In ‘The nature of moral judgments and the extent of the moral domain’, Fraser criticises findings by Kelly et al. that speak against the moral/conventional distinction, arguing that the experiment was confounded. First, we note that the results of that experiment held up when confounds were removed . Second, and more importantly, we argue that attempts to prove the existence of a M/C distinction are systematically confounded. In contrast to Fraser, we refer to data that support our view. We highlight (...) the implications for the moral/conventional theory. (shrink)

Objective: To evaluate existing ethical guidelines for the treatment of hunger strikers in light of findings on psychological changes that accompany the cessation of food intake.Design: Electronic databases were searched for editorials and ethical proclamations on hunger strikers and their treatment; studies of voluntary and involuntary starvation, and legal cases pertaining to hunger striking. Additional studies were gathered in a snowball fashion from the published material cited in these databases. Material was included if it provided ethical or legal guidelines; shed (...) light on psychological changes accompanying starvation, or illustrated the practice of hunger striking. Authors’ observations, opinions, and conclusions were noted.Conclusions: Although the heterogeneous nature of the sources precluded statistical analysis, starvation appears to be accompanied by marked psychological changes. Some changes clearly impair competence, in which case physicians are advised to follow advance directives obtained early in the hunger strike. More problematic are increases in impulsivity and aggressivity, changes which, while not impairing competence, enhance the likelihood that patients will starve themselves to death. (shrink)