in bioethics. Each case is described in a few pages, which includes bioethical context, a concise narrative of the case itself, and a discussion of its importance, both for broader philosophical issues and for practical problems in clinical ethics and (...) health policy. Each entry also contains a brief, annotated, list of suggested readings. In addition to the classic cases in bioethics, the book contains discussion of cases that involve several emerging bioethical issues: especially, issues around disability, social justice, and the practice of medicine in a diverse and globalized world. (shrink)