Interest in understanding the experience of moral distress has steadily gained traction in the 30 years since Jameton first described the phenomenon. This curiosity should be of no surprise, since we now have data documenting the incidence across most caregiver roles and healthcare settings, both in the United States and internationally. The data have also amplified healthcare providers’ voices who report that the quality of the ethical environment is pivotal to preventing and containing the adverse effects caused by moral distress. (...) Healthcare providers are asking for a moral space where ethics occurs at the bedside, in real time, applied to real cases. They are asking for ethics expertise to be available as part of the care team during their daily work, when treatment goals must be determined and decisions must be made. They are asking for an embedded ethicist who can help cultivate an ethical environment where formal ethics policy is properly applied to practice. This discussion advocates for an embedded ethics resource model that responds to contemporaneous ethics needs as a strategy to mitigate the effects of moral distress. (shrink)

Different methods have been developed to address ethical issues during research. Most of these methods were developed at universities. In this article ethical parallel research within a Research and Technology Organization is described. Within a European project about perceived security, CPSI, the ethical issues were identified by ethicists cooperating in the project. The project CPSI was aimed at developing a research method that can be used by (local) government to monitor or assess perceived and actual security. Together with the researchers (...) a way was sought to address the ethical issues. Several issues could be addressed by choices with regard to the design of the validation study, in this case a survey. The ethical and legal reasons that were relevant for choices in the design of the validation study were made an integral part of these decisions. Some issues were already identified during the writing of the proposal others were only identified during the research. Participating in the research gave the ethicists access to all relevant information. It made it possible to address the ethical issues when they became relevant. Ethical reasons were part of some of the discussions on research method. It proved possible to address most ethical issues satisfactorily during the research project. (shrink)

Contemporary literature investigating the significant impact of technology on our lives leads many to conclude that ethics must be a part of the discussion at an earlier stage in the design process i.e., before a commercial product is developed and introduced. The problem, however, is the question regarding how ethics can be incorporated into an earlier stage of technological development and it is this question that we argue has not yet been answered adequately. There is no consensus amongst scholars as (...) to the kind of ethics that should be practiced, nor the individual selected to perform this ethical analysis. One school of thought holds that ethics should have pragmatic value in research and design and that it should be implemented by the engineers and/or scientists themselves, while another school of thought holds that ethics need not be so pragmatic. For the latter, the ethical reflection can aim at a variety of goals, and be carried out by an ethicist. None of the approaches resulting from these lines of thinking have been adopted on a wide-scale basis. To that end, the approach presented here is intended to bridge the gap between these schools of thought. It is our contention that ethics ought to be pragmatic and to provide utility for the design process and we maintain that adequate ethical reflection, and all that it entails, ought to be conducted by an ethicist. Thus, we propose a novel role for the ethicist—the ethicist as designer—who subscribes to a pragmatic view of ethics in order to bring ethics into the research and design of artifacts—no matter the stage of development. In this paper we outline the series of steps that a pragmatic value analysis entails: uncovering relevant values, scrutinizing these values and, working towards the translation of values into technical content. In conclusion, we present a list of tasks for the ethicist in his/her role as designer on the interdisciplinary team. (shrink)

The emergence of ethical concerns surrounding artificial intelligence (AI) has led to an explosion of high-level ethical principles being published by a wide range of public and private organizations. However, there is a need to consider how AI developers can be practically assisted to anticipate, identify and address ethical issues regarding AI technologies. This is particularly important in the development of AI intended for healthcare settings, where applications will often interact directly with patients in various states of vulnerability. In this (...) paper, we propose that an ‘embedded ethics’ approach, in which ethicists and developers together address ethical issues via an iterative and continuous process from the outset of development, could be an effective means of integrating robust ethical considerations into the practical development of medical AI. (shrink)

Debates regarding clinical ethicists’ scope of practice are not novel and will continue to evolve. Rapid changes in healthcare delivery, outcomes, and expectations have necessitated flexibility in clinical ethicists’ roles whereby hospital-based clinical ethicists are expected to be woven into the institutional fabric in a way that did not exist in more traditional relationships. In this article we discuss three emerging roles: the ethicist embedded in the interdisciplinary team, the ethicist with an expanded educational mandate, and the (...) ethicist as a therapeutic presence in the patient care space. Such expanded capacities offer more robust, positive contributions to institutional culture, stakeholders’ relationships, and patient-centered care. (shrink)

The existence of a plurality of communities, a diversity of norms, and the ultimate contingency of all decisions in modern societies complicates the task of academics and practitioners who wish to be ethical. In this paper, we envisage and articulate a dialogical, communitarian approach to embedding business ethics that requires business ethicists to more reflexively engage with practitioners in working on and representing the normative criteria that people in organisations use to deal with moral dilemmas in business. We promote the (...) idea that business ethicists should not only cross the divide between normative ethics and empirical research, but also take a step beyond the empirical to become more active change agents. As potential exemplars of this approach in practice, we explore how self-critique and cross-disciplinary collaboration in education and teaching might be used by academics to engage current and future business ethicists, as well as managers, in dialogic partnership. In an organisational context, we also propose a three-part approach to embedding reflexive ethics in practice, through dialogic research, debate, and re-presentation of ideas. We contend that our approach has more efficacy than the traditional grand theories of ethics or more focused theories of business ethics, such as Integrated Social Contract Theory; it has the potential to provide more grounded, and therefore more practical, advice to academics, current and future business ethicists, and business practitioners. (shrink)

Several times each month, usually on a Thursday morning, I join one or more of my physician colleagues on teaching rounds. Most weeks these are traditional rounds, where an attending physician leads a group of medical students, residents, and clinical fellows from bed to bed reviewing charts, examining patients, and planning daily procedures. As a medical ethicist, my role is to discuss some of the ethical issues that are embedded in these decisions about medical care and help students (...) to hone the skills required to manage these issues successfully in the context of ongoing care.Although the clinical setting varies, questions of patient management are always at the center of teaching rounds. Since my training is in philosophy, and not in medicine or nursing, there have been occasions when this focus on patient care has prompted me to reflect upon my role as a medical ethicist in these contexts. Lacking even the most basic medical training, and having been remarkably fortunate in having had limited personal experiences as a patient, what can I possibly contribute to the training of physicians?I suspect that at some time or another most teachers, but perhaps especially those trained in the humanities, have moments when they question the usefulness of their teaching. In my case, by introducing perspectives from the humanities on teaching rounds, my hope is to add some balance to the often narrow focus on the ordering of diagnostic tests, scheduling of procedures, obtaining of patient consent, and other practical matters. I often stress, for example, how the patients with whom students and residents interact are not mere patients, but persons with lives outside the hospital that can be made profoundly better or worse as a result of the brief time they are seen in the hospital. I draw attention to the …. (shrink)

ABSTRACT:Bioethicists today are taking a greater role in the design and implementation of emerging technologies by "embedding" within the development teams and providing their direct guidance and recommendations. Ideally, these collaborations allow ethical considerations to be addressed in an active, iterative, and ongoing process through regular exchanges between ethicists and members of the technological development team. This article discusses a challenge to this embedded ethics approach—namely, that bioethical guidance, even if embraced by the development team in theory, is not (...) easily actionable in situ. Many of the ethical problems at issue in emerging technologies are associated with preexisting structural, socioeconomic, and political factors, making compliance with ethical recommendations sometimes less a matter of choice and more a matter of feasibility. Moreover, incentive structures within these systemic factors maintain them against reform efforts. The authors recommend that embedded bioethicists utilize principles from behavioral science (such as behavioral economics) to better understand and account for these incentive structures so as to encourage the ethically responsible uptake of technological innovations. (shrink)

How can a realistic ethical imagination about the future of a technology take shape? This article contains a reflection which is based on the experiences of an embedded ethicist in the context of biophysical research conducive to the development of photoacoustic mammography, which is intended for the non-invasive detection of breast cancer. Imagination in this context already informs the activities of the biophysical researchers, but its role is limited: biophysical future scenarios concentrate on the technological advances that photoacoustics (...) could bring about. In this article it is argued that it is advisable to also consider the medical practice and the ways in which this practice is likely to change as an effect of the introduction of photoacoustic mammography into it. On the basis of this more encompassing imaginative endeavor it is possible to get a clearer idea about how new technologies are able to contribute to human well being, which is informative for the setting of research-goals/priorities and a responsible implementation of new technologies into the world. (shrink)

We discuss the implementation of Responsible Research and Innovation (RRI) within a project for the development of an AI-supported exergame for assisted movement training, outline outcomes and reflect on methodological opportunities and limitations. We adopted the responsibility-by-design (RbD) standard (CEN CWA 17796:2021) supplemented by methods for collaborative, ethical reflection to foster and support a shift towards a culture of trustworthiness inherent to the entire development process. An embedded ethicist organised the procedure to instantiate a collaborative learning effort and (...) implement RRI in a translational context. Within the interdisciplinary setting of the collaboration and with the support of a technoethicist, we successfully identified relevant, project-specific challenges and developed a roadmap with derived actions, thus meaningfully integrating RRI into the development process. We discuss the methodological procedure in terms of its effectiveness and efficiency, the allocation of responsibilities and roles, particularly regarding potential frictions in the interdisciplinary context with embedded ethics, and the challenges of the translational context. We conclude that the responsibility-by-design standard effectively established a productive workflow for collaborative investigation and work on ethical challenges. We reflect on methodological difficulties and propose possible avenues to our approach. (shrink)

Research on opioid use in pregnancy is critically important to understand how the opioid epidemic has affected a generation of children, but also raises significant ethical and legal challenges. Embedded ethicists can help to fill the gaps in ethics oversight for such research, but further guidance is needed to help strike the balance between integration and independence.

Purpose – The purpose of this paper is to develop a novel approach for the ethical analysis of data collected from an online file-sharing site known as The PirateBay. Since the creation of Napster back in the late 1990s for the sharing and distribution of MP3 files across the Internet, the entertainment industry has struggled to deal with the regulation of information sharing at large. Added to the ethical questions of censorship and distributive justice are questions related to the use (...) of data collected from such file-sharing sites for research purposes. Design/methodology/approach – The approach is based on previous work analysing the use of data from online social networking sites and involves value analysis of the collection of data throughout the data’s various life cycles. Findings – This paper highlights the difficulties faced when attempting to apply a deontological or utilitarian approach to cases like the one used here. With this in mind, the authors point to a virtue ethics approach as a way to address ethical issues related to data sharing in the face of ever-changing data gathering and sharing practices. Practical implications – This work is intended to provide a concrete approach for ethical data sharing practices in the domain of Internet security research. Originality/value – The approach presented in this paper is a novel approach combining the insights from: the embedded values concept, value-sensitive design and the approach of the embedded ethicist. (shrink)

Clinical ethicists encounter the most emotionally eviscerating medical cases possible. They struggle to facilitate resolutions founded on good reasoning embedded in compassionate care. This book fills the considerable gap between current texts and the continuing educational needs of those actually facing complex ethics consultations in hospital settings. 28 richly detailed cases explore the ethical reasoning, professional issues, and the emotional aspects of these impossibly difficult consultations. The cases are grouped together by theme to aid teaching, discussion and professional growth. (...) The cases inform any reader who has a keen interest in the choices made in real-life medical dilemmas as well as the emotional cost to those who work to improve the situations. On a more advanced level, this book should be read by ethics committee members who participate in ethics consultations, individual ethics consultants, clinicians who seek education about complex clinical ethics cases, and bioethics students. (shrink)

Environmental ethicists will often say that in dealing with natural entities we need the guidance of an ethic rooted in 'the intrinsic value of nature'. They will add that subjectivist value theories are unable to account for the normativity of intrinsic value discourse. This preoccupation with normativity explains why many environmental ethicists favour value objectivism. As I see it, value theories must address not only the problem of normativity but also the problem of motivation. In fact, my approach to the (...) question as to which type of value theory does most justice to our intuition regarding the value of nature is primarily in terms of the motivational perspective. I argue that neither the usual objectivist theories nor their subjectivist counterparts can accommodate and explain the fact that those who agree that nature has intrinsic value may well differ in motivation to support its preservation. I suggest that such difference in kinds of motivation is related to distinct kinds of value judgement in which belief in the intrinsic value of nature is expressed. To clarify my view I discuss the subjectivist value theory of Gerald Gaus [1]. Gaus regards the distinction between personal and impersonal value judgements to be deeply embedded in his theory. His internalism about the relation between reason and motivation however, leads him to the mistaken conclusion that independent impersonal value judgements do not provide reasons for action. Next, I introduce the distinction between identity-neutral and identity-constitutive reasons. This distinction allows me to formulate more clearly the differences between the kinds of reasons provided by personal and impersonal value judgements. The resulting theory explains how it is that people who do not (personally) value nature may still be motivated to support nature preservation. It also explains why not everyone who endorses natural values will join movements for the preservation of nature. (shrink)

Healthcare ethics consultation is therefore one of the most consequential, institutionally accepted, and widespread forms of public philosophy in the United States. In this chapter, the authors begin with an overview of the development of healthcare ethics and its emergence as a concrete practice embedded in healthcare settings. They then describe the core ethical principles that inform the everyday practice of ethics consultations and the generally accepted steps involved in conducting a consultation. The authors discuss the role of clinical (...) ethicists in medical education and policy development. Finally, they conclude with some remarks on the distinctive contributions made by those with philosophical training to these endeavors and the importance of continued engagement by philosophers in this important public work. (shrink)

Although environmental ethicists often focus on applying ethics to policy, the ethics embedded in policy documents such as Agenda 21 are also significant. Though largely ignored by ethicists after early responses to the document focused on intrinsic value, Agenda 21's ethics are particularly valuable for their ability to resonate with many people and link politics, technical studies, and ethics. For instance, their use draws attention to the need to ethically evaluate sustainability indexes and identifies limitations of existing indexes. At (...) a broad level, this study of the ethics of Agenda 21 also suggests that the ethics of international environmental policy documents deserves more attention. (shrink)

Public funding institutions are able to influence what aspects researchers take into account when they consider the future impacts of their research. On the basis of a description of the evaluation systems that public research funding institutes in the Netherlands (STW and SenterNovem) use to estimate the quality of engineering science, this article shows that researchers are now predominantly required to reflect on the intellectual merit of their research and on the usability and marketability of the technology it contributes to. (...) In addition, SenterNovem also mandates reflection on sustainability. Here it is argued that these requirements do not suffice. Funding institutions should also do more to enhance reflection during the research process on the “soft impacts” of technologies, which refer to the alterations that technologies may bring about in the quality of human life. To do this it is suggested that it is helpful to engage a specifically trained ethicist to monitor the research process and create a feedback loop from the ethicist to the funding institution. (shrink)

In many industrialized countries ethicists and lawyers favour advance directives as a tool to guarantee patient autonomy in end-of-life-decisions. However, most citizens seem reluctant to adopt the practice; the number of patients who have an advance directive is low across most countries. The article discusses the key argument for seeing such documents as an instrument of self-interpretation and life-planning, which ultimately have to be interpreted by third parties as well. Interpretation by third parties and the process of self-reflection are conceptually (...) linked by a qualitative concept of identity. Identity is conceived here as constructed in a processual dialogue between a personal and a cultural perspective. How the cultural dimension comes into play in understanding the motivation, rejection or content of wished for end-of-life-decisions, is shown by a brief review of empirical and cultural studies. Understanding advance directives as a culturally embedded tool of self-interpretation should help to overcome urgent moral problems in clinical settings: how to interpret such documents, how to deliberate on the content and on the best form. (shrink)

Virtue words, such as justice, fairness, care, and integrity, frequently feature in organizational codes of conduct and theories of ethical leadership. And yet our modern organizations remain blemished by examples lacking virtue. The philosophy of virtue ethics and numerous extant theories of leadership cite virtues as essential to good leadership. But we seem to lack understanding of how to develop or embed these virtues and notions of good leadership in practice. In 2012, virtue ethicist Julia Annas pointed to a (...) training program which she touted as a practical application of virtue ethics. The program Annas identified is called The Virtues Project, and while promising, she warned that in its current state, it lacked theorizing. We address this by aligning its practical strategies to extant theory and evidence to understand what virtues it might develop and how it might facilitate good leadership. Doing so makes two key contributions. First, it lends credence to The Virtues Project’s potential as a leadership development program. Second, it provides a means of applying theories of good leadership in practice. Our overarching objective is to advance The Virtues Project as a means of incorporating virtues into workplace dynamics and embedding virtues in the practice of organizational leadership. (shrink)

The gap between economic rationality, as embedded in utility maximization, and ethical rationality, identified with a set of rules that prescribe the right course of action, has been a challenging issue for economists, philosophers, and business ethicists. Despite the difference and the noncompetition between a scientific economic approach of economics and business ethics, and a behavioral and philosophical one, we highlight the importance of the Aristotelian concept of prudence or phronesis applied to business activity. Phronesis allows for a conceptualization (...) of rationality that can be simultaneously applied to economics and ethics. It also allows conceiving the intrinsically ethical nature of economic rationality. This relationship requires an appropriate education and the intervention of the state. (shrink)

This paper argues that a standard analysis of modals from formal semantics suggests a solution to the detaching problem — the problem of whether un-embedded 'ought'-claims can "detach" (be derived) from hypothetical imperatives and their antecedent conditions. On a broadly Kratzerian analysis, modals have a skeletal conventional meaning and receive a particular reading (e.g., deontic, epistemic, teleological) only relative to certain forms of contextual supplementation. I argue that 'ought'-claims can detach — subject to an important qualification — but only (...) as long as the 'ought's in the conditional premise and conclusion are interpreted relative to the same ordering sources. Although modus ponens can be shown to fail with hypothetical imperatives, the cases in question do not constitute a failure of detachment in the sense that ethicists have cared about. Rival wide-scoping accounts are proven to be linguistically problematic. They make incorrect predictions about the meanings of hypothetical imperatives, and founder in response to quantificational variants of the detaching problem. (shrink)

In an age of professionalization and specialization, the practice of clinical ethics is facing an identity crisis. Are clinical ethicists moral experts, ethics experts, or merely quasi-lawyers giving legal advice? Are they extensions of the hospital, always working to advance the hospital’s interests? Or is there another option? Since 1998, when the American Society for Bioethics and Humanities first issued its Core Competencies for Healthcare Ethics Consultation, there has been debate about the role of standardization and proceduralism in clinical ethics (...) consultation. Now, as ASBH continues to move forward with its credentialing program, proceduralism in clinical ethics must be critically examined. In this paper, I argue that the proceduralist approach to clinical ethics consultation, as espoused by the ASBH’s call for credentialing, creates a demeaning experience for all parties involved and precludes goods internal to the practice of clinical ethics consultation from being actualized. As a practice embedded in medicine and in institutions such as the hospital, clinical ethics consultation must define and examine its own goods in order to bring about more than a sterile, law-like solution to difficult moral quandaries, as these sterile solutions leave patients, families, and providers unsatisfied, abandoned, and disappointed. Thus, in an effort to push back against this proceduralism in clinical ethics consultation, I will offer a preliminary exploration of what these goods might be. (shrink)

Although justice is a central principle in clinical ethics, work that centers social justice is often marginalized in clinical ethics. In addition to institutional barriers that may be preventing clinical ethicists from becoming the activists that Meyers argues we should be, we must also recognize the barriers embedded in the field of clinical ethics itself. As clinical ethicists, we have an opportunity to support anti‐racism work in particular by altering our own organizational structures to be more inclusive and reflective (...) of the Black, Indigenous, and other communities of color we serve, enhancing clinical ethics education and training by making critical theories foundational, and decolonizing our clinical ethics consultation tools and practices. (shrink)

We are grateful for the thoughtful attention the commentators and editors have given our paper. They raise many substantive points that warrant a response, but for reasons of journal space our reply must be brief. In our paper, we argue for an amended hybrid account of ‘disease’ in human medicine that takes normative ethics seriously, guards against pernicious classifications of disease and reconnects the concept with the goals of healthcare institutions in which disease diagnosis is embedded. Carel and Tekin, (...) in their respective pieces, raise issues about the objectivity and effective operationalisation of our account, Agar makes an ‘evolutionary’ case for disease concept eliminativism in mental health, and Wakefield and Conrad contend that our proposed modification to the harmful dysfunction account is unnecessary and undesirable. We will respond to each in turn. The rational moral justification component of our account raises difficult moral epistemological questions regarding which reasons are the weightiest ones and who should be allowed to participate in the rational justification process. Carel suggests that inevitable disagreement on this point undermines the alleged objectivity of our proposal. We agree with Tekin, however, that this is a feature of our account rather than a bug. What constitutes a good reason in moral deliberation is a question that goes to the very philosophical foundation of ethics ; but disagreement over which reasons are the weightiest ones does not prevent ethicists and policy makers from objectively assessing the strength of moral arguments by evaluating their empirical adequacy and logical structure, and this can take us a long way toward adjudication. The fact that rational justification has been used to support immoral practices and institutions does not warrant abandoning a reason-based approach to ethics any more than …. (shrink)

“The Zadeh Scenario,” when taken together with the subsequent layers of peer review and commentary on that peer review, highlights two crucial insights regarding peer review for clinical ethics. The first is one that most of Finder’s peer reviewers miss: peer-reviewers who would give attestation to quality need to be critically attentive to, and reflective about, the evidence supplied to them by candidates. The second is a more significant point: the kind of doing that is clinical ethics consultation is a (...) local form of moral enquiry, seeking not just to achieve medical – or clinical ethical – goals, but to enact human goods. Good peer review thus turns on being clear regarding the goods of ethics consultation. Buried inside “The Zadeh Scenario” one can find several goods of clinical ethics. These goods are subjective, idiosyncratically named and defined by patients, and embedded in an institution of healthcare that purports to be of service to the goods of health. The clinical ethics consultant, at her best, acts as a careful mid-wife, attempting to bring forth the goods desired, the goods possible, and perhaps even the goods that, while desired, are not possible. After all, some goods pursued by patients are not possible due to the limits of medicine. On the other hand, some goods pursued by medicine are not desired by patients. And equally, some goods pursued by clinical ethicists might be limited, provisional, and local. “The Zadeh Scenario” thus acts to problematize the goals of clinical ethics consultation, asking it to focus on the goods that the practice might bring forth. (shrink)

Slippery slope‐, taboo‐breaking‐ or Nazi‐analogy‐arguments are common, but not uncontroversial examples of the complex relationship between bioethics and the various ways of using historical arguments in these debates. In our analysis we examine first the relationship between bioethics and medical history both as separate disciplines and as argumentative practices. Secondly, we then analyse six common types of historical arguments in bioethics (slippery slope‐, analogy‐, continuity‐, knockout/taboo‐, ethical progress‐ and accomplice‐arguments), some as arguments within the academic debate of bioethics, others as (...) arguments within political and public debates over bioethical issues. We conclude by suggesting to bioethicists to better understand historical arguments as socially and culturally embedded practices of critical reflection of power, medical and government paternalism and possible future scenarios. More interdisciplinarity between ethicists and medical historians is needed to appropriately rationalize and understand the different legacies. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Latina/o Social Ethics: Moving beyond Eurocentric Moral Thinking, and: Racism and God-Talk: A Latino/a PerspectiveKevin N. York-SimmonsLatina/o Social Ethics: Moving beyond Eurocentric Moral Thinking Miguel A. de La Torre, Waco Tex.: Baylor University Press, 2010. 160 pp. $24.95.Racism and God-Talk: A Latino/a Perspective Rubén Rosario Rodríguez New York: New York University Press, 2008. 320 pp. $24.00Although Latina/o theologians have contributed much to Christian moral discourse in recent decades, (...) the impact of these contributions has too often remained limited to other Latina/os and those with particular interests in liberation theologies. Miguel de La Torre and Rubén Rosario Rodríguez build on the contributions of theologians before them while challenging the broader theological community to take notice of these rich and provocative works.In four concise chapters, Miguel de La Torre’s Latina/o Social Ethics delivers a forceful criticism of prominent thinkers in the field of Christian ethics and offers a creative reconstruction of ethics from a Latina/o perspective. De La Torre offers a critique of “Euroamerican” Christian ethicists whose works have greatly influenced contemporary Christian moral discourse. He addresses the writings of Walter Rauschenbusch, Reinhold Niebuhr, Stanley Hauerwas, Anthony Campolo, Ron Sider, and Jim Wallis. De La Torre faults these theologians for the ways in which their moral thinking participates in the oppression and marginalization of Latina/os, either through their silence or through their endorsement of specific polices. De La Torre concludes that the legacy of cultural and economic privilege and the oppression of Latinas/os are so [End Page 199] deeply embedded in the Eurocentric thinking that has dominated the field of Christian ethics that it cannot be the foundation for Latino social ethics.De La Torre’s aim is to “move beyond” Eurocentric modes of thinking rather than dwell on critique. This eagerness to move forward to the creative and constructive aspects of Latina/o ethics, however, limits the forcefulness of his critique of Euroamerican ethicists. De La Torre’s reading of Euroamerican ethics—and even the application of that term—is highly selective, both in terms of the thinkers chosen and the writings examined. While De La Torre’s criticisms of these thinkers are generally insightful and serve to illustrate his basic criticism of Eurocentric ethics, these criticisms are limited in their depth of analysis. De La Torre is less concerned with the broader historical and theological considerations at work in these Euroamerican ethicists than with their failures to adequately address issues of concern to Latinas/os.The second half of Latina/o Social Ethics moves to his constructive, or “reconstructive,” project. De La Torre reviews central concepts in the methodology of Latina/o social ethics, including lo cotidiano, nepantla, la lucha, en conjunto, and acompañamiento. De La Torre’s explanation of these terms is brief and accessible. Moving beyond these concepts, the fourth chapter of Latina/o Social Ethics offers a creative approach to a liberative ethics that draws on Christian tradition as well as broader Hispanic cultural resources, including folk characters and themes of the trickster found in Afro-Caribbean religious traditions. De La Torre addresses the concern for how to imagine a Christian ethics with a role for the trickster, including identifying trickster characters and themes in the Bible. His “disruptive ethics” challenges the preference for order over justice that has characterized Eurocentric ethics, for which he provides helpful examples. De La Torre is clearly concerned with imperialism, immigration, and free trade, yet it is unclear what justice means in those contexts. Perhaps due to the powerlessness of marginalized Latina/os, criticisms of injustice weigh far more heavily than visions of justice.The concise length of this book broadens its appeal. Academics unfamiliar with some of the concepts and methodologies of Latina/o theologians will find this short introduction a useful starting point. This provocative book would also be a welcome addition to the classroom, either in part or in its entirety.In contrast to De La Torre’s short work, Rubén Rosario Rodríguez sets a broader and more ambitious task in his Racism and God-Talk. His project... (shrink)

Randomized controlled trial trial designs exist on an explanatory-pragmatic spectrum, depending on the degree to which a study aims to address a question of efficacy or effectiveness. As conceptualized by Schwartz and Lellouch in 1967, an explanatory approach to trial design emphasizes hypothesis testing about the mechanisms of action of treatments under ideal conditions, whereas a pragmatic approach emphasizes testing effectiveness of two or more available treatments in real-world conditions. Interest in, and the number of, pragmatic trials has grown substantially (...) in recent years, with increased recognition by funders and stakeholders worldwide of the need for credible evidence to inform clinical decision-making. This increase has been accompanied by the onset of learning healthcare systems, as well as an increasing focus on patient-oriented research. However, pragmatic trials have ethical challenges that have not yet been identified or adequately characterized. The present study aims to explore the views of key stakeholders with respect to ethical issues raised by the design and conduct of pragmatic trials. It is embedded within a large, four-year project that seeks to develop guidance for the ethical design and conduct of pragmatic trials. As a first step, this study will address important gaps in the current empirical literature with respect to identifying a comprehensive range of ethical issues arising from the design and conduct of pragmatic trials. By opening up a broad range of topics for consideration within our parallel ethical analysis, we will extend the current debate, which has largely emphasized issues of consent, to the range of ethical considerations that may flow from specific design choices. Semi-structured interviews with key stakeholders, across multiple jurisdictions, identified based on their known experience and/or expertise with pragmatic trials. We expect that the study outputs will be of interest to a wide range of knowledge users including trialists, ethicists, research ethics committees, journal editors, regulators, healthcare policymakers, research funders and patient groups. All publications will adhere to the Tri-Agency Open Access Policy on Publications. (shrink)

This imaginative and unusual book explores the moral sensibilities and cultural assumptions that were at the heart of political debate in Victorian and early twentieth-century Britain. It focuses on the role of intellectuals as public moralists and suggests ways in which their more formal political theory rested upon habits of response and evaluation that were deeply embedded in wider social attitudes and aesthetic judgments. Collini examines the characteristic idioms and strategies of argument employed in periodical and polemical writing, and (...) reconstructs the sense of identity and of relation to an audience exhibited by social critics from John Stuart Mill and Matthew Arnold to J.M. Keynes and F.R. Leavis. (shrink)

The question I investigate concerns the ethics of clinical ethics consultation. To begin, I reconstruct and critically assess a widespread understanding of clinical medical ethics, one most prominently advanced by Mark Siegler. That examination reveals an overtly political strategy designed to reinforce physician authority. Next, John La Puma's work is discussed. Arguably the most prominent of Siegler's students, and certainly the most prolific, La Puma appears attentive to the problems in Siegler's view regarding clinical judgment. I conclude, however, that La (...) Puma assumes a relatively flexible system of formal rules and more extensive informal codes which define the concepts and procedures of medical consultation and which he simply transcribes for ethics consultation. ;Albert Jonsen and Stephen Toulmin have apparently endorsed this medicalized strategy. They contend that the view of ethics advocated by these physicians represents a "new" casuistry consistent if not identical to their own theory. I show that the casuist method of clinical ethical decision making simply appropriates features of the diagnostic apparatus embedded in the political economy of the enterprise of medicine and makes the role of ethicist parasitic on that of the physician as expert. Their casuistry, I argue, merely serves as a means to reinforce the standardized apparatus of professional authority exercised in medical procedures and concepts. ;Finally, I sketch an alternative way to think about how experience with other persons informs ethical decision making. On the basis of an extensive and nuanced account of an ethics consultation, I argue that to consult as a clinical philosopher in any situation is, necessarily, to be focused on that individual situation for its own sake. Clinical philosophy, as a result, must be done by attending strictly to what appears as it appears: the issues, concerns, and questions expressed, in their own terms, by those individuals whose situation it is. (shrink)

What does it look like when an organization tentatively steps away from an exclusively rules-based regime and begins to attend to both rules and principles? What insights and guidance can ethicists and ethical theory offer? This paper is a case study of an organization that has initiated such a transition. The American Institute of Certified Public Accountants has begun a turn toward the promotion of ethical principles and best practices by adding a “conceptual framework” to its existing Code of Professional (...) Conduct. This conceptual framework calls upon its members to intentionally increase their awareness of significant threats to their compliance with its rules of conduct and to establish safeguards to offset or eliminate those threats. To this end, each member is required to regard every questionable situation, circumstance, transaction or relationship by attempting to view it through the eyes of an imagined reasonable third party. This paper examines this protocol theoretically and practically. First, we frame this analysis within the principles and ethical concepts that inform the professional ethics of accountants. Second, we critique the AICPA’s long-standing rules-based approach to its Code. Third, we examine the new conceptual framework with a view toward its potential for the promotion of a more principles-based approach to the professional ethics of the accounting profession. Fourth, we give attention to the notion of the “reasonable and informed third party,” which has been embedded in the new conceptual framework, and consider how two schools of thought—Adam Smith’s modernist “impartial spectator” concept and Emmanuel Lévinas’ postmodern phenomenology in regard to “the Other”—may offer theoretical support and clarity for this epistemic exercise. Finally, we point out several ways in which the AICPA’s commitment to its new conceptual framework could be strengthened and enhanced. (shrink)

Tamara Browne proposes a provocative idea: She argues that philosophers, sociologists, and bioethicists should act as an independent editorial panel for future editions of the Diagnostic and Statistical Manual of Mental Disorders. Her paper depends on some well-versed claims in philosophy of psychiatry: She argues that psychiatric classifications are inherently value laden and philosophers, sociologists, and ethicists are best placed to discern the values are that embedded within scientific descriptions of mental disorders, and to speculate on the effects of (...) any such classifications on individuals and the populace at large as a result of these classifications.I agree with Browne that the DSM (and... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Ethnography as Christian Theology and Ethics ed. by Christian Scharen and Anna Marie VigenJohn KiessEthnography as Christian Theology and Ethics Edited by Christian Scharen and Anna Marie Vigen New York: Continuum, 2011. 304 pp. $29.95Over the past decade, an increasing number of Christian theologians and ethicists have turned to ethnographic methodologies in order to attend more closely to the complexities of lived faith and the bodily character of (...) theological knowledge. For those wishing to get a glimpse of what this looks like in practice, what its implications might be for theology and ethics, and how one might set off and do it oneself, this book is an excellent introduction.Editors Christian Scharen and Aana Marie Vigen organize the book into three parts. The first part orients readers to the use of ethnography in cultural anthropology and reviews the recent “ethnographic turn” in Christian theology and ethics. This is followed by a brief survey of theological critiques of social science and a defense of ethnography against these critiques. Scharen and Vigen argue that the use of ethnography, far from compromising the integrity of theology, has the potential to renew and enrich the discipline through the incorporation of long-overlooked forms of local wisdom. As a method attuned to practical, often noncognitive forms of knowledge, ethnography can help scholars move away from an exclusive focus on texts to a deeper consideration of the theological and ethical claims “embedded and embodied” in the lives and practices of everyday communities (xxii). [End Page 190]Naturally, the best argument for such an approach is exemplification. The second part of the book presents an impressive collection of ethnographic work from contexts as diverse as Chicago, Atlanta, Oregon, Chiapas, Nairobi, and Gulu. Contributors employ ethnography to compare pastoral leadership in two African American churches, track grassroots dissent on the issue of contraception among women living with HIV/AIDS, and reimagine the debate on physician-assisted suicide from the perspective of the poor and disabled. Particularly effective are Vicini’s exploration of the liturgical response of local churches to the legacy of violence in Chiapas and Whitmore’s critical examination of his own place as a white researcher in Northern Uganda, which makes hauntingly transparent the ethical complexities of the research process itself.The final part of the book offers a more practical how-to guide for those looking to do ethnography, covering such issues as institutional review board approval, interview methodology, and accountability to research subjects. This part, like the rest of the book, will be a gift for graduate students facing down a dissertation proposal or scholars contemplating the use of ethnography in their work. Admirably reflexive, vigilantly attentive to issues of power and privilege, and articulate about the ways that research can be a form of discipleship, one can only hope this book will succeed in its aim of encouraging other scholars to “go and do likewise.”Those who have already incorporated ethnographic techniques in their scholarship or who are looking for a fuller articulation of the relation between ethnography, ethics, and theology may find themselves less satisfied with the book. Its treatment of existing options (virtue ethics, Catholic social ethics) and thinkers (David Ford, Stanley Hauerwas, and John Milbank) is thin, and a number of key figures in the broader story of the ethnographic turn in theology (Karl Barth, Dietrich Bonhoeffer, and Hans Frei) are conspicuously missing. Their absence is felt particularly strongly in the unanswered questions the volume provokes, including how to account for God’s difference when appeals to experience become primary (Barth), and how to avoid positivism when appeals to the “reality” of the church become the point of departure for ecclesiology (Bonhoeffer).Such provocations, however, are reminders that we are still at the very early stages of the ethnographic turn in Christian theology and ethics. If this volume is any indication, the future of this exciting intersection of thought and practice looks very promising indeed. [End Page 191]John KiessLoyola University MarylandCopyright © 2013 Society of Christian Ethics... (shrink)

“Theater” has become a fashionable metaphor that theologians and ethicists deploy to correct what they see as a Gnostic or antinomian impulse to prioritize “inner state” over “outer action.” But their turn to theater as an easy way to valorize “outer action” conflates person and role, generating a confused anthropology that 1) obscures what theater could make obvious about occupational roles; 2) misses the distinctively non‐theatrical character of performing Christ and church; and 3) renders actions more easily legible than they (...) in fact are. These losses are traced in the work of several theater theologians, and their resultant distortions in self, power, and freedom are elaborated with the help of Stephen Mulhall's critique of Alasdair MacIntyre and Charles Taylor. Gregory of Nyssa's use of theater, by contrast, avoids such distortions by invoking theater together with the “mysteries of our existence”—death and creatio ex nihilo. Theater, for Gregory, becomes a way to describe the estrangement Christians must live into in a world beholden to wealth and power. The anthropology embedded in his metaphor of theater elaborates how Christians might approach their occupational roles, the world, and skepticism. (shrink)

BackgroundThe COVID-19 pandemic has magnified pre-existing challenges in healthcare in Africa. Long-standing health inequities, embedded in the continent over centuries, have been laid bare and have raised complex ethical dilemmas. While there are very few clinical ethics committees (CECs) in Africa, the demand for such services exists and has increased during the COVID-19 pandemic. The views of African healthcare professionals or bioethicists on the role of CECs in Africa have not been explored or documented previously. In this study, we (...) aim to explore such perspectives, as well as the challenges preventing the establishment of CECs in Africa.MethodsTwenty healthcare professionals and bioethicists from Africa participated in this qualitative study that utilized in-depth semi-structured interviews with open-ended questions. Themes were identified through thematic analysis of interviews and open-ended responses.ResultsKenya and South Africa are the only countries on the continent with formal established CECs. The following themes emerged from this qualitative study: (1) Lack of formal CECs and resolution of ethical dilemmas; (2) Role of CECs during COVID-19; (3) Ethical dilemmas presented to CECs pre-COVID-19; (4) Lack of awareness of CECs; (5) Lack of qualified bioethicists or clinical ethicists; (6) Limited resources to establish CECs; (7) Creating interest in CECs and networking.ConclusionsThis study illustrates the importance of clinical ethics education among African HCPs and bioethicists, more so now when COVID-19 has posed a host of clinical and ethical challenges to public and private healthcare systems. The challenges and barriers identified will inform the establishment of CECs or clinical ethics consultation services (CESs) in the region. The study results have triggered an idea for the creation of a network of African CECs. (shrink)

In this article, we argue that a critical examination of epistemological and anthropological presuppositions might lead to a more fruitful use of theory in clinical-ethical practice. We differentiate between two views of conceptualizing ethics, referring to Charles Taylors' two epistemological models: ‘monological’ versus ‘dialogical consciousness’. We show that the conception of ethics in the model of ‘dialogical consciousness’ is radically different from the classical understanding of ethics in the model of ‘monological consciousness’. To reach accountable moral judgments, ethics cannot be (...) conceptualized as an individual enterprise, but has to be seen as a practical endeavor embedded in social interactions within which moral understandings are being negotiated. This view has specific implications for the nature and the role of ethical theory. Theory is not created in the individual mind of the ethicist; the use of theory is part of a joint learning process and embedded in a cultural context and social history. Theory is based upon practice, and serves practical purposes. Thus, clinical ethics support is both practical and theoretical. (shrink)

This paper re-envisions the personhood of severely disabled children, who are often excluded from the category of human beings in the academic literature due to their perceived lack of mental faculties, based on Japanese philosopher Watsuji Tetsuro’s concept of human beings. It begins with Carl Elliott’s claim that personhood should be used as a thick ethical concept. This concept has two features. First, it represents a fusion of fact and value. Second, it is embedded in our rich and culturally (...) specific forms of life. This paper suggests that Watsuji’s concept of ningen also has these features. Watsuji criticizes how Western ethicists take individual consciousness or will as their starting point for determining personhood. Instead, he argues that neither a subject nor a community exists as an entity in itself, but that the relationality between them is essential to their identity and that our communication is embedded within rich and social contexts. Through his etymological study of Japanese word ari, Watsuji points out that in making statements, one both discloses the world and becomes aware of the attitude one should take toward other beings. Some commentators, such as Sakabe Megumi, have suggested that such self-awareness entails the transformation of our sense of relationality. This paper leverages Watsuji’s concept of ningen to re-envision the relationship between caregivers and severely disabled children as relationality-based and therefore open to complex and rich communication. (shrink)

Unlike bioethics mediators who are employed by healthcare organizations as outside consultants, mediators who are embedded in an institution must be authorized to chronicle a clinical ethics consultation (CEC) or a mediation in a patient’s medical chart. This is an important privilege, as the chart is a legal document. In this article I discuss this important part of a bioethics mediator’s tool kit in my presentation of a case illustrating how bioethics mediation may proceed, and what this approach using (...) both bioethics and mediation may add. (shrink)

Both as cardinal and as Pope Benedict XVI, one of Josef Ratzinger's consistent concerns has been the foundational moral imperatives of the natural law. In 2004, then Cardinal Ratzinger requested that the University of Notre Dame study the complex issues embedded in discussions about "natural rights" and "natural law" in the context of Catholic thinking. To that end, Alasdair MacIntyre provided a substantive essay on the foundational problem of moral disagreements concerning natural law, and eight scholars were invited to (...) respond to MacIntyre's essay, either by addressing his work directly or by amplifying his argument along other yet similar paths. The contributors to this volume are theologians, philosophers, civil and canon lawyers, and political scientists, who reflect on these issues from different disciplinary perspectives. Once the contributors' essays were completed, MacIntyre responded with a closing essay. Throughout the book, the contributors ask: Can a persuasive case for a foundational morality be made etsi Deus daretur? And, of course, persuasive to whom? The exchanges that take place between MacIntyre and his interlocutors result, not in answers, but in rigorous attempts at clarification. __Intractable Disputes about the Natural Law__ will interest ethicists, moral theologians, and students and scholars of moral philosophy. "Lawrence Cunningham has assembled an esteemed group of scholars to provide incisive analyses of the contemporary state of natural law theory, particularly in light of Alasdair MacIntyre's groundbreaking work. The essays are lucid, engaging, and intellectually sophisticated. __Intractable Disputes about the Natural Law_ _is a must-read not only for moral theologians, but for anyone concerned about the conceptual foundations of human rights, human dignity, and moral dialogue in pluralistic societies." --_Stephen J. Pope, Boston College_ "MacIntyre's first essay, on its own, would make this book an important scholarly contribution. But the ensuing contributions enable the book to flourish further, with contributions on subjects both readily associated with natural law and moral disagreement as well as those more creatively connected to the genesis of the text. Cunningham's volume both broadens and deepens contemporary thinking on a perennial topic, and will richly reward its readers." --_William C. Mattison III, The Catholic University of America_. (shrink)

Alongside fostering academic excellence in their students, many colleges and universities aspire to cultivate responsible citizens. In this article, I explore some challenges accompanying this task and offer my Ethics in Political Action course as one approach to support students’ development as ethically engaged citizens. I begin by outlining two obstacles which make pursuing this civic mission difficult, speaking both as a faculty member and Christian ethicist who works at the intersection of religion and politics. I then describe my (...) Ethics in Political Action course, which examines various forms of political participation so that students can explore ethical issues embedded in U.S. political life as well as critically reflect on their own political activity. By weaving together civic education with the questions and insights of the Christian ethical tradition, this course equips students with the political knowledge and skills they need to engage effectively and ethically in the U.S. today. (shrink)

If the possible ends of art criticism are taken to include not only the provision of a detailed evaluation of the artwork, but, cognately, an elaboration upon how one has been, or believes oneself to have been, changed by a particular artistic encounter, then the very praxis of art criticism stands to benefit from a theoretical elucidation of the possible nature of the subjective transformations that may flow from the critical appreciation of art. We are entitled to enquire, in particular, (...) into the conditions under which, and indeed the extent to which, such putative change at the personal level can be explicated in moral epistemological terms. It is pertinent in this context also to investigate the phenomenal character of the experiences that have been operative and their essential structures; to enquire, in short, into the phenomenology of the transformative artistic encounter. In this thesis, the bearing, in particular, of intersubjectivity upon the content and modalities of disclosure in a literary context will be investigated. It will be shown how an understanding of the relevance of intersubjectivity to the phenomenology of literary experience can inform an assessment of the claims of literary aesthetic moral cognitivism. Yet the intention to clarify the connection between literary experience and intersubjectivity also requires reflection upon what it is in the first place to encounter someone else, and to apperceive a foreign subjectivity and its motivations. For this reason, the contributions of Edmund Husserl and Edith Stein to the investigation of the phenomenology of empathy will be discussed and evaluated. This discussion will in turn be shown to be of assistance in clarifying the role of the imagination in the apperception and comprehension of another person’s mental life. The thought of Jean Starobinski will prove to elucidate the question of why the insights of the phenomenological tradition are highly pertinent to the investigation of literary experience, and to the development, in particular, of a conception of an imagined ‘Other’ who is (in a sense that will be clarified) embedded within the literary text, a person, that is, to whom one might coherently refer as the “implied author”. For reasons which will emerge in the course of this study, it will be argued that authentic empathy, in its fulfilling explication (in the Steinian sense), is given to the empathising consciousness in the manner of a semblance, and, consonantly, that the phenomenological structure of authentic empathy is characterised in its mature phases by an homological relation to pictureconsciousness. The epistemological significance of literature’s capacities for moral suggestion will be explicated principally in terms of the unfolding of values within the human personality, and in terms of the disclosure of the phenomenal character and structures of virtuous experience. It will be explained why the structure of empathy has implications for the aesthetic value of literature. The question of the relation between aesthetic and ethical value will be clarified. In this context, it will be argued on phenomenological grounds that the appresentation of moral virtue in an implied author could contribute to the aesthetic value of a literary work, although it will also be shown that implied authorial moral virtue could conflict irremediably with other qualities like moral doubt and uncertainty, which may themselves be important sources of aesthetic value. For this reason, the thesis will conclude by challenging the ethicist view that an aesthetically relevant ethical flaw in a literary work must count as an aesthetic flaw. (shrink)

One of the challenges of modern healthcare ethics practice is the navigation of boundaries. Practicing healthcare ethicists in the performance of their role must navigate meanings, choices, decisions and actions embedded in complex cultural and social relationships amongst diverse individuals. In light of the evolving state of modern healthcare ethics practice and the recent move toward professionalization via certification, understanding boundary navigation in healthcare ethics practice is critical. Because healthcare ethics is endowed with many boundaries which often delineate concerns (...) about professional expertise and authority, epistemological reflection on the relationship between theory and practice points toward the social context as relevant to the conceptualization of boundaries. The skills of social scientists may prove helpful to provide data and insights into the conceptualization and navigation of clinical ethics qua profession. Empirical ethics research, which combines empirical description (usually social scientific) with normative-ethical analysis and reflection, is a way forward as we engage and reflect upon issues which have implications for practice standards and professionalization of the role. This requires cooperative engagement of the descriptive and normative disciplines to explore our understandings of boundaries in healthcare ethics practice. This will contribute to the ongoing reflection not only as we envision the professional role but to ensure that it is enacted in practice. (shrink)

Purpose The purpose of this paper is to address the following question: In times of permanent connectivity, what forms of freedom need to be considered to prevent permanent availability as an unintended consequence? By using the Hegelian perspective on freedom, the paper categorizes three forms of freedom to transfer them to a common, contemporary understanding of freedom relating it to freedom through human-to-human digital communication. The aim is to show that freedom is not only about independence and realizing choices but (...) also about embedding and committing oneself. Design/methodology/approach This mainly conceptual paper derives implications based on the Hegelian theory. This is supplemented by an interdisciplinary approach, whereby categories of other philosophers, ethicists, economists and sociologists are applied. The analysis of the contemporary perspective on freedom is enriched by referencing empirical studies. Findings Digital communication offers new freedom such as working with fewer restrictions from time and space, especially for knowledge workers. It is theoretically possible to work 24 h per day from anywhere, as well as to decide on the final location and timing of one’s work. When solely focusing on these – seemingly advantageous – forms of freedom in times of permanent connectivity, unintended consequences such as the expectation of permanent availability develop. The key message of the paper is that considering one’s temporal and social dependencies is an indispensable part of actual freedom to avoid unintended consequences. Practical implications Organizations need to invest in moral discernment to understand unintended consequences, as well as to cope with them. Originality/value Applying the Hegelian theory on freedom based on digital communication to better understand social dynamics of digital communication is a largely unexplored avenue in the existing scientific literature. The decision to undertake this venture resulted from the identified necessity of understanding freedom better. It is often not clear what is meant by freedom through digital communication. Although freedom is a complex construct, it is often reduced to independence/having a choice and realizing choices. When solely focusing on independence and realizing choices, unintended consequences such as permanent availability often go unnoticed. It is exactly because of these issues that this paper endeavors to examine the meaning of the powerful, yet complex, term of freedom. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Resisting Structural Evil: Love as Ecological-Economic Vocation by Cynthia Moe-LobedaKiara A. JorgensonReview of Resisting Structural Evil: Love as Ecological-Economic Vocation CYNTHIA MOE-LOBEDA Minneapolis: Fortress Press, 2013. 309 pp. $22.00The factors that have contributed to today’s perilous global economy and ecology originate in structures that predate recent implosions of international banks or measurements of rising climates. These structures—systemic and social while also personal—are the focus of Moe-Lobeda’s work, Resisting (...) Structural Evil: Love as Ecological-Economic Vocation. Convinced that sin and violence is “uncreating” the beauty of God’s interdependent community and can only be countered and alleviated by a moral vision structured around “justice-seeking love,” Moe-Lobeda provides a compelling theological critique and reconstruction of the Christian concept of love by way of a fresh retrieval of the classical Christian doctrine of vocation.The book’s argument consists of a tapestry of sobering statistics, theological analysis, and narrative prose. Early on Moe-Lobeda takes great care to explain how the moral crises of today relate to the embedded social structures of yesterday. Here her attention to the globalization of economies and subsequent ecological injustice is particularly helpful since few contemporary texts make explicit this critical connection. In a chapter titled “Countering Moral Oblivion” she also devotes attention to why seemingly good people, particularly good Christians, passively and ignorantly participate in systems of oppressive power. This portion of her book, coupled with her discussion of how Christian theology can be a resource of hope, is empowering and particularly attentive to the role of biblical theology in the ecological conversation. Unlike many other theoretical books on the topic, Moe-Lobeda’s book can be appropriated as a tool for lifestyle appraisal useful to the academician, pastor, and lay reader alike. Indeed, Moe-Lobeda can evoke discomfort with her compelling vision and challenging call for a change in our current practices.Pivoting her argument on the promise of hope, the second half of Resisting Structural Evil discusses what can and must be realized. And it is here that Moe-Lobeda’s voice makes a contribution not only to Christian ecological ethics but also to Christian social ethics at large. Vocation, she argues, encompasses more than what traditional renderings of vocare have sought to connote. The human call to life is a call to love in compassion and justice both the neighbor [End Page 208] and the self, and must be made manifest in the public sphere. What is more, one must fulfill one’s vocation not only for the sake of the human other but also for the benefit of the oikos (household) present within all economic and ecological communities. To this end, Moe-Lobeda’s attention to love as vocation uniquely characterizes her approach to ecological ethics, thereby transcending traditional deontolological or teleological classifications. Unique within Protestant work on ecological ethics, Resisting Structural Evil provides a fresh depiction of character ethics wherein the pursuit of moral aptitude is fundamentally rooted in biotic community.This very strength may also foster some critique since Moe-Lobeda’s schema is so thoroughly corporate in scope that it affords little time and attention to what some virtue and character ethicists would call the inward journey. Yet Moe-Lobeda, aligned with the liberal and feminist traditions from which she hails, views love and power as inseparable. “What is needed,” she argues, “is a realization that power without love is reckless and abusive and that love without power is sentimental and anemic” (169). Hence, on a very fundamental level Resisting Structural Evil is a book arguing for a radically new paradigm, one where the enormity of today’s crises is met with an equally comprehensive dose of transformative loving power.Kiara A. JorgensonLuther SeminaryCopyright © 2015 Society of Christian Ethics... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:A Place for Healing:A Hospital Art Class, Writing, and a Researcher's TaskJulia Kellman (bio)Introduction[O]bjects transform the top of our chest into a site of memory. I think of private landscapes like this one as querencias, places that hold the heart. The word has been translated as homing instinct and affection. Expatriate Alastair Reid introduced me to it in 1965, writing about the Spanish bullfight in The New Yorker. After (...) the first wound the bull chooses his querencia, the place in the ring where he returns for a moment to rest before the fight goes on, and where he finally dies. Querencia comes from the common Spanish verb querer; among its many meanings are to love, to want, to hold, and to command. Reid spoke of hometowns and native countries as querencias; exiles cling to their memories of them.1Place, "space that has the capacity to be remembered and to evoke what is most precious,"2 by its nature orients us to a particular perspective, to a way of looking at the world. Each place has its own local accent, its own constellation of habits, its own rhythm of language and thought. We are grounded in landscape in the same manner that we are situated in our social world, imprinted like other creatures on a typography, pattern of weather, cycle of seasons, scents, and colors.3Our hearts, too, are embedded in such places; and in this article, through this "act of personal witness," this "inscription of a self and a description of an object" as the anthropologist and writer Ruth Benhar4 describes it, we will see how the members of an art class for people with HIV/AIDS at a local hospital have similarly become grounded in their art space and in the tiny art community that has grown up around it. Additionally, we will discover the importance of a more descriptive style of writing as means for examining the role of art in the lives of people who are ill, for their various difficult [End Page 106] situations call for particular clarity and empathy that both honors and relates the stories of their lives. It will become clear as this article proceeds that the personal engagement of a researcher/writer in such a situation is critical as well. For not only must she be open—vulnerable, as Behar suggests—to the people with whom she works as a means of spanning the chasm between a life of illness and a life of health, but she must also be sensitive to the reader's needs, for she is the reader's guide and surrogate.5 This role as guide and alter-ego demands that the researcher tell the story of other lives in a manner that enables the reader to empathetically and eagerly undertake a journey with the researcher into a world unlike her own.6Personal Engagement: The Researcher/WriterHoward Brody, doctor and medical ethicist, explains the necessity for stories of illness to be descriptive.7 He asserts that the stories in which we are most interested are not merely factual recitations; they are about what the illness means to the individual—they include how that person understands events. "It is far too simple-minded" he writes, to assume that "the writer of literature presents to us a world of fantasy that never existed whereas the author of a nonfictional pathography has some special insight into the world as it really exists, even if the relevant world is nothing but his own subjective experiences."8 He concludes "in stories of that sort (stories of the meaning of things) the line between so-called truth and fiction becomes more blurred and ceases to affect the uses we make of the stories for the deeper understanding of the human response to illness."9 Further, Brody continues, one must understand stories of sickness in order to truly develop a philosophical understanding of what it means to be ill. Such an understanding, Brody suggests, not only provides ethical guidance for health care workers and others but also will lead to improved care for patients and better education of health professionals.10 This view of... (shrink)

While recent developments in evolutionary theory, particularly game-theoretical models of group selection, can appear to provide a potential evolutionary grounding for human altruism, significant ethical problems remain embedded in such portrayals of human interaction. Specifically, such models end up treating the value of the individual as subservient to group survival, rather than viewing each unique individual as an ‘end in herself’. As such, a contradiction remains between the picture of human relationships that arises from evolutionary game-theoretical accounts and the (...) picture that arises from many ethical and religious accounts, particularly those linked to the biblical conception of the image of God. However, I argue that such contradictions between scientific and ethical-religious pictures need not lead to despair; rather, by drawing a parallel to dialogues between individuals holding ‘contradictory’ theological claims, we can discern ways in which such contradiction can generate a fruitful tension that can lead to deeper understanding both of one’s own tradition and that of the other person. Accordingly, as with inter-faith dialogue, interactions between evolutionary theorists and religious ethicists can also give rise to greater self-understanding and expanded intellectual horizons, not in spite of but precisely by virtue of their ‘incompatible’ pictures of the human being. (shrink)

Discharge planning for vulnerable infants and children is a collaborative, inter-disciplinary, decision-making activity that is grounded in the ethical complexities of clinical practice. Although it is a psychosocial intervention that frequently causes moral distress for professionals and has the potential to inflict harm on children and their families, the process has received little attention from ethicists. An ongoing study of the transition of technology-dependent children from hospital to home suggests that the ethical issues embedded in the discharge-planning process may (...) be concealed by dominant cultural values, institutional policies, clinical standards, historical precedents, and legal regulations. (shrink)

How do we respond to the patient who no longer needs inpatient care but refuses to leave the hospital? Complex hospital discharges commonly involve consideration of legal, financial, clinical, and practical issues. Yet, the ethical and contextual issues embedded in complex inpatient discharges are of concern and have not received adequate attention by medical ethicists. The aim of this work is to encourage clinicians and administrators to incorporate a justice rubric when approaching inpatient discharge dilemmas. This paper presents justice (...) as the ethical principle most neglected in situations involving complex discharges and suggests that a justice focused lens allows clinicians and administrators to move beyond notions of patient autonomy in crafting morally responsible hospital discharge decisions that reflect efficient stewardship of an appropriate share of medically indicated services. This issue deserves additional attention from medical ethicists in the future. (shrink)

Organizations such as the EU High-Level Expert Group on AI and the IEEE have recently formulated ethical principles and (moral) values that should be adhered to in the design and deployment of artificial intelligence (AI). These include respect for autonomy, non-maleficence, fairness, transparency, explainability, and accountability. But how can we ensure and verify that an AI system actually respects these values? To help answer this question, I propose an account for determining when an AI system can be said to embody (...) certain values. This account understands embodied values as the result of design activities intended to embed those values in such systems. AI systems are here understood as a special kind of sociotechnical system that, like traditional sociotechnical systems, are composed of technical artifacts, human agents, and institutions but—in addition—contain artificial agents and certain technical norms that regulate interactions between artificial agents and other elements of the system. The specific challenges and opportunities of embedding values in AI systems are discussed, and some lessons for better embedding values in AI systems are drawn. (shrink)

The concept of the receptive field, first articulated by Hartline, is central to visual neuroscience. The receptive field of a neuron encompasses the spatial and temporal properties of stimuli that activate the neuron, and, as Hubel and Wiesel conceived of it, a neuron’s receptive field is static. This makes it possible to build models of neural circuits and to build up more complex receptive fields out of simpler ones. Recent work in visual neurophysiology is providing evidence that the classical receptive (...) field is an inaccurate picture. The receptive field seems to be a dynamic feature of the neuron. In particular, the receptive field of neurons in V1 seems to be dependent on the properties of the stimulus. In this paper, we review the history of the concept of the receptive field and the problematic data. We then consider a number of possible theoretical responses to these data. (shrink)